Brazilian Metropolis Research Articles

Teen-dating violence: conception of adolescents in a Brazilian metropolis.

Teen-dating violence (TDV) can lead to health problems for those involved, especially females, including homicides and is predictive of intimate partner violence in adulthood. To analyze the adolescents' perception of definitions, justifications and consequences of TDV, a qualitative study through 13 focus groups with 132 high school students from public and private schools of Rio de Janeiro city, including 70 girls and 62 boys was conducted. We followed a guide with questions about interpersonal violence and participants completed a self-administered questionnaire on socio-demographic data. The data analysis included reading and comprehension of the textual data; coding of the reports according to the emerged categories; identification of the meanings attributed by the subjects to the questions raised; comparative dialogue with literature; and elaboration of interpretative synthesis. Most adolescents affirmed that TDV is not justifiable. However, in practice, they found it acceptable in certain situations. The narratives of the boys were based on the role of the perpetrator and the girls on that of the victim. Violence occurs when the man feels his power challenged and is influenced by situations of violence experienced in his own family as victims or witnesses. The TDV consequences are for the women and include, in addition to physical and psychological damage, relational problems in other spheres such as family, friends and school. The experience of violence was more common among public school students. The adolescents' narratives reflect the gender patterns of society in which violence results from inequality of power. The data of this study offer subsidies to policies on TDV prevention and its consequences. They can contribute to training primary care professionals to identify on clinical consultations signs and symptoms of violence and to develop interventions to reduce the health problems of victims.

Human immunodeficiency virus/acquired immunodeficiency syndrome epidemic in adolescents from a Brazilian metropolis (1978-2017).

INTRODUCTION:Prevalence of human immunodeficiency virus among adolescents is increasing. This study aimed to analyze this current situation in Rio de Janeiro City. METHODS:This was a retrospective longitudinal study using secondary data from the National System of Notifiable Diseases database of cases in adolescents aged 13-19 years.RESULTS:There were 885 acquired immunodeficiency syndrome cases from 1978 to 2017 and 445 human immunodeficiency virus new cases from 2014 to 2017. Over time, sexually transmitted human immunodeficiency virus/acquired immunodeficiency syndrome cases increase.CONCLUSIONS:Human immunodeficiency virus/acquired immunodeficiency syndrome epidemic in adolescents requires novel prevention policies.

Heterogeneity of Illegal Markets: A Book Review Essay

Literature on the economic-sociology of illegal markets is progressing convincingly, as scholars identify the need to investigate illegality through the perspective of the market, as well as through the perspective of the actor. In this book review essay, two recent publications are reflected upon: The Architecture of Illegal Markets: Towards an Economic Sociology of Illegality in the Economy (Beckert and Dewey, 2017) and Illegal Markets, Violence, and Inequality: Evidence from a Brazilian Metropolis (Daudelin and Ratton, 2018). While the books undertake a different journey through the field of illegal markets, they reach the same theoretical destination, concluding that illegal markets are not homogenous and cannot be boxed into preconceived generalisations.

Book Review: Jean Daudelin and José Luiz Ratton, Illegal Markets, Violence, and Inequality: Evidence from a Brazilian Metropolis

Book Review: Jean Daudelin and José Luiz Ratton, <i>Illegal Markets, Violence, and Inequality: Evidence from a Brazilian Metropolis</i>

National general truck drivers' strike and food security in a Brazilian metropolis.

We analysed the impact of the national general truck drivers' strike on the availability, variety and price of foods sold by a food supply centre. Descriptive study using secondary data to examine the percentage change in the mean price of fruits, vegetables and eggs before, during and after the strike. The strike in Brazil lasted 10 d from 21 to 30 May 2018. The drivers were on strike in order to make diesel oil tax-free and to obtain better working conditions. The food supply centre, named CEASA-Minas Grande BH, was located in the metropolitan area of a Brazilian city. We examined twenty types of foods. After 10 d, there was a ~30 % reduction in the availability of all types of foods and prices increased. Foods with the highest price increases included cabbage (233·3 %), potatoes (220·0 %), papaya (160·0 %) and oranges (78·6 %). At the end of the strike, we observed reductions in the price of eggs, fruits, vegetables, roots and tubers; however, some foods remained more expensive than before the strike, including chayote (203·2 % higher), cucumber (66·7 % higher) and potatoes (60·0 % higher). The general truck drivers' strike was correlated with a reduction in the availability of food and, consequently, increases in price and possibly restrictions on access. The strike demonstrated the dependence of metropolises on road transportation and the conventional market. We speculate that initiatives aiming to shorten the food supply chain and promote food sovereignty and resilience of the supply circuits could be important.

The conflicts of (Neo)extractivism: Mines, tailings dams, and protected areas in the metropolitan area of Belo Horizonte, Brazil

The third largest Brazilian metropolis - Belo Horizonte - accommodates local communities within its peri-urban area surrounding the Serra do Gandarela. These communities experience tensions, risk, and conflicts due to the expansion of mining activities. By analyzing the creation of the Serra do Gandarela National Park, as well as the existing and new tailings dams in the area, this article aims to unveil the conflicts experienced by these communities. We conclude that the environmental conflicts arise from policies of economic development (neo-extractivism related to progress and growth), which tend to deprive the local communities of access, use, and control of natural and land resources. In addition, the "imminent risks" and the disasters associated with the construction and operation of tailings dams allow for the rise of disaster capitalism.

Can we foretell violence? Predictors of being victim and perpetrator of domestic violence involving children and adolescents in a Brazilian metropolis

ABSTRACTDomestic Violence involving children and adolescents is a complex multi-causal phenomenon. This research aims to determine the predictors’ factors for children and adolescents’ victims and perpetrators of domestic violence in a Brazilian Metropolis. Cross-sectional study (n = 780). The logistic regression model was realized to present predictors. The models obtained good prediction, evaluation, and applicability. The main findings: 1) Model for victims was composed by the previous violence suffered, absence at school, working, using chemical substances and Divorced parents. 2) Model for perpetrators was composed of threats suffered and parents using chemical substances. Finally, it is fundamental to strengthen intersectoral and interdisciplinary public policies.

Das imprevidentes baixas densidades à imprudente verticalização

Entre aqueles preceitos presentes na concepção original de Brasília que deixaram marcas profundas no seu posterior crescimento destaca-se a opção por baixas densidades. Desde sempre, a densificação populacional tem sido anátema, tanto mais denegrida quando associada a altas alturas nas edificações. As consequências são visíveis na dimensão desmesurada da mancha urbanizada do Distrito Federal. Contudo, o aumento crescente das distâncias e a elevação dos valores fundiários findaram por impor sua lógica nesta que já é a terceira metrópole brasileira. Hoje, está em curso um processo de acelerada verticalização justamente naquelas áreas menos capacitadas para suportar os impactos da nova massa edificada e do concomitante aumento populacional.

HIV/AIDS Epidemic in Adolescents From a Brazilian Metropolis, 1978 - 2017

Background: Recent data from the Health Brazilian Ministry indicate that in the last 10 years there has been a greater increase in the HIV prevalence among adolescents. The objective of the study is to analyze the trend of the HIV / AIDS epidemic in adolescents in the city of Rio de Janeiro. Methods: Retrospective longitudinal study with secondary data from the National System of Notifiable Diseases database of HIV-AIDS cases among adolescents aged 13 to 19 years in the city of Rio de Janeiro, Brazil. For each case analyzed, from the beginning of the epidemic until June 2017, we assessed sociodemographic information, type of transmission and if the case advanced to death. Multilevel logistic models were used to estimate the mortality AIDS odds in adolescents. Findings: There were 885 AIDS cases in adolescents from 1978 to 2017 and 445 HIV cases from 2014 to 2017. The more recent the period, the higher the number of AIDS cases. In all periods, there were more nonwhite race AIDS cases than white ones. The percentage of AIDS cases in pregnant increased in the last two periods. Over the time, the percentage of AIDS cases transmitted through sexual route increases, while the cases transmitted through blood route decreases. Adjusted analyses indicated that the odds to die by AIDS was 63% higher in male, 66% lower for those who completed elementary school, about 3 times higher for those infected by injected drugs. Interpretation: The increase in AIDS rates in adolescents in and the high incidence of HIV in the last 4 years reveal that the epidemic is not controlled. There have been advances in secondary and tertiary prevention of AIDS and setbacks in primary prevention. Funding Statement: The authors state: This study did not receive funding. Declaration of Interest: None. Ethics Approval Statement: The Ethical Committee of Municipal Health Secretary of Rio de Janeiro approved the project, with the CAAE no 84670817.4.3001.5279 in April 16th 2018.

Factors Associated with Excessive Gestational Weight Gain Among Brazilian Mothers.

Gestational Weight Gain (GWG) is an important predictor of maternal and child health. Cross-sectional study was carried out in a public maternity unit of a hospital in a Brazilian metropolis that aimed to evaluate the factors associated with excessive GWG. Data were collected on food consumption, anthropometry, and on socioeconomic, demographic, and health status. The GWG was obtained by consulting each woman's gestational record. The association between GWG and the other variables was assessed using the chi-square test with the Bonferroni correction, with a significance level of 5%. We evaluated 98 mothers with a mean age of 25.4 ± 6.8 years and a postpartum time of 2.5 ± 1.2 days. Before pregnancy, 42.9% of this population was overweight. The mean GWG was 12.2 ± 6.5 kg, with 39.8% classified with excessive GWG. A higher prevalence of excessive GWG was observed among mothers who had higher per capita income (p = 0.003), had had cesarean delivery (p = 0.016), lower limbs edema (p = 0.012), and excess weight before pregnancy (p = 0.001). There was no significant association of GWG with eating habits. Excessive GWG is associated with socioeconomic and nutritional factors. Nutritional monitoring during prenatal care may favor effective interventions and contribute to positive outcomes for both maternal and child health.

Reliability and validity of the Brazilian version of the HSOPSC: a reassessment study.

This study aimed to reassess the psychometric properties of the Hospital Survey on Patient Safety Culture (HSOPSC) adapted to Portuguese for use in the Brazilian context. An observational, cross-sectional study was performed in a large, private, non-profit, acute care hospital, reference in patient safety, in a major Brazilian metropolis. Participants were selected from a non-probability sample of all eligible personnel in the various hospital departments invited to participate in the study. Reliability of the HSOPSC was assessed by estimating Cronbach's alpha for each dimension. confirmatory factor analysis (CFA), a matrix of correlations between the dimensions, and exploratory structural equation modelling (ESEM) were used in exploratory and confirmatory analyses of the structural validity of the construct. The overall response rate was 18.7% (n = 1,439). Four dimensions ("overall perceptions of patient safety"; "staffing"; "teamwork across units"; and "non-punitive response to error") returned problems of internal consistency. CFA returned acceptable fit with the original 12-dimension model. Correlations between the dimensions of the original 12-dimension model indicated discriminant validity problems, while residual variance was greater than 0.70 in 13 items. The ESEM of the original 12-dimension model returned good fit, with the following indices: CFI = 0.985; TLI = 0.968, and RMSEA = 0.026 (90%CI: 0.024-0.029). Although better than those of the first evaluation, the results obtained in this validity and reliability reassessment of the Brazilian version of the HSOPSC require further research.

Can We Blame it on Rio?

The Rio de Janeiro Olympic Games were the last major sporting event in a decade‐long cycle in the Brazilian metropolis. In the years leading up to the Rio 2016 Summer Olympic Games, the city's urban planning agenda was captured by the exogenous demands of hosting the quadrennial spectacular. This capture has exacerbated four tendencies that will pertain in Rio de Janeiro for the foreseeable future: consolidation of consumer sovereignty, restructuring of urban circulations, financialisation of urban territories, and securitisation of exception.

Graph mining for the detection of overcrowding and waste of resources in public transport

The imbalance between the quantity of supply and demand in public transport systems causes a series of disruptions in large metropolises. While extremely crowded vehicles are uncomfortable for passengers, virtually empty vehicles generate economic losses for system managers, and this usually comes back to passengers in the form of fare increases. In this article a new data processing methodology will be presented for the evaluation of collective transportation systems. It proposes the construction and mining of graphs that represent complex networks of supply and demand of the system to find such imbalances. In a case study with the bus system of a large Brazilian metropolis, it was shown that the methodology in question is capable of identifying global imbalances in the system based on an evaluation of the weight distributions of the edges of the supply and demand networks. It has also been shown that even in a scenario where information about the demand is incomplete, using community detection techniques it is possible to identify the stretches of the network that are potentially causing these imbalances on a global scale.

Quantifying the spatial spread of dengue in a non-endemic Brazilian metropolis via transmission chain reconstruction

The ongoing geographical expansion of dengue is inducing an epidemiological transition in many previously transmission-free urban areas, which are now prone to annual epidemics. To analyze the spatiotemporal dynamics of dengue in these settings, we reconstruct transmission chains in Porto Alegre, Brazil, by applying a Bayesian inference model to geo-located dengue cases from 2013 to 2016. We found that transmission clusters expand by linearly increasing their diameter with time, at an average rate of about 600 m month−1. The majority (70.4%, 95% CI: 58.2–79.8%) of individual transmission events occur within a distance of 500 m. Cluster diameter, duration, and epidemic size are proportionally smaller when control interventions were more timely and intense. The results suggest that a large proportion of cases are transmitted via short-distance human movement (<1 km) and a limited contribution of long distance commuting within the city. These results can assist the design of control policies, including insecticide spraying and strategies for active case finding.

Prevalence of neurological complications associated with Zika virus in a brazilian metropolis.

The aim of this paper is to study the prevalence of Zika Virus (ZIKV) and the index of its neurological complications. This is a quantitative, cross-sectional epidemiological study. Data were collected through the compulsory notification of suspected ZIKV and its neurological alterations cases. 113 suspected ZIKV cases were reported, most of them in the summer, with a higher prevalence of females and in the fourth decade of life. Among the neurological changes, 15 Guillain-Barré Syndrome cases were reported, with one registered death. As neurological manifestations, most of them started 30 days after a ZIKV infection. No case has been confirmed laboratory. It is necessary to combat the vector, mainly in the summer, to reduce ZIKV infection and its neurological complications, besides instruction to the health professionals about these complications and serological tests requests for an accurate diagnosis.

Clostridium difficile contamination in retail meat products in Brazil

IntroductionClostridium difficile is an important cause of diarrhoea, particularly in patients receiving antibiotic therapy. Recent studies have shown that a substantial proportion of C. difficile infections are acquired in the community, as a zoonotic disease. Brazil is a large exporter of meat and so far no study has evaluated meat contamination with C. difficile spores. MethodsHere we analysed 80 retail meat products purchased from local supermarkets in a Brazilian metropolis (Porto Alegre, Southern Brazil). Samples from these products were grown in anaerobic conditions, and tested with a real time polymerase chain reaction test. ResultsContamination with C. difficile spores was not found in the study. Bacteria isolated from meat included Streptococcus gallolyticus, Lactobacillus plantarum, Enterococcus gallinarum and Pediococcus acidilactici. DiscussionClose vigilance is required in order to guarantee the quality of Brazilian retail meat in the long term.

Nutritional Intervention Based on Ludic Activities: Effect on Eating Habits and Nutritional Status of Brazilian Schoolchildren

This study aimed to evaluate the effect of a nutritional intervention on eating habits and nutritional status of schoolchildren. It is a non-controlled intervention study with children from the 4th grade of elementary of nine public schools of a Brazilian metropolis. Five workshops based on healthy eating habits were performed using ludic activities. Eating habits (food frequency questionnaire) and anthropometry (weight and height) were evaluated before and after the intervention. Nutritional status was obtained by Body Mass Index (BMI)-for-age. McNemar test was performed with 5% significance. We evaluated 613 students with a median age of 9.4 (8.6-11.9) years. After the nutritional intervention, we observed a reduction in the consumption of chips, cookies, candy, artificial juice and soft drinks (p0.05). The intervention had a positive effect on eating habits of schoolchildren which might contribute to future changes on nutritional status.

Barriers to Access to Dental Treatment for People with Physical Disabilities in a Brazilian Metropolis

Objective: To evaluate the barriers for accessing dental care for people with physical disabilities. Material and Methods: A cross-sectional study with 191 caregivers of individuals with physical disabilities attending a rehabilitation center in Sao Paulo, who responded to a questionnaire about information related to barriers (user, caregiver, government and professional) found in dental treatment, visit to the dentist and age of the first dental appointment. Data were collected from medical records regarding age, sex, family income and medical diagnosis of patients. Statistical analysis was performed using the MedCalc for Windows software version 12.3.0. The Chi-square test was applied for heterogeneity, with significance level of 5%. Results: The main barriers identified by caregivers (p<0.0001) were patient fear/anxiety (66.8%), patient requiring accompaniment to access treatment (87.4%), treatment costs (82.7%), lack of treatment at primary health care units (73.3%) and professionals not specialized in dental care for people with physical disabilities (67.0%). It was observed that caregivers of individuals with cerebral palsy reported greater physical barriers for accessing dental treatment compared to caregivers of other diagnoses (p=0.0307). Conclusion: Individuals with physical disabilities face financial constraints, fear of dental treatment, lack of treatment options in public services and, perhaps most importantly, lack of qualified professionals interested in treating such individuals.

Air pollution and hospitalizations in the largest Brazilian metropolis.

ABSTRACTOBJECTIVE To evaluate the impact of air pollution on hospitalizations for respiratory and cardiovascular diseases in the largest Brazilian metropolis.METHODS This study was carried out at the Metropolitan Region of São Paulo, Brazil. Environmental data were obtained from the network of monitoring stations of nine municipalities. Air pollution exposure was measured by daily means of PM10 (particles with a nominal mean aerodynamic diameter ≤ 10 μm) per municipality, while daily counts of hospitalizations for respiratory and cardiovascular diseases within the Brazilian Unified Health System were the outcome. For each municipality a time series analysis was carried out in which a semiparametric Poisson regression model was the framework to explain the daily fluctuations on counts of hospitalizations over time. The results were combined in a meta-analysis to estimate the overall risk of PM10 in hospitalizations for respiratory and cardiovascular diseases at the Metropolitan Region of São Paulo.RESULTS Regarding hospitalizations for respiratory diseases, the effect estimates were statistically significant (p < 0.05) for all municipalities, except Santo André and Taboão da Serra. The RR (Relative Risk) of this outcome for an increase of 10 µg/m3 in the levels of PM10 ranged from 1.011 (95%CI 1.009–1.013) for São Paulo to 1.032 (95%CI 1.024–1.040) in São Bernardo do Campo. The RR of hospitalization for respiratory diseases in children for an increase of 10 µg/m3 of PM10 ranged from 1.009 (95%CI 1.001–1.017) in Santo André to 1.077 (95%CI 1.056–1.098) in Mauá. Only São Paulo and São Bernardo do Campo presented positive and statistically significant results for hospitalizations for cardiovascular diseases.CONCLUSIONS This is the first study to estimate the risk of illness from air pollution in the set of municipalities of the Metropolitan Region of São Paulo, Brazil. Global estimates of the effect of exposure to pollution in the region indicated associations only with respiratory diseases. Only São Paulo and São Bernardo do Campo showed an association between the levels of PM10 and hospitalizations for cardiovascular diseases.

High Zika Virus Seroprevalence in Salvador, Northeastern Brazil Limits the Potential for Further Outbreaks.

ABSTRACTDuring 2015 to 2016, Brazil reported more Zika virus (ZIKV) cases than any other country, yet population exposure remains unknown. Serological studies of ZIKV are hampered by cross-reactive immune responses against heterologous viruses. We conducted serosurveys for ZIKV, dengue virus (DENV), and Chikungunya virus (CHIKV) in 633 individuals prospectively sampled during 2015 to 2016, including microcephaly and non-microcephaly pregnancies, HIV-infected patients, tuberculosis patients, and university staff in Salvador in northeastern Brazil using enzyme-linked immunosorbent assays (ELISAs) and plaque reduction neutralization tests. Sera sampled retrospectively during 2013 to 2015 from 277 HIV-infected patients were used to assess the spread of ZIKV over time. Individuals were georeferenced, and sociodemographic indicators were compared between ZIKV-positive and -negative areas and areas with and without microcephaly cases. Epidemiological key parameters were modeled in a Bayesian framework. ZIKV seroprevalence increased rapidly during 2015 to 2016, reaching 63.3% by 2016 (95% confidence interval [CI], 59.4 to 66.8%), comparable to the seroprevalence of DENV (75.7%; CI, 69.4 to 81.1%) and higher than that of CHIKV (7.4%; CI, 5.6 to 9.8%). Of 19 microcephaly pregnancies, 94.7% showed ZIKV IgG antibodies, compared to 69.3% of 257 non-microcephaly pregnancies (P = 0.017). Analyses of sociodemographic data revealed a higher ZIKV burden in low socioeconomic status (SES) areas. High seroprevalence, combined with case data dynamics allowed estimates of the basic reproduction number R0 of 2.1 (CI, 1.8 to 2.5) at the onset of the outbreak and an effective reproductive number Reff of <1 in subsequent years. Our data corroborate ZIKV-associated congenital disease and an association of low SES and ZIKV infection and suggest that population immunity caused cessation of the outbreak. Similar studies from other areas will be required to determine the fate of the American ZIKV outbreak.