Brazilian State Capitals Research Articles

Contributions of parenting styles and parental drunkenness to adolescent drinking.

Objective:To estimate the association of parental drunkenness and parenting style with alcohol consumption among adolescents and the contributions of parental drunkenness and parenting style to the prevalence of binge drinking among adolescents.Method:Cross-sectional survey of a representative sample of secondary students aged 13 to 18 from 27 Brazilian state capitals (n=17,028). Private and public schools were included. A self-report questionnaire collected data on adolescents’ alcohol drinking behavior, parenting styles, and parenting and peer models of drunkenness.Results:Non-authoritative parenting style and parental drunkenness are associated with binge drinking among adolescents. Authoritarian, indulgent, and negligent parenting styles were associated with 1.50-, 2.51-, and 2.82-fold increases in prevalence of adolescent binge drinking, and parental drunkenness, with a 1.99-fold increase. The non-authoritative parenting style made a larger contribution than parental drunkenness to adolescent binge drinking.Conclusions:Non-authoritative parenting style and parental drunkenness seem to play an important role in adolescents’ binge drinking behavior. At the population level, parenting style appears associated with a greater contribution to this behavior among adolescents. Prevention strategies targeting parental drunkenness may be bolstered if a broader approach including parenting styles is in place.

“Alunos são todos iguais, não têm sexo:” análise das práticas de educação sexual e o enfrentamento à homofobia nas escolas

A análise das políticas públicas de enfrentamento à homofobia implementadas no Brasil nos últimos 15 anos e as pesquisas realizadas sobre o tema indicam que há consciência de que a homofobia no país é um problema importante e prioritário. Os estudos também indicam que, embora haja consenso de que o enfrentamento da homofobia deveria começar desde a infância, pouco se sabe sobre a situação da homofobia na comunidade escolar e muito pouco sobre as causas que a mantém nas escolas. Realizou-se um estudo descritivo e exploratório de abordagem qualitativa, com análise de conteúdo, com o objetivo de descrever a situação da homofobia na comunidade escolar em 11 capitais brasileiras. Utilizaram-se: entrevistas em profundidade com secretários/as estaduais e municipais de educação, diretor/a e coordenador/a de ensino; grupos focais com professores/as e estudantes; entrevistas informais com pessoal administrativo; e observação do ambiente escolar. Embora a legislação aponte que a educação sexual deve ser um tema transversal e incluir aspectos de gênero e diversidade sexual, constatou-se uma grande distância ao que realmente acontece. A pesquisa corrobora com dados nacionais pesquisas que foram feitas em âmbitos locais em diversas cidades brasileiras. O discurso de autoridades foi de que existem políticas públicas de educação sexual que consideram a diversidade sexual, mas na prática, quando ocorre, esta se da de forma espontânea e enfoca somente os aspectos biológicos de prevenção da gravidez e das ITS/HIV-Aids. Os dados mostraram a forte presença de preconceito homofóbico e o despreparo da escola para lidar com a diversidade sexual. Esta configuração é problemática para o tratamento da sexualidade, pois a isola das demais dimensões da vida e impede que sua força motivadora participe das demais práticas escolares.

Prevalence and co-occurrence of modifiable risk factors in adults and older people.

ABSTRACTOBJECTIVE To estimate the co-occurrence of the major risk factors for chronic diseases in adults (18-59 years old) and older people (≥ 60 years old) living in Brazilian state capitals and the Federal District.METHODS Cross-sectional study with population-based data from 35,448 adults and 18,726 older people collected in the Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (System of Surveillance of Risk and Protective Factors for Chronic Diseases by Telephone Survey – Vigitel) in 2015. The prevalence of each of the five risk factors (smoking, overweight, physical inactivity, alcohol and unhealthy diet) was estimated, as well as their co-occurrence for the different possible combinations, according to socioeconomic and health self-assessment variables. The independent associations were verified via multinomial logistic regression to obtain the estimates of the odds ratio (OR) and corresponding 95% confidence intervals.RESULTS At least two risk factors were present in 38.5% of the adults and 37.0% of the older participants. The male adults and older participants who did not have private health insurance and classified their health as average or poor/very poor were more likely to have two or more concurrent risk behaviors. The greater chance of co-occurrence of smoking and alcohol abuse in adults (adjusted OR = 3.52) and older people (adjusted OR = 2.94) stands out.CONCLUSIONS The subgroups with increased risk of developing multiple unhealthy behaviors and the most prevalent behaviors were identified. These findings are expected to contribute to the better targeting of health promotion and preventive care. It is worth noting that, for the adoption of healthy lifestyle habits, macro-social and inter-sectoral policies are more effective.

In utero exposure to economic fluctuations and birth outcomes: An analysis of the relevance of the local unemployment rate in Brazilian state capitals.

ObjectiveAnalyze if in utero exposure to economic downturns is associated with worsened birth outcomes.MethodsWe used birth records from all live singleton births in the 27 Brazilian state capitals between October 2012 and December 2016 (n = 2,952,430) and linked them to local unemployment rates according to the mother’s residence. We estimated the association between different birth outcomes and the local unemployment rate in the three trimesters before birth. We included maternal characteristics and month, year and municipality fixed effects as covariates. We also estimated the association for different groups of mothers, based on marital status, educational level, age and race.ResultsA 1 p.p. increase in the local unemployment rate in the trimester before birth is associated with 2.68% higher odds of being born with very low birthweight (< 1500 grams) (OR: 1.0268, 95% CI: 1.0006–1.0536). That result is pushed by the effect among newborns from mothers younger than 24 (OR: 1.0684, 95%CI: 1.0353–1.1024), from mothers with 11 years of schooling or less (OR: 1.0477, 95% CI: 1.0245–1.0714), and from brown or black mothers (OR: 1.0387, 95%CI: 1.0156–1.0624). The associations among children born from younger, less educated and black or brown mothers are robust to the application of a procedure to control for multiple testing, albeit the results considering the whole sample are not.ConclusionsOur study shows that there is an association between in utero exposure to higher unemployment rates during the last gestational trimester and the odds of being born with VLBW among children born from mothers younger than 24 years old, with less of 11 years of education and black or brown. These results suggest that children born from women of low socioeconomic status are more vulnerable to in utero exposure to economic downturns.

Desafios da inovação pedagógica num curso interdisciplinar de formação de professores de música

The offering of higher education programs outside of the capitals of Brazilian states seems to have opened a very intense discussion on the need for new pedagogical approaches closely related to the specific socio-cultural contexts of these places. The Brazilian national political panorama of recent years has generated a set of reformulations on the Education Guidelines and Basis Law – Law n. 9394/96 and, with it, new ordinances and resolutions from CNE – National Chamber of Education. In this direction, the pedagogical projects of Music Teacher Formation Courses have been undergoing curricular reformulation which often exceeds and suppress the actual specific local needs. In this paper, we present and discuss the creation and implementation of an interdisciplinary music teacher formation course at a public university in Maranhao, Brazil, under the demand for innovation. The goal here is to better understand the concept of pedagogical innovation in an interdisciplinary degree aimed at the music teacher's training, to be able to outline the possibilities of pedagogical management for better results and finally to list formative processes in music that could turn to pedagogical strategies that catalyze innovation processes. We seek to understand how the concept is seen in different contexts and situations and confront them with a methodological model of the area of Music, that from Artistic Research. This movement has led us to the unifying principle of methods in Artistic Research, the artistic practice and therefore the creative practices in a broader way, starting a chain of relations that has signaled to us how much Artistic Research and Pedagogical Innovation can contribute to a certain sight flexibility from the part of artistic-educators and educators-artists as something essential for the opening of innovation spaces, including in the very process of seeking for common points in both areas.

Sociodemographic determinants of health behaviors among Brazilian adolescents: Trends in physical activity and food consumption, 2009–2015

IntroductionFood consumption habits and physical activity levels are health behaviors influenced by sociocultural factors during adolescence. This study analyzes the trends and the sociodemographic determinants in the adoption of health behaviors among students in Brazilian state capitals regarding frequencies of consumption of healthy and unhealthy foods and level of physical activity in 2009, 2012 and 2015. MethodsThis study comprises an investigation of three editions of a cross-sectional survey conducted, at national level, by the Brazilian Institute for Geography and Statistics in partnership with the Brazilian Ministry of Health. Students attending elementary school ninth grade in public and private schools were selected using two stage sampling process to participate in the survey in 2009, 2012 and 2015. We selected variables that were comparable in the three editions of the survey, including individual-level sociodemographic and behavioral features, and household-level family and geographical characteristics. The dependent variables selected for multivariate logistic regression models included physical activity levels and frequencies of healthy and unhealthy foods consumption. ResultsMale adolescents from higher socioeconomic strata in 2009 and 2015 and students who declared frequent consumption of healthy foods were more likely to practice physical activities. However, there was a significant decrease in physical activity among Brazilian adolescents during the period analyzed, independently of socioeconomic strata. Healthy eating patterns were observed among non-white adolescents, students who declared having meals with their parents, and individuals who fulfill recommendations of physical activity level throughout the week. On the other hand, unhealthy eating pattern was more frequently observed among female adolescents and students who declared having meals while watching television. ConclusionEvidence shows limited effects of socioeconomic level on the adoption of healthy behaviors among adolescents in Brazil, and influence of family practices on the establishment of healthy food consumption patterns (e.g., presence of parents and absence of practices like watching television during meals).

The association between the neighbourhood social environment and obesity in Brazil: a cross-sectional analysis of the ELSA-Brasil study

ObjectiveTo investigate the association between the neighbourhood social environment, including social cohesion, perceived neighbourhood safety, perceived neighbourhood violence, and obesity in Brazil.DesignCross-sectional study.Setting6 state capitals in Brazil (Salvador, Vitoria, Belo...

Forecasting dengue fever in Brazil: An assessment of climate conditions.

Local climate conditions play a major role in the biology of the Aedes aegypti mosquito, the main vector responsible for transmitting dengue, zika, chikungunya and yellow fever in urban centers. For this reason, a detailed assessment of periods in which changes in climate conditions affect the number of human cases may improve the timing of vector-control efforts. In this work, we develop new machine-learning algorithms to analyze climate time series and their connection to the occurrence of dengue epidemic years for seven Brazilian state capitals. Our method explores the impact of two key variables—frequency of precipitation and average temperature—during a wide range of time windows in the annual cycle. Our results indicate that each Brazilian state capital considered has its own climate signatures that correlate with the overall number of human dengue-cases. However, for most of the studied cities, the winter preceding an epidemic year shows a strong predictive power. Understanding such climate contributions to the vector’s biology could lead to more accurate prediction models and early warning systems.

Factors associated with aggression perpetrated by unknown assailants among young males treated by the emergency services: a case-control study

This study aims to analyze the factors associated with aggression perpetrated by unknown assailants among young males treated by the emergency services. It is a case-control study with data from the Violence and Accident Surveillance System conducted in 2014 by 86 emergency services located in Brazilian State capitals. Young males between 15 and 29 years of age were included. All victims of assault perpetrated by unknown assailants were included as cases. Controls were randomly selected among those who had suffered accidental injuries in the ratio of 2:1. Unconditional logistic regression was used to estimate crude and adjusted odds ratios (OR), and 787 cases and 1,574 controls were included. Risk factors according to the adjusted analysis were: lack of paid work (OR 2.09; 95% CI; 1.66; 2.64), alcohol consumption (OR 3.14; 95% CI; 2.36; 4.17), occurrence at night (OR 3.39; 95% CI; 2.50; 4.61) or early morning (OR 5.31; 95% CI; 3.63; 7.75). Higher age (25-29 years) and schooling (5-8 years of study) were factors of protection. The results revealed the need for more effective and multisectoral actions to prevent violence among young males, which consider the factors associated with such aggression, including alcohol consumption, and investments in qualified education and paid employment.

Six-year trends in dental pain and maternal education inequalities among Brazilian adolescents.

To analyse trends in dental pain prevalence among Brazilian adolescent students over 6years, focusing on inequalities by maternal education. Data from the National Adolescent School-Based Health Survey (PeNSE) carried out in 2009 (n=45239), 2012 (n=46482) and 2015 (n=35592) were analysed, including ninth grade students from the 27 state capitals in Brazil who were of ages 11-17years or older. Variables analysed were dental pain within the last 6months (yes/no) and the following sociodemographic factors: age, sex, race, type of school and maternal schooling (years of study: ≤8; 9-11; ≥12). The prevalence of dental pain in the 3years was compared using the Rao-Scott test. Relative and absolute measures of socioeconomic (maternal education) inequalities in dental pain were applied using the slope index of inequality (SII) and the relative concentration index (RCI). The prevalence of dental pain increased from 17.5% (95% CI=16.9-18.2) in 2009 to 20.4% (95% CI=19.7-21.1) in 2012, then to 21.8% (95% CI=21.1-22.5) in 2015. All sociodemographic factors investigated were associated with dental pain in all survey years. There was an increasing proportion of the outcome in all categories of maternal education over the years studied. Absolute (SII) and relative (RCI) inequalities regarding of maternal education were found; these indicate higher levels of dental pain in the lower socioeconomic group in each study year. However, no significant changes in inequalities were found from 2009 to 2015. The prevalence of dental pain increased in the 2009-2012 and 2012-2015 periods, and social inequalities were found. Higher levels of dental pain persisted in the lower maternal education group. Inequalities remained stable over time. Broader actions to reduce the existing inequalities are needed and should be a priority for public policies.

Mujeres en situación de violencia: red de atención y perfil de la demanda en Natal, Brasil

Brazil is in the fifth position in homicide rates compared to other countries. Among Brazilian state capitals, Natal has shown a fast rise of reports of violence against women, particularly homicides. The Municipal Secretariat of Policies for Women (SEMUL) has two social facilities of direct care to women in situations of violence: the Centro Especializado Elizabeth Nasser (CREN) and the Casa Abrigo Clara Camarao. Due to the strategical location that it presents as an intra and interinstitutional articulator between the organisms within the service network and permanent foster care to women, the purpose of this article is to present CREN and characterize the profile of women who sought its service between 2013 and 2015, noting, finally, the difficulties detected when it comes to functioning and the tools for interdisciplinary, intersectorial and culturally sensitive work.

Climate drivers of hospitalizations for mycoses in Brazil

Climate can modulate human health at large spatial scales, but the influence of global, regional, and local environments remains poorly understood, especially for neglected diseases, such as mycoses. In this work, we present the correlation between climatic variables and hospitalizations for mycoses in Brazilian state capitals, evaluating the period of 2008 to 2016 at different time scales. The results indicate that climate modulates the hospitalizations for mycoses differently at annual and monthly time scales, with minimum temperature as a key climatic variable during periods of high prevalence in the 10 Brazilian capitals with the highest hospitalizations for mycoses rates. The greatest number of hospitalizations coincided with La Niña events, while a reduction was observed during El Niño events, thereby demonstrating the influence of the Pacific Interdecadal Climate Oscillation on the prevalence of mycoses in Brazil. At a regional scale, the mycoses burden in Brazil appears to respond differently to local and global climatic drivers.

The development potential index of creative economy for Brazilian federal state capitals

The article deals with the measurement of the potential dynamism of creative economy in the 26 capitals of Brazilian states and the Federal District. The central aim is to estimate the potential of creative economy in the selected cities through the creation and application of the Development Potential Index of Creative Economy, which is an index composed of secondary data. The methodological procedures consisted of three steps, the first one dedicated to the theoretical revision of some indexes previously constructed and applied to the understanding of the dynamism of the creative economy in several countries. In the second step, we selected the indicators for the analysis of Brazilian reality, which were aggregated into three dimensions: talent; attractiveness and connectivity; cultural environment and creative entrepreneurship. In the third step, we calculated the DPICE based on two techniques: one that assigned equal weights to the three dimensions and the other one that established different weights, using endogenous weights. The results confirm the regional inequality in Brazil, for the state capitals with greater development potential are located in the southeastern and southern regions of Brazil, and show ways for public policies to strengthen the development of creative economy in those cities.

Physical inactivity, television time and chronic diseases in Brazilian adults and older adults.

This study aimed to investigate the association between simultaneity of leisure-time physical inactivity and high television time with the presence of chronic diseases in adults and older adults in Brazil. We analyzed secondary data from Vigitel 2013 database, a cross-sectional national survey. It was included 37947 adults (18-59 years) and 14982 older adults (≥60 years) living in Brazilian state capitals. The association was between simultaneity of risk behaviors considering leisure-time physical inactivity (<10 min/day) and high television time (≥2 h/day), with the presence of chronic diseases (diabetes, dyslipidemia, hypertension and obesity), measured according to the age group. We performed a binary logistic regression, crude and adjusted analysis, using weighted to reflect population estimates. In adults, there was an association between leisure-time physical inactivity and television time with the presence of diseases. In practice, the simultaneity of risk behaviors when compared with those without risk behavior had higher odds for diabetes (OR = 1.83), dyslipidemia (OR = 1.17), hypertension (OR = 1.54) and obesity (OR = 1.60). In older adults, the simultaneity was associated with diabetes (OR = 1.61), hypertension (OR = 1.33) and obesity (OR = 1.81). We concluded that for adults and older adults the simultaneity of leisure-time physical inactivity and high television time increased the odds for the presence of chronic disease, especially for diabetes and obesity.

Adult body weight trends in 27 urban populations of Brazil from 2006 to 2016: A population-based study.

ObjectiveWe aimed to estimate trends in population-level adult body weight indicators in the 26 state capitals and the Federal District of Brazil.MethodsSelf-reported weight and height data of 572,437 adults were used to estimate the mean body mass index (BMI), and the prevalence of BMI categories ranging from underweight to morbid obesity, in Brazil’s state capitals and Federal District, from 2006 to 2016, by sex. All estimates were standardized by age.ResultsFrom 2006 to 2016, the main findings showed that: (i) the overall mean BMI increased from 25.4 kg/m2 to 26.3 kg/m2 in men, and from 24.5 kg/m2 to 25.8 kg/m2 in women; (ii) the overall prevalence of overweight increased from 48.1% to 57.5% in men, and from 37.8% to 48.2% in women; (iii) the overall prevalence of obesity increased from 11.7% to 18.1% in men, and from 12.1% to 18.8% in women; (iv) in general, the largest increases in overweight and obesity prevalence were found in state capitals located in the north, northeast, and central-west regions of Brazil; (v) the prevalence of severe obesity surpassed the prevalence of underweight in 22 and 9 state capitals among men and women, respectively; and (vi) the mean BMI trend was stable only in Vitória state capital in men.ConclusionsThe policies for preventing and treating obesity in Brazil over the past years were not able to halt the increase in obesity prevalence either in the state capitals or the Federal District. Thus, a revision of policies is warranted. Furthermore, although policies are necessary in all state capitals, our results suggest that policies are especially necessary in the north, northeast, and central-west regions’ state capitals, where, in general, the largest increases in overweight and obesity prevalence were experienced.

Progress and setbacks in socioeconomic inequalities in adolescent health-related behaviours in Brazil: results from three cross-sectional surveys 2009–2015

ObjectivesDespite some progress, Brazil is still one of the most unequal countries, and the extent of socioeconomic inequalities in adolescent health is unclear. We assessed trends in socioeconomic inequalities in...

Problems associated with binge drinking among students in Brazil's state capitals

The scope of this article is to describe and estimate the odds of problems among adolescents who reported binge drinking compared to those who reported alcohol consumption without binge drinking. The sample included 10,666 fourteen to eighteen-year-old public and private high school students in the 27 Brazilian state capitals who reported alcohol consumption at least once in the 12 months prior to the survey The odds of problems arising were estimated by ordinal logistic regression. Half of the students reported binge drinking and 33.1% admitted to at least one problem as a result. Binge drinking in the year (aOR = 4.7; CI: 3.9-5.7) and month (aOR = 4.4; CI:3.6-5.4) was associated with greater odds of reported problems. The most likely problems were: going to school or work drunk (aOR:6.5; CI:3.6-11.9); having sex without a condom (aOR:5.0; CI:3.7-6.8); and getting into a fight (aOR:4.5; CI:3.2-6.3). Adolescents who go binge drinking are more exposed to alcohol-related problems than those who report lower alcohol consumption. It is suggested that alcohol education/prevention programs should consider the most prevalent problems and risk behaviors, thereby broadening the discussion on consumption of alcohol versus non-consumption of alcohol.

Is the availability of open public spaces associated with leisure-time physical activity in Brazilian adults?

This study aims to analyse the association between perceived presence of public spaces near residences and practice of physical activity during leisure time by adults in the state capitals of Brazil, based on sociodemographic characteristics. Participants were individuals aged ≥18 years living in the 27 state capitals of Brazil (n = 52 929, 53.9% female) who responded to a national survey called VIGITEL in 2013. Physical activity during leisure time (≥1 time/week), perception of space, population and sociodemographic variables (sex, age, years of study and geographic region) were self-reported. The adjusted binary logistic regression analysis was used. Among adults, the prevalence of physical activity during leisure was 45.1% (95% CI [44.2; 46.0]), and 71.1% (95% CI [70.2, 71.8]) perceived public space near their residence. A direct association between perceiving public space and physical activity ([OR] = 1.43; 95% CI [1.32; 1.55]) was observed. No significant difference was observed in the population groups (men and women, younger and older adults, and those with more and fewer years of study). Thus, even with the possible regional differences in Brazilian state capitals, the presence of public spaces increases the practice of physical activity during leisure time, independent of sociodemographic variables.

Association of excess weight and obesity and mortality in Brazilian state capitals and Argentine provinces

This study aimed to assess the association between prevalence of excess weight and obesity and overall and disease-specific mortality rates in Brazilian state capitals and Argentine provinces. This was an ecological study with secondary data, where the principal exposures were prevalence rates for excess weight and obesity, estimated with data from Brazil's Vigitel survey (Risk and Protective Factors Surveillance System for Chronic Non-Communicable Diseases Through Telephone Interveiew) in 2014 and Argentina's National Risk Factor Survey in 2013. Overall and specific mortality rates for the year 2015 were obtained from the Brazilian Mortality Information System in the Brazilian Health Informatics Department and the Division of Health Statistics and Information of the Argentine Ministry of Health. Brazilian mortality rates were standardized with the age structure of the Argentine population as the standard. Crude and adjusted linear regressions were used to assess the association between the prevalence rates for excess weight and obesity and the overall and specific mortality rates. After adjusting for potential confounding factors, prevalence of obesity was positively associated with the overall mortality rate both in Brazil (β = 0.18; 95%CI: 0.01; 0.35) and in Argentina (β = 0.06; 95%CI: 0.01; 0.13). There was no association with the specific cardiovascular and cancer mortality rates. We conclude that the Brazilian state capitals and Argentine provinces with the highest prevalence of obesity present higher overall mortality rates, while this association was inconsistent for the specific rates.

School meals and family farming: analysis of funds spent in food purchases

The study aimed to verify the adequacy of funds for food purchases from family farming in the scope of the National School Food Program (PNAE) in Brazil's state capitals and the Federal District. This was a descriptive study based on secondary data obtained from the webpage of the National Fund for the Development of Education (FNDE) in the link dedicated to information on family farming. We analyzed the amounts transferred to the FNDE and the percentage used in purchasing foods from family farmers for school meals in the state capitals and Federal District from 2011 to 2017. Data were collected in May 2019. One-third of the 27 cities (33.3%) reported purchases above the minimum recommended level (30%). The North of Brazil complied with the recommended level (39.4%), while the Southeast reported the lowest level (6.4%). There was an increase from 2011 to 2017 in the total amounts invested and in the number of cities that purchased foods from family farming. Boa Vista (Roraima) was the capital that spent the largest share of its school meal funds on foods produced by family farmers (56.6%). In 2017, the local governments in Boa Vista and Aracaju (Sergipe) offered matching funds for the funds transferred from the FNDE for these food purchases. In conclusion, from 2011 to 2017, only one-third of the capital cities adequately used the percentage of funds for purchasing foods from family farming, although there was a gradual increase in the purchase of these foods, especially in the state capitals from North and Northeast Brazil.