Brazilian Capitals Research Articles

Temporal trend of overweight and obesity prevalence among Brazilian adults, according to sociodemographic characteristics, 2006-2019.

To analyze the temporal trend of overweight and obesity prevalence rates among adults in the Brazilian state capitals and Federal District between 2006 and 2019. This was a time series study using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey, 2006-2019 (n=730,309). Prevalence of overweight and obesity for each of the years was analyzed, according to combined sex, age, and schooling. Temporal variation trend was analyzed using Prais-Winsten regression. Variations in overweight prevalence were observed, mainly among males 18-24 years old with up to 8 years of schooling (3.17%/year) and among women between 18-24 years old with more than 12 or more years of schooling (6.81% /year). Variations in obesity prevalence were found mainly among women 18-24 years old with more than 12 years of schooling (10.79%/year). There was an increase in overweight and obesity in most of the socio-demographic strata studied, especially among more educated young people.

Tendência do uso e fontes de obtenção de antidiabéticos orais para tratamento de diabetes no Brasil de 2012 a 2018: análise do inquérito Vigitel

To estimate the prevalence of use of oral medications for the treatment of diabetes, as well as the distribution of sources for obtaining according to sociodemographic variables, in the Brazilian states' capitals and in the Federal District, and their evolution from 2012 to 2018. Cross-sectional and population-based study with individuals aged ≥ 20 years who reported a medical diagnosis of diabetes, interviewed through Vigitel from 2012 to 2018. We estimated the prevalence of use and the distribution of sources for obtaining according to sociodemographic variables (95%CI). We checked differences among proportions using the Pearson's χ2 test (Rao-Scott), with a significance level of 5%. There was an increase in the prevalence of use of oral medications for the treatment of diabetes from 77.4 to 85.2% between 2012 and 2018, and a decrease in obtaining in the Health Unit Pharmacies of the Unified Health System (SUS), while there was an increase in obtaining in Popular Pharmacies. In Brazil, SUS remained the main source for obtaining oral antidiabetic drugs, financing more than 70% of them in the country, considering the Health Unit Pharmacies and Popular Pharmacies, thereby showing the importance of public Pharmaceutical Policies in guaranteeing the access to medications by the Brazilian population, as well as in reducing inequities in the country. Nevertheless, the migration of obtaining by users from SUS Health Units to Popular Pharmacies suggests the weakening the responsibility of Primary Health Care in the provision oral antidiabetic drugs, thereby undermining the bond and the longitudinal care.

Adolescents, Street, Drugs and Psychoactive Substances: A Study on Risk and Protection

Abstract The article describes the consumption of psychoactive substances (PSs) by street-involved children and adolescents (SCA) in three Brazilian state capitals and examines adverse life events due to drug involvement. The longitudinal study included 108 SCA (9-18 years old, both sexes), grouped according to the main reason for going to the street: drugs, caregivers, escape, work and freedom. It also discusses the impact of drugs, trafficking and the place that this theme has occupied in public policies, social interventions and the life trajectory of these participants, through a case study. It is intended that these data can support the operation of interventions and the formulation of public policies that guarantee integral protection.

Contraceptive discontinuities in the use of oral and injectable hormonal contraceptives, and male condoms

The study aimed to estimate the total contraceptive discontinuity rates in the use of oral and injectable hormonal contraceptives, and male condoms and dropout rates due to switches to more effective and less effective methods. Data on 2,051 women, users of primary healthcare services in three Brazilian state capitals, were collected using the contraceptive calendar. The results showed that 24.5% of users of oral hormonal contraceptives, 33.5% of users of injectables, and 39% of users of male condoms had discontinued the respective method after 12 months of use, independently of the reason, and that the rates varied little between the capitals but did depend on the method. The main reason for discontinuing use of the contraceptive method was the desire to become pregnant (20.8%). Conception while using the method was reported by 20% of the women, a proportion that reached 25.7% in users of male condoms. After 12 months with the method, the dropout rate for reasons related to the contraceptive method was 11.4% in users of injectables; 15.9% of users of male condoms switched to a more effective method; and 16.3% of users of injectables switched to a less effective method. Contraceptive discontinuity rates were high and varied according to the contraceptive method.

Contextual and individual determinants of use of newborn hearing screening: the Brazilian National Health Survey, 2013

The current study assessed the effect of contextual and individual determinants of the use of newborn hearing screening in Brazilian state capitals and the Federal District. The conceptual theoretical model proposed by Andersen & Davidson (2014) oriented the analyses using multilevel logistic modeling with data from the Brazilian National Health Survey, 2013. The study population (n = 585) is representative of 230,112 pairs of women/responsible person over 18 years of age and their respective children under 2 years of age. At the contextual level (state capitals and Federal District), the use of newborn hearing screening was determined by the proportion of extremely poor individuals (odds ratio - OR = 0.91; 95% confidence interval - 95%CI: 0.83-0.99) and by monthly coverage of newborn hearing screening (OR = 1.02; 95%CI: 1.01-1.02). At the individual level, use of newborn hearing screening was higher in the maternal age bracket 25 to 39 years, compared to < 25 years. The odds of use of newborn hearing screening were lower in mothers with brown race/color (OR = 0.47; 95%CI: 0.26-0.83) compared to white mothers. As for schooling, complete university education nearly tripled the odds of newborn hearing screening when compared to primary schooling (OR = 2.99; 95%CI: 1.15-7.79). Predominantly private prenatal care increased the odds of using newborn hearing screening by 2.18 times, compared to public prenatal care (OR = 2.18; 95%CI: 1.02-4.64). Effective enforcement of existing hearing health laws and policies and prioritization of primary healthcare and health education practices with a focus on more vulnerable newborns, based on the characteristics identified in this study, are initiatives that can help ensure an equitable social protection system.

An Assessment of Brazilian States and State Capitals Remote Public Education Programs during the COVID-19 Pandemic

School closures were one of the policies adopted worldwide for containment of the COVID-19 pandemic. While this type of non-pharmaceutical intervention has proven to be an effective policy to reduce virus transmission, there has not been a systematic investigation to verify if governments implemented remote education programs to continue to deliver education to students. In Brazil's case, due to the lack of effective control of the pandemic, schools remained closed for in-person schooling over a prolonged period for the majority of the 2020 academic year. In developing countries, such as Brazil, this can increase education inequalities, especially if access to remote learning technologies is limited for vulnerable populations. In this working paper, we report the results of a novel effort to collect data to document the types of programs adopted by state and state capitals' governments to deliver remote schooling during the pandemic. We measure the duration, scope, and coverage of remote public education programs through quantitative indicators and an index that measures the overall quality of remote education programs in early childhood, primary and secondary education in Brazil in 2020. Our research reveals that there were significant delays in the adoption of these programs by both state and municipal governments. Furthermore, our findings confirm that the programs dedicated insufficient attention to ensuring access to technologies that would encourage learning, interaction and supervision of students remotely. We then show that remote education programs are correlated with previous economic and educational conditions and use survey data collected from households across Brazil to show that remote education programs affected educational outcomes. We conclude by noting that the evidence collected in our report underscores that greater attention must be directed to the challenges and problems encountered in implementing remote education programs. The available evidence suggests that policies must be designed to address the preexisting, now augmented, unequal access and unequal provision of education for vulnerable groups.

Análise temporal do uso e cobertura do solo da capital brasileira do amianto: Minaçu, estado de Goiás

The municipality of Minaçu, in the northern region of the state of Goiás, differs from many Brazilian municipalities due to the intense changes that have occurred in its territory. The municipality is known as the Brazilian capital of asbestos, an ore that gave rise to the occupation of the region, whose extraction has lasted six decades. In addition to the large pits opened by mining, the municipality also has two hydroelectric plants, in addition to part of their respective reservoirs, which occupy a large part of their land. The objective of this study was to analyze the land use and cover between the years 1988 and 2018 of Minaçu. For that, the data of land use of the MapBiomas project were used, also used for analysis of the conversion between the classes of the mapping from the initial year to the end of the period of analysis. The least significant classes for the period under analysis were non-vegetated area, mining, urban infrastructure and planted forest. The areas of natural vegetation, such as forests and savanna, were converted to areas for human use, mainly pasture, also had the largest areas flooded by the two reservoirs of hydroelectric plants present in the municipality. The data used enabled an efficient and low-cost study, which serves as a basis for a greater understanding of the dynamics of use and coverage, also serving as a basis for planning sustainable land occupation.

Use of psychotropic drugs by students from the health area: a comparative and qualitative analysis

Abstract: Introduction: The use of psychotropic substances is highly prevalent among students in the health area. This situation reveals an inversion of values, in which future professionals who will give advice on drug use and abuse make inadequate consumption of drugs. Objective: This research aims to collect and comparatively analyze the profile of psychotropic substance use by health students, as well as analyze the subjective significance of drug use by health students. Methods: This is a cross-sectional study, with a quantitative sample of 745 students, aged 15 to 70 years, from the Psychology, Medicine, Nursing, Nutrition and Physiotherapy courses. A questionnaire adapted from the “I National Survey on the Use of Alcohol and Other Drugs by University Students in the 27 Brazilian Capitals” was used for data collection. Regarding the qualitative work, a focal group was carried out, whose participants comprised ten students, of which three were Psychology students, three were Physiotherapy students, one was a medical student and one a Nursing student. Results: The study results showed that the psychotropic substances most often used by the participants were: Alcohol, Tobacco and Marijuana, in addition to Tranquilizers and Anxiolytics. Furthermore, in comparison with the other courses, Psychology students were the ones who used the most drugs in general, followed by Nutrition and Medicine. Moreover, drug use was perceived as a means of escape from psychological distress, as well as a way to maximize pleasure. For university students, the use of psychotropic drugs is seen as an combination of interpersonal relationships, being also influenced by the desire to improve academic performance. Conclusion: The study data disclosed a high consumption of psychotropic drugs by university students in the health area, a condition associated to psychological distress and which reveals a demand for support and assistance in terms of substance dependence. It is important that further research on the subject be carried out, so that effective public policies can be implemented.

Use of psychotropic drugs by students from the health area: a comparative and qualitative analysis

Abstract: Introduction: The use of psychotropic substances is highly prevalent among students in the health area. This situation reveals an inversion of values, in which future professionals who will give advice on drug use and abuse make inadequate consumption of drugs. Objective: This research aims to collect and comparatively analyze the profile of psychotropic substance use by health students, as well as analyze the subjective significance of drug use by health students. Methods: This is a cross-sectional study, with a quantitative sample of 745 students, aged 15 to 70 years, from the Psychology, Medicine, Nursing, Nutrition and Physiotherapy courses. A questionnaire adapted from the “I National Survey on the Use of Alcohol and Other Drugs by University Students in the 27 Brazilian Capitals” was used for data collection. Regarding the qualitative work, a focal group was carried out, whose participants comprised ten students, of which three were Psychology students, three were Physiotherapy students, one was a medical student and one a Nursing student. Results: The study results showed that the psychotropic substances most often used by the participants were: Alcohol, Tobacco and Marijuana, in addition to Tranquilizers and Anxiolytics. Furthermore, in comparison with the other courses, Psychology students were the ones who used the most drugs in general, followed by Nutrition and Medicine. Moreover, drug use was perceived as a means of escape from psychological distress, as well as a way to maximize pleasure. For university students, the use of psychotropic drugs is seen as an combination of interpersonal relationships, being also influenced by the desire to improve academic performance. Conclusion: The study data disclosed a high consumption of psychotropic drugs by university students in the health area, a condition associated to psychological distress and which reveals a demand for support and assistance in terms of substance dependence. It is important that further research on the subject be carried out, so that effective public policies can be implemented.

Impact of global warming on Potential Years of Life Lost by cardiopulmonary diseases in Brazilian capital cities

This study aims at assessing the future impact of global warming in the Potencial Years of Life Lost (YLL) for cardiovascular diseases in adults (≥45 years) and respiratory diseases in the elderly (≥60 years). This is an ecological study, which includes all the capitals of Brazil. Future projections used temperature data sourced from the Eta-HadGEM2S Regional Model for the RCP8.5 scenario. YLL fractions attributable to temperature were estimated for global warming scenarios of 1.5°C, 2.0°C, and 4.0°C. The results showed that, in absolute numbers, Rio de Janeiro and São Paulo have presented the largest YLL contribution attributable to global warming among the capital cities. Campo Grande and Cuiabá were the most impacted capitals by a global warming of 1.5ºC compared to the baseline period (1961-2005), both for respiratory diseases in the elderly and for cardiovascular diseases in adults. Results of this research suggest that the impact of exposure to temperature on YLL tends to increase as the level of global warming increases.

Assistência e repressão: pilares no enfrentamento da “questão social” no capitalismo dependente brasileiro

The text focuses on the relationship between the repression of the working class and conservative forms of assistance. It proposes the hypothesis that such articulation constitutes one of the structuring axes of social policies in Brazilian dependent capitalism. This is an essay with a literature review starting from the Marxist criticism of social policy and using dependent capitalism as the category guide for analysis. Considering some of the main foundations of the Brazilian economic-social formation, we examine how dependent patterns, although they change in shape, are structural elements of the State and social policies. Based on this, we analyze how assistance and repression interact under neoliberalism, particularly from the worsening of the capital crisis after 2008. We conclude that we are facing a new pattern of coping with “social issues” in Brazil, where the advance of conservatism in the assistance field and more punitive as well as coercive actions via criminal policy are accentuated.

Transparência governamental em capitais dos estados no Brasil nas contratações emergenciais para o combate da COVID-19

O artigo objetivou avaliar a construção da transparência das informações sobre contratações emergenciais para o combate da Covid-19 pelos municípios-capitais do Brasil e sua relação com o avanço da pandemia em seus contextos locais, tomando por base os três rankings elaborados e divulgados pela Transparência Internacional Brasil (TIB) e os dados das secretarias municipais de saúde. Fez-se um estudo de casos múltiplos, de cunho exploratório-descritivo e de caráter qualitativo-quantitativo. Os dados mostram que os indicadores de transparência nas contratações emergenciais apresentaram melhora significativa ao longo dos três levantamentos considerados; que o avanço no cumprimento de uma dimensão não tinha relação com as outras dimensões, exceto controle social e formato, e entre controle social e legislação; e que os esforços dos governos em implementar recursos para a promoção da transparência não foram motivados pelo avanço maior ou menor do contágio e das mortes por Covid-19.

Precariedad y mistificación de la precariedad: superexplotación de la fuerza de trabajo

This article, based on Marx's Social Theory and on the Brazilian Marxist social thought, aims to analyze the precariousness, the overexploitation of the workforce and the mystification of precariousness with the expropriation of rights. Thus, it highlights the particularities of Brazilian dependent capitalism and the marks of colonial slavery with the apprehension of the meaning of the expropriation of labor and the export of economic surplus. It highlights the current ultraneoliberal period enhanced by the government of Jair Bolsonaro, with the reinforcement of the culture of “entrepreneurship” via the “prosperity theology”, increasing the setbacks of labor rights.

Mortality by road traffic injuries in Brazil (2000-2016): capital cities versus non-capital cities.

ABSTRACTOBJECTIVES:To compare the magnitude and trend of mortality by road traffic injuries (RTI) in the capitals and other municipalities of each Brazilian state between 2000 and 2016.METHODS:A time series analysis of mortality rates by RTI standardized by age was performed, comparing the capitals and the cluster of non-capital municipalities in each state. Data on deaths were obtained from the Sistema de Informações sobre Mortalidade (SIM – Mortality Information System). RTI deaths were considered to be those, whose root cause was designated by ICD-10 codes V01 to V89, with redistribution of garbage codes. To estimate mortality rates, we used the population projections of the Brazilian Institute of Geography and Statistics (IBGE) from 2000 to 2015 and the population estimated by polynomial interpolation for 2016. The trend analysis was performed using the Prais-Winsten method, using the Stata 14.0 program.RESULTS:There were 601,760 deaths due to RTI in the period (114,483 of residents in capital cities). Mortality by RTI did not present an increasing trend in any of the Capitals in the period under study. Among non-capital municipalities, the trend was growing in 14 states. The greatest increase was observed in Piaui (AIR = 7.50%; 95%CI 5.50 – 9.60). There was a decreasing trend in RTI mortality in 14 capitals, among which Curitiba showed the greatest decrease (AIR = −4.82%; 95%CI −6.61 – −2.92). Only São Paulo and Rio Grande do Sul showed a decreasing trend in mortality by RTI in non-capital cities (AIR = 2.32%; 95%CI −3.32 – −1.3 and AIR = 1.2%, 95%CI −2.41 – 0.00, respectively).CONCLUSIONS:We conclude that RTI mortality rates in non-capital cities in Brazil showed alarming trends when compared with those observed in capital cities. The development of effective traffic safety actions is almost always limited to Brazilian capitals and large cities. Municipalities with higher risk should be prioritized to strengthen public policies for prevention and control.

Are there really many runners out there? Is the proportion of runners increasing over time? A population-based 12-year repeated cross-sectional study with 625,460 Brazilians

ObjectivesTo investigate the proportion of individuals who practice running, its temporal trend, and to describe the runners’ characteristics. DesignPopulation-based repeated cross-sectional study. MethodsThe data from the Protective and Risk Factors for Chronic Diseases by Telephone Survey (Vigitel) from Brazil were used. Telephone interviews were conducted with adults from the Brazilian capitals (27 cities) between 2006–2017. The interviewer read the questions and recorded the participants’ responses immediately in a questionnaire. Data analyses were conducted using a Bayesian approach. ResultsThe Vigitel database consisted of 625,460 Brazilian participants composed of 295,681 exercisers and within them 15,529 runners. The mean yearly proportion of runners was about 2.45% (95% Bayesian credible interval [CrI] 1.93 to 3.11) and 5.32% (95%CrI 4.29 to 6.54) in the entire study population and within exercisers, respectively. The absolute increase in the proportion of runners per year over the 12-year period was 0.13% and 0.17% in the entire study population and within exercisers, respectively. Runners were more likely to be younger, men, within normal body mass index, highly educated, moderate alcohol drinkers, non-smokers, less exposed to TV, living near physical activity/sports facilities and less exposed to health conditions such as arterial hypertension, diabetes and dyslipidaemia. ConclusionThere was a 95% probability that the yearly proportion of runners lies between 1.93% and 3.11% in the population of the 27 Brazilian capitals, and between 4.29% and 6.54% within exercisers. There has been an increase in the proportion of runners over time. Runners were associated with healthier characteristics compared to non-runners and non-exercisers.

New Capital Cities: A Timeless Mega-project of Intercontinental Presence

Mega-projects are projects that require immense resources to create. This includes all different aspects; funding, labour, etc. These projects are meant to create a massive effect on the city or national level through providing job opportunities during construction as well as after completion. Moreover, these projects usually have an intercontinental effect that echoes worldwide and may affect other projects, cities or even countries either positively or negatively. Mega-projects are not restricted to certain project typologies; in fact they range from Olympic cities to water dams and channels. We can even claim that the first mega-project was the great pyramid. Mega-projects can also be linked to mega-events thus achieving more international acknowledgement. This paper discusses the creation of new capital cities as a mega-project typology. It analyzes different examples worldwide where a new capital city was created to act as a mega-project that would create ripples of economic and urban development through a country. The capitals of Brazil, Kazakhstan and Egypt are studied to display the authors view of them as mega-projects that have the same function but span across time, space and cultures.

PP288 Health Technology Assessment In Universal Health System: A Network At The Brazilian Capital

IntroductionCollaborative networking is adopted to implement health technology assessment (HTA) in academic and research institutions and exchange knowledge with hospitals and health services. Since 2016, the District Network for Health Technology Assessment (ReDAPTS) has been dedicated to generating and promoting evidence that supports decision-making, promoting continuous qualification, supporting and guiding managers in priorities and demands, analysing the economic, ethical and social implications of problems and situations, and contributing to healthcare quality at the Unified Health System. The objective of this study is to present the construction process of ReDAPTS from 2016 to 2019.MethodsThis experience report about ReDAPTS considered three main actions: (i) situational diagnosis in 2016 and 2017, (ii) agreements of internal regulation and governance and (iii) HTA training strategies for professionals. The scientific events and executive group meetings were described to identify the strategies for the implementation of a collaborative network in the Federal District (FD), Brazil.ResultsIn total, fifteen institutions were identified with a potential to develop the HTA field at the district level. Between 2016 and 2019, three scientific events, eighteen technical meetings for network governance and two scientific meetings were carried out, organized by ReDAPTS and with 269 participants, highlighting assistance and university hospitals, FD Department of Health and academic and research institutions. Four HTA courses were offered and 319 professionals from the FD were trained.ConclusionsCollaborative networking provided strengthening capacity for study production and debates on institutional processes for public health policies at the FD. Networking encouraged collaboration between institutions and promoted sharing HTA experiences. The network faces challenges to operate with full capacity. Political and institutional commitment, physical infrastructure and trained personnel sustainability are key to maintaining the HTA process at the FD. Institutions can develop HTA-teams to promote continuous qualification, study production and the rational use of technologies.

Inequalities in mammography and Papanicolaou test coverage: a time-series study.

Cancer is a serious public issue problem worldwide. In Brazil, breast cancer is the most common type and cervical cancer is the third most frequent among women. To analyze the temporal trend of coverage of mammography and cervical oncotic cytological testing, between 2007 and 2018. Time-series study conducted in the 26 Brazilian state capitals and in the Federal District. A linear regression model was used to estimate trends in coverage of mammography and cervical oncotic cytological testing over the period. The data collection system for Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey (Vigitel) was used. A significant increase in mammography coverage was observed, from 71.1% in 2007 to 78.0% in 2018. There was a trend towards an increase among women with 0 to 8 years of schooling, in all regions of Brazil. Regarding cervical oncotic cytological testing coverage, there was a trend towards stability during the period analyzed, reaching 81.7% in 2018. On the other hand, there was a significant increase in the northern region. There was an improvement in the coverage of these screening examinations, especially regarding mammography. However, it is still necessary to expand their provision, quality and surveillance, aimed towards women's health.

Neighborhood physical disorder and common mental disorders in adolescence

The aim of this study is to estimate the association between observed indicators of neighborhood physical disorder and common mental disorders in adolescents. The study population included 2506 adolescents from three Brazilian state capitals (Rio de Janeiro, Porto Alegre, and Fortaleza) who participated in the Cardiovascular Risk Study in Adolescents (ERICA), a cross-sectional school-based study conducted in 2013-2014. Common mental disorders were assessed using the 12-item General Health Questionnaire. Measures of neighborhood physical disorder were based on the 2010 Brazilian census data and were derived using principal component analysis. Although associations were found between some exposure components and CMD, there were no clear or consistent trends across exposure quartiles. Overall, there was no evidence of an association between observed indicators of neighborhood physical disorder and common mental disorders. Future studies should explore alternative tools for measuring neighborhood physical disorder to minimize the likelihood of exposure misclassification.

Free cooling potential for Brazilian data centers based on approach point methodology

Data centers cooling loads may reach about 40% of their electricity demands. The number of that type of facility is continuously growing around worldwide and actions addressing energy saving are welcome to rationalize their operation. Free cooling appears as an effective solution to achieve energy savings, and the present work proposes a methodology for assessing data center free cooling operation based on the heat exchanger approach point. The methodology can be applied to both airside and waterside economizer modes. The proposed methodology is applied to fourteen Brazilian state capitals that represent all country climatic conditions. Free cooling environmental air temperature and humidity criteria are based on literature review and on ASHRAE thermal guidelines. Results show that cities such as Curitiba, São Paulo, Porto Alegre and Brasília can potentially operate in both airside and waterside economizer modes for more than 3000 h per year, even considering conservative data center thermal operating limits. Facilities placed on North and Northeast regions can only run under free cooling conditions if operational parameters are to be relaxed to consider more flexible operating limits. It is shown that indirect economizers are potentially more suitable to operate under ASHRAE recommended limits. The proposed methodology is shaped for evaluating free cooling hours during system conception.