Challenges In Brazil Research Articles

Unveiling inclusive education: teachers’ perspectives in Rio de Janeiro

This study examines inclusive education challenges in Brazil's West Zone of Rio de Janeiro. Despite legal guarantees and policy efforts, student dropout and exclusion persist. Ethnomethodology is used to understand daily practices and perspectives of teachers and managers. The research aims to bridge the gap between policy ideals and implementation realities. Findings highlight persistent challenges due to social disparities. While legal frameworks ensure access, implementation falls short. Educators and administrators stress the need for training, improved communication, and better infrastructure. Comprehensive interventions are crucial for inclusive education success. This study offers insights into the hurdles and suggests strategies for aligning policy goals with practice.

Lifestyle Medicine Interventions to Manage Hypertension in Brazilian Patients With Type 2 Diabetes

Hypertension and type 2 Diabetes (T2D) are highly associated and can promote an additive risk of mortality and hospitalization, as well as a significant burden on the Brazilian Unified Healthcare System. Despite this, blood pressure and glycemic control are still suboptimal and remain a significant challenge in Brazil. As it will be reviewed in this paper, current evidence supports the effectiveness of various dietary, exercise, and lifestyle interventions for hypertension and T2D. Among dietary interventions, the DASH diet appears to be particularly effective in reducing blood pressure and decreasing the risk of cardiovascular mortality, with a moderate effect on glycemic control. Regular physical activity, including aerobic, resistance, or combined exercise programs, is also recommended to reduce blood pressure, improve glycemic control and also reduce cardiovascular disease risk. Stress reduction programs have also been shown to be effective in reducing blood pressure. However, although numerous lifestyle interventions are effective for hypertension and T2D, factors such as personal preferences, motivation, and cultural background should be considered to ensure the long-term sustainability of these interventions. In addition, there is a need for further research to determine the cost-effectiveness of lifestyle interventions in the Brazilian population to encourage the development of evidence-based health policies.

Advancing plastic pollution hotspotting at the subnational level: Brazil as a case study in the Global South

Identifying sources is crucial for proposing effective actions to combat marine litter pollution. Here, we used an innovative approach to identify hotspots of mismanaged plastic waste (MPW) within Brazil and subsequent leakage to the ocean, based on population density, socio-economic conditions, municipal solid waste management and environmental parameters. We estimated plastic waste generation and MPW for each of the 5570 Brazilian municipalities, which totaled 3.44 million metric tons per year. Then, we estimated the probability of litter mobilization and transport (P) and the relative risk of leakage to the ocean (MPW × P). The Guanabara Bay and La Plata River comprised the main oceanic entry hotspots of litter produced in Brazil. The use of national databases allowed us to increase spatial and temporal granularity, offering a detailed baseline for the application of prevention and mitigation actions. However, overcoming data limitations is still a challenge in Brazil as in other Global South countries.

Perspectives and challenges for mother-to-child transmission of HIV, hepatitis B, and syphilis in Brazil.

Eliminating mother-to-child transmission (MTCT) of HIV, hepatitis B, and syphilis is a challenge in Brazil. Many policies have been implemented since 1986, but important gaps remain. This study aimed to describe the trends of MTCT in Brazil and evaluate the gaps and perspectives in this scenario. This is a descriptive study conducted with secondary data publicly available in the information systems of the Brazilian Ministry of Health regarding data on HIV, syphilis, and hepatitis B in pregnant women and children from 2011 to 2021. HIV and hepatitis B have had constant rates over the years in pregnant women, with the detection rates around 2.5/1,000 live birth (LB) and 0.5/1.000LB, respectively. The same did not happen with syphilis, which has shown an increasing line in the last decade. In 2011, the detection rate of syphilis in pregnancy was 4.7/1,000LB, and in 2021 it reached 27.1/1,000LB. Regarding the trends in children, an important decrease was observed in HIV/AIDS (incidence rate from 0.18/1,000 in 2011 to 0.04/1,000 in 2021) and Hepatitis B (incidence rate from 0.9/1,000LB in 2011 to 0.5/1,000LB in 2021). For congenital syphilis, there is a continuous increase, being 3.3/1,000LB in 2011 and 9.9/1,000LB in 2021. Data from the HIV clinical monitoring showed that antiretroviral treatment coverage among pregnant women identified increased slightly between 2011 and 2021, in Brazil, from 92.3% to 94.3%. For syphilis, 82.5% of pregnant women were treated with benzathine penicillin, and 88.7% in 2011. The historical series of hepatitis B vaccination coverage in children has decreased over the years; it was 96% in 2013 and 76% in 2021. These data show many gaps and some perspectives in the MTCT program in Brazil. The country is close to reaching MTCT HIV elimination, but there are many challenges regarding HBV and syphilis. These data can be used to organize the strategies to improve the Brazilian response to MTCT elimination of HIV, hepatitis B, and syphilis.

Pandemic and fundamental right to housing: new criteria for adequate housing in the face of COVID-19 challenges in Brazil (2020-2022)

The pandemic problem brought with it a new social reality in the moral realm as well as in the habits that people engage in daily, which has irreversibly altered the way people live. In light of this, the goal of this research is to look into the fundamental right to housing, as well as the right to adequate housing, as outlined in the International Covenant on Economic and Social Rights (ICESCR), in the context of changes in people's daily routines brought about by the COVID-19 pandemic in terms of whether or not the environment is habitable. As a result, it explores whether the COVID-19 pandemic influenced the purchasing of houses with a larger number of rooms, given that families began to utilize the home more regularly. It specifically asks if the habitability parameter was changed to satisfy the new requirements that occurred because of the epidemic. To obtain an answer to this question, we will investigate whether or not there has been an increase in the desire for or acquisition of larger homes since the outbreak began. This is because a large percentage of the population is forced to work and study from home. Bibliographic research and data collection are carried out within the framework of the hypothetical-deductive methodology, using information obtained from the website of SECOVI-SSP (Union of Real Estate Purchase and Sale Companies) in relation to the cities of Campinas and Bauru from 2011 to 2022. It has been noted that the pandemic scenario has prompted people's daily lives to become an experience of social containment procedures with the goal of decreasing viral propagation. Despite this, there were no significant changes in the consumption model of new residences in the municipalities of Campinas and Bauru, even during the zenith of the COVID-19 pandemic.

An Analysis of Key Actor Networks for Scale-Up Strategies for Childhood Obesity Prevention and the Care of Children with Obesity in Brazil

BackgroundEffective scale-up of multisectoral strategies aimed to prevent and treat childhood obesity has been a challenge in Brazil, the largest country in Latin America. Implementation Science methods, such as Net-Map, can identify key actors and opinion leaders (OLs) to advance the implementation and promote sustainability. ObjectivesThis study aimed to analyze power relations between key actors and OLs who influence the scale-up of Brazilian strategies for childhood obesity at the federal and state/municipal (local) levels. MethodsA mixed method study, applying the Net-Map method, collected data through virtual workshops with federal and local level stakeholders. The Net-Map included key actors mapping, power mapping, and identification of OLs. Four domains of power were analyzed: command, funding, technical assistance, and dissemination. Network cohesion and centrality measures were calculated. A qualitative analysis was conducted to qualify power relations according to ∗ gears for a successful scale-up (i.e., coordination, goals, and monitoring; advocacy; political will; legislation and policy; funding and resources; training; program delivery; communication; and research and technical cooperation). ResultsA total of 121 federal key actors and 63 local key actors were identified across networks, of which 62 and 28 were identified as OLs, respectively. Whereas the command domain of power had the highest number of key actors, the funding domain had the least. The health sector executive branch emerged as an OL across all domains of power. ConclusionsBarriers that threatened successful scale-up include the lack of coordination between domains of power, missing leadership within key actors, and lack of mechanisms to manage conflict of interest. Governance strategies to enhance multisectoral coordination and communication are needed to effectively scale-up and sustain childhood obesity strategies in Brazil.

Legacies and impacts of sports mega-events in Brazil: São Paulo as a host city for football matches

Football is an integral part of Brazil’s historical-cultural process, and tourism represents one of the segments deeply impacted by the occurrence of sporting mega-events. The present study aims to present and critically reflect on the main legacies and impacts that these events brought to the Brazilian population. This paper is based on notes surrounding the legacies put forward for the city of São Paulo. To do this, information gathering lends to suggestions that help situate future planning and organization. The purpose of this paper concerns sociocultural and economic futures and the role of tourism and events for local communities based on the current realities and challenges in Brazil. The article is based on a qualitative approach, where descriptive and explanatory information is triangulated. This study utilizes a range of methods, employing a combination of bibliographic research, documentary analysis, and content analysis to frame the base of the research. Moreover, we use field research techniques such as semi-structured interviews with managers, questionnaires administered to residents, interviews with local representatives, direct observation, and active participation in events held at the main stadium associated with sport mega-events in São Paulo, namely, the Neo Química Arena. Noteworthy findings demonstrate a discrepancy between the objectives pursued by host city planners, who strive to maximize the positive legacies encompassing local infrastructure, stadiums, and the city’s image, and the experiences reported by local residents, who have encountered negative impacts and legacies resulting from the same sport mega-event. These adverse effects include issues such as flooding, gentrification, exclusion from decision-making processes, and real estate speculation. Stadiums are considered the greatest tangible legacies of sport mega-events, although their construction and maintenance costs are questionable. The participation of local residents seems to be essential in the promotion, knowledge, appropriation, belonging, support, and transparency in all phases of the mega-event planning.

HSD114 "Value-Based Healthcare" Initiative Is like a Marathon, Not a Sprint: Achievements and Challenges in Brazil

Value-based healthcare (VBHC) has been discussed globally as a potential solution to high costs and uneven quality of care in healthcare systems. This study carried out a systematic literature review (SLR) on the advances and challenges of the theme in Brazil.

Beyond the buzzwords: some thoughts on interoperability and military change challenges in Brazil

ABSTRACT Innovation spreads not only through new technologies but also through new processes and concepts populating international and security studies. Consequently, the popularity of these concepts, extensively diffused across defence documents worldwide, does not emerge alone. Difficulties in estimating how much of them became tacit knowledge and how successfully these new processes and concepts were adopted come as a plus. That scene depicts the diffusion of “interoperability,” quickly aggregated to the defence vocabulary but arguably translated into practice, particularly from an organisational standpoint. Provided that significant challenges lie ahead of regions where the debate still requires a more solid groundwork, this study addressed Brazil’s interoperability state of the art. We performed a qualitative analysis based on the very same referential used in the country’s latest CONOPS in this regard – Tolk’s Measures of Merit in Coalition Operations Model. By doing so, we aimed to establish a dialogue with the current perspective of the country whilst showing that neglecting the organisational aspects of interoperability poses practical consequences, undermining a complete translation of this central capability into practice. We argue that interoperability adoption stands for far more than its reproduction across the defence metier, comprising organisational change underpinned by reforms in civil-military relations..

Degradation of Sludge Generated in ETEs An integral part of the Sanitation Challenge in Brazil and the Relationship between Sludge Quantity and ETE Efficiency

Degradation of Sludge Generated in ETEs An integral part of the Sanitation Challenge in Brazil and the Relationship between Sludge Quantity and ETE Efficiency

Panorama of Intimate Partner Violence Against Women in Brazil and its Association With Self-Perception of Health: Findings From a National Representative Survey.

Intimate partner violence (IPV) is a challenge in Brazil. The country holds one of the highest rates of femicide in the world, most of which are preceded by IPV. We conducted a cross-sectional study with 34,334 women, aged 18 to 59 years, from the 2019 Brazilian National Health Survey to analyze the prevalence of IPV and its subtypes among the Brazilian adult women in the last 12 months, encompassing their health consequences and the use of health services resulting from IPV. We also used logistic regression models to estimate the association of sociodemographic characteristics and self-perceived health status with IPV. The prevalence of IPV among Brazilian adult women in the last 12 months was 7.6% (95% confidence interval [CI] [7.0, 8.2]). Women aged 18 to 39 years, not married, and with income of up to 1 minimum wage (MW), had higher odds of suffering IPV. Among those who reported health consequences due to IPV, 69% reported psychological consequences, and 13.9% sought health care, mostly in primary or secondary health care services in the Brazilian Unified Health System (41.9%). Regarding the self-perceived health variables, women who reported eating problems (odds ratio [OR] = 1.29; [1.01, 1.65]), lack of interest/absence of pleasure (OR = 1.41; [1.11, 1.79]), depressive feelings (OR = 1.39; [1.03, 1.88]), feeling of failure (OR = 1.75; [1.36, 2.24]), and suicidal thoughts (OR = 1.73; [1.25, 2.41]) had greater odds of reporting IPV compared to those who did not report these same perceptions. The results show that younger, divorced or single, low-income women with eating problems and mental health disorders were more likely to suffer IPV. IPV often led to health problems, and many abused women sought support from public health services. Health professionals must be trained to identify and care for these women, thereby acting as allies in preventing and reducing IPV.

After a far-right government: challenges for Brazil's Unified Health System

After a far-right government: challenges for Brazil's Unified Health System

Temporal and spatial patterns of fire activity in three biomes of Brazil

The trade-off between conservation of natural resources and agribusiness expansion is a constant challenge in Brazil. The fires used to promote agricultural expansion increased in the last decades. While studies linking annual fire occurrence and rainfall seasonality are common, the relationship between fires, land use, and land cover remains understudied. Here, we investigated the frequency of the fires and performed a trend analysis for monthly, seasonal, and annual fires in three different biomes: Cerrado, Pantanal, and Atlantic Forest. We used burned area and integrated models in distinct scales (interannual, intraseasonal, and monthly) using Probability Density Functions (PDFs). The best fitting was found for Generalized Extreme Values (GEV) distribution at all three biomes from the several PDFs tested. We found the most fire in the Pantanal (wetlands), followed by Cerrado (Brazilian Savanna) and Atlantic Forest (Semideciduous Forest). Our findings indicated that land use and land cover trends changed over the years. There was a strong correlation between fire and agricultural areas, with increasing trends pointing to land conversion to agricultural areas in all biomes. The high probability of fire indicates that expanding agricultural areas through the conversion of natural biomes impacts several natural ecosystems, transforming land cover and land use. This land conversion is promoting more fires each year.

Public Policies for Geodiversity in Brazil

Ensuring the legal protection of geosites, or areas that have relevant geodiversity, and obtaining resources for the development of programs and actions in these territories are two of the great challenges in Brazil. This article presents an analysis of Brazilian legislation, seeking to identify the responsible bodies, sources of funds, and how each specific policy can relate to the protection and promotion of geodiversity. In addition, the proposed public policy for geodiversity, geotourism, and geoparks in the state of Mato Grosso is presented and discussed. For this, documentary research of national legislation was carried out, and existing records in the Legislative Assembly of Mato Grosso were analyzed for the Thematic Sectorial Chamber to debate the Geopark Project of Chapada dos Guimarães. The information was discussed based on a bibliographic survey with national and international references. The results show that although some geodiversity elements, such as fossils and caves, have specific legislation, there is no articulated national public policy on geodiversity that guarantees the identification, protection, and continuous management of geosites or even structural and financial support for the development of geoparks in Brazil. The creation of policies at the state or national level, aimed at establishing a managing body and permanent sources of funds, can be an important step to enable the development of actions related to the protection and dissemination of geodiversity, linked or not to geopark proposals. At the international level, the creation of a United Nations Educational, Scientific and Cultural Organization (UNESCO) convention that establishes clear bases for the dissemination and protection of geodiversity could encourage the development of policies in different countries as an international framework to guide themes.

Feasibility of an Online-Based Safety Decision Aid for Brazilian Women Living with Intimate Partner Violence: Findings from Participatory-Action Research in a One Stop Center.

Intimate partner violence (IPV) is a challenge in Brazil; the country is ranked 6th globally for femicide and one in four women experience physical and/or sexual IPV in their lifetimes. Safety decision aids (SDA) are tools for women experiencing IPV. Building upon previously developed and tested online SDA tools, we intend to adapt an SDA tool for use in Brazil. The purpose of this study was to examine the feasibility of a technology-based SDA to support Brazilian women living with IPV, tailored for the Brazilian context. Our participatory-action research approach built upon research between 2018 and 2019 at the House of the Brazilian Woman (HBW) of Curitiba, Brazil, a cross-sectoral one-stop center (OSC) providing comprehensive care for IPV survivors. Field research included observation, field notes, and in-depth interviews with twenty-eight (n = 28) participants (HBW staff and survivors). The results were grouped into four main thematic categories: advantages; uncertainties; barriers; and suggestions. The triangulated results showed that the majority of participants considered the SDA feasible, highlighting flexibility and confidentiality; information about IPV; and access to resources for formal help-seeking as advantages of the tool. Participants also expressed uncertainties about SDA’s ability to increase women’s safety and its accessibility for the most vulnerable. They made suggestions for improvement to meet the unique needs of Brazilian women. This study provided evidence on the potential of an SDA tailored for use within a comprehensive program of women survivors in Brazil. This step was crucial to inform the future implementation and evaluation.

Conservation opportunities and challenges in Brazil's roadless and railroad-less areas.

Policy and legislation rarely acknowledge the importance of keeping intact ecosystems road- and railroad-free. By modeling Brazil’s remaining roadless and railroad-less (RLRL) areas, we found that, although they hold the vast majority of the country’s remaining native vegetation (81.5%), because of their limited protection status, only 38% of Brazil’s remaining native vegetation is both protected and in RLRL areas. Current federal policy aims to develop transportation infrastructure designed with antiquated planning methods that threaten remaining intact ecosystems, while concurrently weakening the country’s hallmark environmental protections and commitments. Where Brazil builds its new roads and railroads matters for conservation planning. The occurrence of native vegetation and anthropic land use is associated, at varying degrees, to transportation infrastructure throughout most of Brazil. We highlight that by pursuing conservation opportunities in RLRL areas, Brazil could instead make impactful steps for conservation, restoration planning, and tangible progress toward achieving national and international environmental and conservation commitments.

The role of agroforestry in restoring Brazil's Atlantic Forest: Opportunities and challenges for smallholder farmers

Abstract Restoring the degraded Atlantic Forest is one of the biggest conservation challenges in Brazil. In a biome with high human presence, understanding the potential for restoration approaches, such as agroforestry, to provide benefits to smallholder farmers and biodiversity is essential in developing equitable restoration strategies. Smallholder or family farmers are essential to national food security, producing most fruit and vegetables consumed in Brazil. Their farms can also provide ecological stepping stones for biodiversity. To better understand their role in Atlantic Forest restoration, this study explores the use of agroforestry by smallholder farmers from the Movimento Sem Terra (MST), the Rural Landless Workers' Movement, in Pontal do Paranapanema. We use quantitative and qualitative data to assess farmer perceptions of the measures which support agroforestry farming, barriers to implementation and its impact on indicators of wellbeing. We find agroforestry farmers report significant benefits in 8 of 18 tested indicators. Attitudes to agroforestry are varied, but common themes emerge including the high value of tree cover for shade and cooling effects, and the difficulties in selling agroforestry products. Our results show lack of policy support and initial investment needs are the biggest constraints to agroforestry, but opportunity cost is not considered a large barrier. Tailored policies and financial measures are needed to integrate thousands of smallholder farmers into the Atlantic Forest restoration agenda, helping to reach biome restoration targets while supporting rural livelihoods and national food security. Further research is required into links between additional socio‐economic and biogeographical variables and agroforestry uptake in the region.

Occupational safety and health risk assessment and management challenges in Brazil – lessons from the AquaSafe mobile software application

Occupational safety and health risk assessment and management challenges in Brazil – lessons from the AquaSafe mobile software application

Benefícios do aleitamento materno exclusivo durante os primeiros meses de vida do recém-nascido

To have breastfeeding only until the ideal age is still an important challenge in Brazil. There are several factors that play a role in interrupting exclusive breastfeeding, from false information to difficulties in offering breast milk. However, it is up to healthcare professionals to have full mastery of aspects related to the benefits of breast milk for the health and well-being of infants and nursing mothers for better care in their follow-up. As a result, we undertook a narrative literature review, with emphasis on the main aspects and benefits of breast milk for infant health, based on 17 papers found in the Medline and SciELO databases. We selected studies that dealt with the purpose of the review, based on assessing the respective abstracts. From the review of selected studies, we found that Exclusive Breastfeeding has benefits beyond the nutritional field and offers a lower risk of developing chronic diseases such as diabetes, hypertension, obesity; and provides protection against different types of cancer to the mother. There was also a discussion that Primary Healthcare plays a key role in ensuring that infants receive breast milk for the proper amount of time. On the other hand, there are still obstacles in the promotion of quality breastfeeding, especially for mothers and infants in situations of greater social vulnerability, an aspect that must be considered in healthcare.

Physiotherapy for headaches: current situation and challenges in Brazil

Physiotherapy for headaches: current situation and challenges in Brazil