Brazilian Context Research Articles

Cost-effectiveness of mineralocorticoid receptor antagonists in heart failure with reduced ejection fraction: the brazilian case with bayesian networks and markov influence diagrams

Abstract Background Heart failure (HF) is one of the leading causes of death worldwide, with a significant burden in middle-income countries, such as Brazil. Mineralocorticoid receptor antagonists (MRAs) have been established as a cornerstone in the treatment of HF with reduced ejection fraction (HFrEF), but their adoption has faced obstacles. Until recently, spironolactone was the only MRA available in Brazil, with restricted use due to associated side effects, such as gynecomastia and hyperkalemia. However, the introduction of new MRAs, such as finerenone and eplerenone, has the potential to change the therapeutic landscape. Understanding the cost-effectiveness of these agents in the Brazilian healthcare context is essential to optimize HF management. Methods A Bayesian Network approach complemented by Markov Influence Diagrams was employed to estimate incremental cost-effectiveness ratios (ICERs), presented in international dollars (Int$) gained per quality-adjusted life year (QALYs). Discontinuation rates for MRAs were incorporated into the model, reflecting real-world clinical practice, along with a 5% annual discount rate for both costs and effectiveness. To inform our model, a comprehensive systematic review was conducted, followed by a network meta-analysis (NMA) to assess the comparative effectiveness of ARMs. Data on incident cardiovascular outcomes were derived from a Brazilian real-world cohort of 1,098 patients with HFrEF. All cost assessments were made from the perspective of the Brazilian public health system, with values converted to Int$. Results The NMA highlighted that spironolactone [HR:0.75 (95%CI 0.67-0.84)], eplerenone [HR:0.84 (95%CI 0.77-0.93)] and finerenone [HR:0.90 (95%CI 0.82-0.98)] significantly reduced the relative risk of all-cause mortality compared to no MRA utilization. Notably, eplerenone significantly reduced hospitalizations due to HF [HR:0.60 (95%CI 0.41-0.90)] compared to no MRA therapy, with spironolactone and finerenone showing HRs of 0.68 (95%CI 0.40-1.17) and 0.83 (95%CI 0.59-1.15) . The analysis also revealed a notably higher risk of MRA discontinuation for finerenone (22%) and spironolactone (51%) compared to eplerenone. In cost-effectiveness comparisons, finerenone was dominated by alternatives, while eplerenone exhibited an ICER of Int$2,614 (95%CI 1,851-3,470)/QALY when compared to spironolactone. Both spironolactone and eplerenone emerged as cost-effective options when compared to no MRA therapy, with eplerenone being particularly favorable below the willingness-to-pay threshold of Int$8,900 per QALY. Conclusions In the Brazilian healthcare context, eplerenone will likely be the most cost-effective MRA compared to spironolactone, offering both a reduction in HF-related hospitalizations and a lower discontinuation rate. These findings underscore the value of integrating cost-effectiveness analyzes into healthcare decision-making processes.

Evaluation of the measurement properties of the parental perceptions of children's exposure to tobacco smoke instrument translated and adapted to the Brazilian context.

Given the need to measure parents' perceptions of their children's exposure to tobacco smoke, the Parental Perceptions of Children's Exposure to Tobacco Smoke (PPE) instrument was developed and validated in Hebrew and later translated into English and Portuguese. The PPE has already been translated and adapted to the Brazilian context but a more robust sample is necessary to investigate the measurement properties. Thus, this study evaluated the measurement properties of the Brazilian version of the PPE instrument. Reliability and validity study were conducted with 161 parents with children up to 18 years of age. Perception of parental smoking status was investigated using analysis of variance. The instrument showed excellent reliability (Cronbach α = 0.92 and intraclass correlation coefficient = 0.91). The exploratory factor analysis identified 4 factors with a total accumulated variance of 71.6%. Confirmatory factor analysis validated this structure with 4 factors. It was necessary to exclude a question that presented low commonality. Analysis of variance demonstrated that nonsmoking and former smoking parents have similar scores, although they are higher than those of current smokers. Our findings provide evidence that the PPE version translated and adapted for the Brazilian context is a reliable and valid instrument. Thus, it can help us understand how parents cope with exposure to tobacco smoke.

Is psychoanalysis a science? An answer in light of scientific pluralism

This paper explores the longstanding debate on whether psychoanalysis qualifies as a science. Grounded in the Brazilian context, where recent publications have revived the debate, I examine the demarcation problem in the philosophy of science, highlighting how traditional criteria for defining scientific knowledge may exclude epistemically fruitful practices, such as psychoanalysis. Drawing on the perspectives of scientific pluralism, I argue for a more inclusive understanding of science, where diverse methods and epistemological approaches are recognized as legitimate contributions to addressing complex phenomena such as mental health. Ultimately, the rigid application of demarcation criteria can obscure the value of psychoanalysis, whereas scientific pluralism offers a pathway for integrating it into broader scientific discourse.

Ensino do Building Information Modeling (BIM) em Instituições de Ensino Superior no Brasil

Building Information Modeling (BIM) has emerged as a necessary tool in the architecture, engineering, construction and operations scenario, offering an innovative and integrated approach not only for project development, but also contributing to the construction management and maintenance of buildings. . In the Brazilian context, academia has dedicated special attention to BIM, reflected in the production of theses and dissertations carried out over the last few years. This research aimed to identify the main trends and pedagogical approaches used in the productions found, presenting their strengths and advances verified in the use of this methodology, as well as the weaknesses or limiting points, based on Brazilian academic production on teaching BIM in the period from 2013 to 2020, resulting from the analysis of theses and dissertations published in the CAPES Catalog of Theses and Dissertations, which address the topic of Construction Information Modeling or Building Information Modeling in the dimension of its teaching. classifies as applied, exploratory, with a qualitative approach, using the bibliographic research method and application of the content analysis technique. It is hoped that, through the results obtained, the adoption of the BIM methodology in undergraduate courses in architecture and urbanism and related areas can be encouraged in the country.

Cross-cultural linguistic adaptation and development of three alternate forms of the Free and Cued Selective Reminding Test to the Brazilian context: The role of word familiarity

In spite of its importance, studies presenting detailed development procedures of alternate forms of verbal memory paradigms remains limited and unclear in terms of word selection criteria, while failing to consider word familiarity factors, despite its crucial role on episodic memory retrieval and encoding mechanisms. The present study aims to present the cross-cultural linguistic adaptation and development procedures of alternate forms of the Free and Cued Selective Reminding Test to the Brazilian context (FCSRT) based on word familiarity. After translation and backtranslation procedures, 231 new words were gathered and underwent a step-by-step familiarity analysis. Initially, overall familiarity feel of each word was assessed through the Familiarity Form (FF) during phase 1, and exposure frequency to words were later assessed through the Familiarity Questionnaire (FQ) completed by healthy controls during phase 2 with the remaining words considered ambiguous in terms of familiarity. Three alternate forms of the FCRST were then developed and assessed in terms of familiarity by the FQ during phase 3, and later administered in healthy control groups during phase 4. Repeated measures analysis revealed no significant differences in terms of familiarity and memory performance among the developed forms. Limitations are discussed, and recommendations are offered for future studies.

Brazilian version of the Appearance Schemas InventoryRevised (ASI-R)

The present study investigated the psychometric properties of the Brazilian adaptation of the Appearance Schemas Inventory-Revised (ASI-R) with adults. We translated the ASI-R, and determined its psychometric properties among two community samples, totaling 843 participants (402 men and 441 women), aged from 18 to 67 years. Six hundred and six participants were recruited online (SurveyMonkey Database), and the remaining were personally recruited from universities, technical schools, and libraries. Exploratory and confirmatory factor analysis indicated that the 13-items Brazilian ASI-R had the same factor structure as the original ASI-R: Self-evaluative and Motivational investment. Internal consistency ranged from .83 to .89, and test-retest reliability indices ranged from .74 to .77. Concurrent and convergent validity was demonstrated by the significant correlations between the ASI-R subscales and body satisfaction, internalization of beauty ideals, disordered eating, and self-esteem. Availability of a Brazilian Portuguese translation of the ASI-R should help to promote greater understanding of body image investment in the Brazilian context.

ASSOCIAÇÃO DE PROTEÇÃO ASSISTÊNCIA AOS CONDENADOS: DESAFIOS E PERSPECTIVAS DO MÉTODO COM OS RECUPERANDOS

This study examines the role of social workers in the Associations for the Protection and Assistance to the Convicted (APACs), exploring the challenges and perspectives of the humane method proposed by these institutions within the Brazilian penal context. Historically, the conventional prison system in Brazil has been characterized by overcrowding, violence, and inhumane conditions, reinforcing the need for alternative methods of resocialization. APACs emerge as an innovative alternative, proposing a penal execution model centered on human dignity and the social reintegration of the convicted. The work of social workers in APACs is multifaceted, ranging from psychosocial support to the implementation of educational and professional training programs. However, these professionals face significant challenges, such as a lack of resources, institutional resistance, and the stigmatization of convicts by society. The research employs a mixed methodological approach, including a literature review and interviews with social workers in APACs, to investigate how these professionals contribute to promoting social reintegration and what innovations can be adopted to optimize their practices. The results indicate that despite the difficulties, the role of social workers is crucial to the success of the APAC method, highlighting the importance of a holistic and personalized approach that respects the dignity of the convicted and promotes effective and humane resocialization.

Política social de Assistência Social e a garantia de direitos sociais: entre ambiguidades e contradições

The field of Social Policies, with special attention to Social Assistance, continues to be a subject of investigation in the peripheral areas of capitalist centers. This study aims to explore the contradictions present in the interaction between social assistance policies and social rights. To this end, it adopts an approach that conceives of social policy as a process influenced by the historical conditions of capitalism and class struggles. It highlights the determining role of the state and capitalism in the formulation of social policies and their incorporation into the realm of social rights, especially in the Brazilian context, where only since the 1988 Federal Constitution has social assistance become a state policy, assuming responsibility for guaranteeing and providing social rights and social protection. The aim of the article is to problematize the perspective of rights in the Brazilian capitalist state and in the National Social Assistance Policy (PNAS), proposing an analysis of a materialist-historical-dialectical nature. The text adopts the structure of a theoretical essay, beginning with a reflection on the capitalist state and social policies, and then addressing the interrelationship between the state, law and social policies, characterized by contradictions inherent to the preservation and perpetuation of capitalism. The conclusion is that the reasons for the state's difficulty in guaranteeing social rights lie in the fact that the relationship between the state, law and social policies is marked by contradictions, since social assistance seeks to guarantee rights in the legal system, which, in turn, are also geared towards the maintenance and reproduction of capitalism.

Projeto de extensão: resgatando sorrisos

The article addresses restorative and aesthetic dentistry, highlighting the importance of adhesion of materials to mineralized dental tissues. The philosophy of minimally invasive restorative treatment is based on principles of prevention and maximum preservation, with minimal intervention in dental structures. Dental aesthetics are subjective, influenced by several factors, and despite advances in aesthetic materials, the need for clinical evaluations on the behavior of composite resin restorations is increasing. In the Brazilian context, where the provision of government dental treatment is limited, perceived need becomes an important predictor of the use of dental services. There is a significant demand for restorative dentistry procedures, often performed by undergraduate and postgraduate students. The article highlights the creation of an Orthodontics Extension Project to deal with repressed demand, although new activities are necessary. It is concluded that initiatives such as extension projects are essential to mitigate the lack of care for the population and prepare academics for clinical practices in restorative dentistry.

Strengthening the Human Rights Guarantee System in the Management of Migrant Policies in Brazil

Objective: This study aimed to conduct a bibliographic survey of scientific productions that deal with migration governance throughout the national territory. Theoretical Framework: Supported by the theoretical and methodological assumptions of dialectical historical materialism, this article is part of the results of a post-doctoral internship that discusses the strengthening and defense of the rights of migrants in Brazil. Method: As a procedure for collecting this data, a time frame of research from the last ten years (2014-2024) was used. For this purpose, a survey of scientific production in Brazilian postgraduate programs indexed in the BDTD (Brazilian Digital Library of Theses and Dissertations) was carried out. The analysis, in turn, was based on the ten dimensions of migration governance, developed by the International Organization for Migration (IOM) adapted to the Brazilian context. Results and Discussion: The results revealed that although there is an effort by municipalities and states to try to strengthen the guarantee of rights to migrants, there are still gaps and difficulties in ensuring them. There is fragmentation in the provision of services to migrants and difficulties for sectoral policies to carry out integrated and cross-cutting actions. Few studies discuss the institutional structure of migration governance, that is, the strategic organization of public policies in order to strengthen the guarantee of the rights of migrants. Research Implications: The importance of this study lies in organizing and producing materials to support professionals who work to promote the human rights of migrants in the country. Originality/Value: Considering that the management of migration and migrant policies is still under construction, this research contributes to thinking about ways to ensure the rights of migrants through effective migration governance.

Cross-cultural adaptation and psychometric evaluation of the Emergency Medical Services Safety Attitudes Questionnaire in the Brazilian context

Cross-cultural adaptation and psychometric evaluation of the Emergency Medical Services Safety Attitudes Questionnaire in the Brazilian context

Overview of Publications on Payment for Environmental Services: Focus on Brazilian Contributions

Objective: This study aims to analyze publications on Payment for Environmental Services (PES), with a focus on Brazil's leadership and the evaluation of case studies, empirical and theoretical research in the Web of Science and SciELO databases up to April 2024. Theoretical Framework: PES is discussed as a tool for environmental conservation and sustainable development, emphasizing challenges such as social inclusion and participatory governance. Method: A systematic literature review was conducted, focusing on publications indexed in the Web of Science and SciELO databases up to April 2024. The exploratory research employed both quantitative and qualitative methodologies in data analysis. Results and Discussion: The analysis revealed that Brazil plays a prominent role in PES publications, both nationally and internationally. Within the Brazilian context, the states of São Paulo and Minas Gerais stand out, with the Conservador das Águas project in Extrema frequently cited in the literature. Research Implications: The results provide a foundation for the development of public policies aimed at expanding PES initiatives in Brazil. Mapping existing projects can encourage the replication of best practices and foster research in underexplored areas, promoting climate mitigation strategies. Originality/Value: This study contributes to the literature by identifying and mapping PES projects, providing valuable insights for the formulation of strategies aimed at improving climate conditions.

The use of photobioreactors in façades for decarbonization process

The paper deals with the application of microalgae in building’s façade, regard to the broader project comprising the aspects of the environmental comfort of academic spaces and the energy consumption with on-grid photovoltaic generation, as well as the investigation of alternatives for the improvement of the performance of the building envelopes. Thus, its main objective is the application of interdisciplinary concepts involving Architecture and Biotechnology, as known by Black Ecologies, referring to an investigative interest to explore a new approach of nature, not only related to architectural space, but an emergent environmental focus. This relationship is performed by using photobioreactors with microalgae, installed on the façades of buildings for educational use. The present work presents the methodological outline of the research, based on literature review and case studies; complementary experimental methodologies are also presented to contextualize the subject and its application and feasibility. The current state of art showed an emergent approach in terms of international level, but in the Brazilian context any further research was identified yet. In addition to thermal and energy performance, the strategies will allow the process of sequestration of carbon dioxide and other GHG (greenhouse gases) that impacts on the process of climate change and can contribute to reach the sustainable development. This subject coincides with the discussions of the 2050 scenarios and emission reduction, which were faced at the recent COP-27 and its connections with an integrative way to contribute to the United Nations Sustainable Development Goals.

Translation and cross-cultural adaptation of the Posthumous Dignity Therapy Schedule of Questions to Brazilian Portuguese.

Dignity Therapy (DT) is a brief form of psychotherapy that helps people with life-threatening illnesses and their loved ones cope with emotional pain and demoralization. Unfortunately, not everyone has the opportunity to receive DT during their lifetime. Posthumous Dignity Therapy (PDT) was then devised to be administered to bereaved family members. However, PDT has not yet been validated or studied in the specific cultural and linguistic context of Portuguese-Brazilians. This study aims to fill this gap by validating PDT for the Portuguese (Brazilian) context. Using Beaton's methodology, including the processes of translation, synthesis, back-translation, evaluation by an expert committee, and pre-testing, the PDT Schedule of Questions underwent validation and cultural adaptation. The research was conducted in a Palliative Care Unit at a tertiary cancer hospital in Brazil. The questionnaire was translated, back-translated, and evaluated by the panel of experts, obtaining a Content Validity Index of 0.97. During the pretest phase, it was observed that the participant's interview method needed to be changed from remote (telephone or videoconference) to in-person. Additionally, it was necessary to modify some terms related to death and dying, as they caused discomfort to the participants. As a result of this process, the PDT was modified, and adapted to the Brazilian cultural and linguistic reality. This validation study will be significant for future DT research from the caregivers' perspective and for projects aiming to implement this therapeutic modality in palliative care units, in addition to helping participants remember their loved ones better by providing a tangible legacy document that assists them emotionally and materially in coping with the grieving process.

A IMPORTÂNCIA DA FORMAÇÃO CONTINUADA PARA PROFESSORES NA EDUCAÇÃO BÁSICA

This study addresses continuing education for teachers, which is highlighted as an essential process for improving knowledge. Continuing education for teachers is currently seen as a process for improving knowledge, involving actions directed at professionals who educate, teach, learn, research, and evaluate. This study aimed to discuss continuing education for teachers within educational policies in Brazil, emphasizing its importance and analyzing the current Brazilian educational context. The methodology was based on bibliographic research, using Google Scholar as the main source. The results make it clear that this review article can intensify the reflection on the importance of continuing education in Brazil, exposing its relevance for a deeper understanding of the educational reality and the teaching-learning process. Continuing education appears as a decisive tool, supporting the work of teachers and driving the evolution of teaching and learning. It is known that the teacher is not a finished product, but a subject in constant transformation, requiring continuous improvement to face the challenges of modern education. Therefore, each teacher must be an eternal learner, breaking with stagnant traditions and embracing a journey of continuous innovation, as only in this way will we be able to transform the Brazilian educational scenario, propelling it towards new spheres of excellence and relevance.

"BECAUSE WE ALSO HAVE OUR RIGHTS”: PHYSICAL-SPATIAL TRANSFORMATION WITH CHILDREN FROM MORRO DO PAPAGAIO

Although child participation in decision-making is a recognized right, children are often excluded from decision-making processes that will affect the quality of their lives, including those related to urban issues. In the Brazilian context, there is a lack of studies aimed at understanding child participation in the transformation of public spaces. This study aims to explore the repercussions of a physical-spatial transformation involving children aged 9 to 10 years, residents of the Morro do Papagaio favela (Belo Horizonte, Brazil). To this end, interviews, photo-elicitation, and participant observation were conducted. Inductive thematic analysis of the data revealed the value of physical-spatial transformation as a practice that enables the exercise of children's rights to participation, sociability, play, freedom, education, use of public spaces, beauty and well-being. Identifying how children experience public spaces in the favela became crucial to understanding how transforming spaces with children can promote their citizenship.

Profiles and motivations of disaster volunteers: a proposed framework in the brazilian context

Purpose: Environmental disasters have caused various human, ecological, and economic damage worldwide. To reduce the potential damage and save lives in the short term, the volunteers are involved in support in disaster situations. Given this scenario, studies on volunteers who work in disaster contexts in Brazil proved to be an interesting and necessary research topic. Design/methodology/approach: This research employed a qualitative methodology, utilizing 16 semi-structured, in-depth interviews to gather data. The process of selecting participants was carried out through the snowball sampling technique, focusing on individuals volunteering in disaster response within the Brazilian setting. Following data collection, a thorough content analysis was undertaken. The motivations uncovered through this analysis were then meticulously compared and contrasted against the Volunteer Functions Inventory (VFI), which is rooted in the psychological functionalist theory of volunteerism. Findings: The findings of this study advance the literature by confirming four motivations for volunteers to act in disasters, as identified in the VFI: values, enhancement, protective, and social. Additionally, this study contributes by bringing to light two new motivations, knowledge, and readiness, which emerged from the content data analysis. The study also advances by clustering the behavior profiles determined from these motivations as expert, sensitive, altruistic, beginner, and social. Originality/value: Based on the results, a Disaster Volunteer Framework was proposed, which serves as a basis for developing public policies for the government and assists institutions that work in disaster management in attracting new volunteers.

Unsupervised Change Detection Methods Applied to Landslide Mapping: Case Study in São Sebastião, Brazil

ABSTRACTLandslides represent a growing global geological hazard, further intensified by climate‐induced changes. Remote sensing data, through its capacity for repetitive collection and change detection techniques, that compare and quantify the spatio‐temporal alterations over time, plays a critical role in landslide detection. Considering the February 2023 São Sebastião event and Sentinel‐2 imagery, we assessed diverse unsupervised change detection techniques, encompassing both traditional and recent machine learning‐based approaches. Notably, the Floating References (FR) and Homogeneous Blocks Single‐class Classification (HBSC) methods outperform classic approaches and deliver the most accurate results with F1‐Score and kappa coefficient exceeding 0.96 and 0.92, respectively. These outcomes demonstrate the efficacy of machine learning in automating landslide delineation and underscore the necessity of meticulous data and parameter selection in achieving high‐accuracy automatic landslide mapping. Lastly, this study fills a significant gap in the existing literature by evaluating unsupervised change detection methods for landslide mapping within the Brazilian context.

Nursing procedures for assisting victims of violence in emergency units

The objective of this study was to carry out the cross-cultural adaptation of the Questionnaire on Preservation of Traces in Victim Assistance by Nurses to the Brazilian reality. The method used was composed by the steps: (1) semantic equivalence; (2) idiomatic equivalence; (3) empirical equivalence; (4) conceptual equivalence; and (5) pre-test. Based on the experts' analysis and recommendations, adjustments were made regarding semantic and empirical equivalence; during the assessment of idiomatic and conceptual equivalence, no changes were made. The pre-test was performed with 24 nurses and the value of Cronbach's alpha coefficient was α = 0.973. The instrument's feasibility assessment showed that most participants found it easy to understand the questionnaire's instructions and questions and mark the answers, which demonstrates its validity with the sample in the pre-test. The performance of the forensic nurse is essential in emergency services. The adapted instrument is valid for use in the Brazilian context.

Virtual reality hindrances in industrial training program: a Grey-DEMATEL analysis

PurposeThis study aims to analyze the relationship between users’ perceived barriers to using virtual and augmented reality technology from stakeholders, identifying perspectives and gaps regarding technology acceptance.Design/methodology/approachThe Decision-Making Trial and Evaluation Laboratory method is useful for quantitatively evaluating the causal relationship between factors. Combining this method with the grey approach ensures greater accuracy even with limited information. A Scoping Review was conducted to identify the barriers, and data were extracted from a questionnaire administered to experts in the field.FindingsSeven diverse barriers were identified by users, and cause-and-effect relationships were estimated. The results indicate three primary causal barriers and three highly dependent barriers. One of the identified barriers is not relevant in this model.Originality/valueVirtual and augmented reality technologies have been gaining popularity since 2018, allowing users to interact with a virtual environment. These technologies are primarily used in training and education areas. However, due to the innovative nature of the topic, there are a small number of studies on technology acceptance, especially in the Brazilian context. Therefore, this paper contributes to the literature and assists in applying technologies in industries.