Brazilian Population Research Articles

Psychometric Evaluation of the Medical Outcomes Study Social Support Survey in Brazilian Older People Psychometric Evaluation of MOS-SSS.

To evaluate the psychometric properties of different factorial models of the Medical Outcomes Study Social Support Survey (MOS-SSS) and screen the frequency of social support in older Brazilians. Methodological study. Five factorial models of the MOS-SSS were tested for their validity and reliability using three Brazilian samples from different locations in the country. The factorial invariance was assessed across locations using multigroup analysis. The global average score was calculated. A total of 1574 older people participated in the study. For all models, there was adequate factorial and convergent validity and good reliability; the discriminant validity was not achieved. Therefore, a second-order hierarchical model was proposed and showed validity, reliability and invariance across samples. In the three Brazilian samples, participants presented high frequency of social support. A second-order hierarchical model was fitted the Brazilian samples, allowing the calculation of the global score of social support, which was high among the participants. The MOS-SSS assesses social support levels among older individuals in community or clinical settings. Nurses can tailor interventions based on scale outcomes for personalised care for older people.

Determinants of the consumption of ultra-processed foods in the Brazilian population.

This article aims to evaluate the sociodemographic determinants of ultra-processed foods (UPF) consumption in the Brazilian population ≥ 10 years of age. The study used data from the personal and resident food consumption module of the Family Budget Surveys, grouping foods according to the NOVA classification of food processing. The classification and regression tree (CART) was used to identify the factors determining the lowest to highest percentage participation of UPF in the Brazilian population. UPF accounted for 37·0 % of energy content in 2017-2018. In the end, eight nodes of UPF consumption were identified, with household situation, education in years, age in years and per capita family income being the determining factors identified in the CART. The lowest consumption of UPF occurred among individuals living in rural areas with less than 4 years of education (23·78 %), while the highest consumption occurred among individuals living in urban areas, < 30 years of age and with per capita income ≥ US$257 (46·27 %). The determining factors identified in CART expose the diverse pattern of UPF consumption in the Brazilian population, especially conditions directly associated with access to these products, such as penetration in urban/rural regions. Through the results of this study, it may be possible to identify focal points for action in policies and actions to mitigate UPF consumption.

Mobile street clinics and harm reduction: pathways to provide care to homeless people in Brazil

Abstract Homeless people (HP) are defined as a heterogeneous group that lives in extreme poverty, with weakened or severed family ties, lacking access to conventional housing, and using public spaces as residence. In terms of health, mental health conditions are prominent as a primary treatment demand, with care aimed at addressing needs arising from the use of alcohol and other drugs being a priority in serving HP. In this context, mobile street clinics (MSC) provide health services directly in street environments, focusing on individuals who use alcohol and other substances through harm reduction approaches. Harm reduction is defined as a set of practices aimed at minimizing the adverse health effects of alcohol and drug use without necessarily eliminating usage. Moreover, it represents an ethical and political direction in care, confronting the logic of criminalization and compulsory abstinence, enhancing access to health care for alcohol and other drug users through strategies that foster autonomy development. In the current study, we conducted an integrative review assessing the facilitators and barriers for HP access to mental health services. Preliminary results indicated that MSC, the connection between healthcare workers and the HP they serve, and the implementation of local street-based actions were the main facilitators of access for individuals who engage in harmful use of alcohol and other drugs to mental health services. Conversely, stigma, services’ lack of adjustment to the lifestyles of homeless people, and excessive bureaucracy were identified as the principal barriers of access. MSC, through their harm reduction activities, have emerged as a potential care technology to facilitate access to health services for homeless people. This research aims to present harm reduction as an ethical and political direction of care through the actions of mobile street clinics, as a way to facilitate access to health services for the homeless people. Key messages • Homeless people require mental health care tailored to the use of alcohol and other drugs, and harm reduction strategies implemented through mobile street clinics prove to be an effective form of care. • Mobile street clinics and harm reduction are important care technologies that enhance access to health services for the homeless population.

Interethnic validation of an artificial intelligence algorithm for prediction of atrial fibrillation using sinus rhythm electrocardiogram

Abstract Background Previous research has demonstrated acceptable diagnostic accuracy of artificial intelligence (AI)-enabled sinus rhythm (SR) electrocardiogram (ECG) interpretation for identifying paroxysmal atrial fibrillation (AF). However, interethnic validations of the AI algorithms have not been widely conducted. Purpose We aimed to develop our own AI model for the identification of paroxysmal AF based on SR ECGs in the Korean population and to validate its diagnostic performance in Brazilian citizens. Methods We trained a Transformer-based vision network on 90% of a dataset comprising 808,194 ECGs from 121,282 patients at Seoul National University Bundang Hospital (2003-2020). The remaining 10% of the dataset was used for internal validation. The model was trained to compute a risk score for paroxysmal AF or new-onset AF within 2 years. External validation was conducted using non-AF ECGs from the CODE 15% dataset provided by the Telehealth Network of Minas Gerais, Brazil. Results In internal validation, our AI model achieved an Area Under the Receiver Operating Characteristic Curve (AUROC) of 0.911 (95% CI: 0.902 - 0.921), with a sensitivity of 78.1% and a specificity of 89.0%. Subgroup analyses showed an AUROC of 0.893 (95% CI: 0.876 - 0.909) for patients in routine health checkups or outpatient settings, and 0.854 for patients with "Normal ECG" interpretations. In external validation with the CODE 15% dataset, the AI model exhibited an AUROC of 0.884 (95% CI: 0.869-0.900), which increased to 0.906 (95% CI: 0.893-0.919) when adjusted for age and sex (Figure 1). In the subset of patients with "Normal ECG" interpretations, the AUROC was 0.826 (95% CI: 0.769-0.883), increasing to 0.861 (95% CI: 0.814-0.908) after applying the same adjustments. Conclusions Our AI-powered SR ECG interpretation model demonstrated excellent diagnostic performance in predicting paroxysmal AF, with valid performance in the Brazilian population as well. This suggests that the model has potential for broad application across different ethnic groups.Figure 1

Clinical and laboratorial profile of patients with ATTR cardiomyopathy: comparison between wild type and p.Val142Ile forms in the Brazilian population

Abstract Background In Brazil, besides the wild type (wt) form, transthyretin amyloid cardiomyopathy (ATTR-CM) is predominantly caused by hereditary form with Val142Ile mutation. Considering that both forms occur in elderly people, the clinical presentation may be similar. We sought to compare the clinical presentation of patients with wt and Val142Ile mutation in a Brazilian cohort of ATTR-CM patients. Methods Among the 642 patients enrolled in REACT/SP, 283 presented ATTR-CM, being 85 wt and 90 Val142Ile patients. We compared the main clinical characteristics between groups. Results The wt in comparison to Val142Ile patients, respectively, presented: older age (78.4+/-8.5 vs 74.2+/-8.1 y.o., p = 0.0009); similar proportion of males (82% vs 81%, p=0.85); lower proportion of blacks (11% vs 39%, p=0.0001); similar prevalence of heart failure (HF) symptoms (85% vs 79%, p=0.33); higher prevalence of syncope (13% vs 2%, p=0.008) and Pacemakers (PM) implantation (8% vs 1%, p=0.027); similar prevalence of neuropathy manifestations (38% vs 51%, p=0.17); lower creatinine (1.5+/-0.8 vs 2.1+/-2.1 mg/dL, p=0.02) and NT-ProBNP levels (2860.0+/-2843.3 vs. 5488.3+/-5455.6 pg/ml, p=0.0001); reduced interventricular septal thickness (15.6+/-3.3 vs 17.0+/-3.3 mm, p= 0.006), posterior left ventricular (LV) posterior wall thickness (14.2+/-2.4 vs 16.2+/-4.4 mm, p=0.0003), higher LV ejection fraction (52.0+/-10.1 vs 48.2+/-13.6%, p=0.038), higher global LV longitudinal strain (8.6+/-8.7 vs 3.4+/-9.8, p=0.0003), smaller LV diastolic diameter (45.9+/-6.1 vs 43.0+/-7.3 mm, p=0.005) at 2D-Echocardiogram. Conclusions In the Brazilian population wt and Val142Ile patients had similar clinical presentation regarding HF and neuropathy symptoms, but higher prevalence of syncope and PM in wt patients. Conversely, Val142Ile patients presented more severe amyloid cardiac infiltration.

Peak oxygen pulse response during maximal cardiopulmonary exercise testing on a treadmill: applicability analysis of the FRIEND registry prediction equation in a Brazilian healthy sample

Abstract Background Peak oxygen uptake (VO2peak), measured by cardiopulmonary exercise test (CPET), is an established variable for prognostic assessment. Other VO2peak-derived variables, such as the peak oxygen pulse (peakO2pulse), also provide valuable information for risk stratification in patients with cardiac diseases. For individualized assessment, the measured peakO2pulse can be compared to reference standards using predictive equations, such as the FRIEND Registry [peakO2pulse = 23.2 – (0.09 × Age) – (6.6 × Sex (female:1; male: 0)]. However, the applicabilty of this equation in a Brazilian population sample has never been evaluated. Purpose To conduct an external validation of the FRIEND registry prediction equation for treadmill peakO2pulse in a sample of healthy Brazilian individuals. Methods Cross-sectional study involving subjects assessed by treadmill CPET in the Brazilian Midwest region from January 2011 to March 2020. Inclusion criteria: healthy individuals aged ≥ 20 years with a peak respiratory exchange ratio ≥ 1.00. Exclusion criteria: history of cardiovascular or pulmonary disease, presence of cardiovascular risk factors (hypertension, diabetes mellitus, current smoking, and obesity), and abnormalities on CPET. Variables were described as median and interquartile range (IQR). Statistical comparisons between measured and predicted values were conducted using the Wilcoxon signed rank test, including the calculation of the median differences and the 95% confidence interval (CI). Furthermore, Bland-Altman agreement analysis was utilized to assess the concordance between measured and estimated values. Results A total of 7,843 CPETs were performed. After applying inclusion and exclusion criteria, 3,544 assessments were included (1,574 females and 1,970 males) aged between 20 to 80 years. In the females, the median and IQR of measured peakO2pulse and predicted values were 10.4 (9.0; 12.1) and 13.1 (12.3; 13.7) ml/beat, respectively. This difference was statistically significant (p &amp;lt; 0.001), with a median difference of 2.54 mL/beat (95% CI: 2.40; 2.69). For males, the measured and predicted values were 17.3 (15.1; 19.7) and 19.7 (19.0; 20.2) ml/beat, respectively. The median difference was statistically significant at 2.26 mL/beat (95% CI: 2.11; 2.46) (p &amp;lt; 0.001) (Figure 1). Bland-Altman agreement analysis indicated a bias of 2.33 mL/beat (95% limits of agreement: -2.17 to 6.83) in females and 2.15 mL/beat (95% limits of agreement: -4.34 to 8.65) in males (Figure 2). Conclusions The study reveals that measured median peakO2pulse values are consistently lower than predicted across both sexes, highlighting a significant bias, which limits the applicability of the FRIEND registry prediction equation in the Brazilian population and underscores the international heterogeneity of the variable. The findings advocate for the development of region-specific reference standards to enhance accuracy in predicting peakO2pulse values.

Lipoprotein(a) and atherosclerotic cardiovascular disease in a Brazilian tertiary hospital population

Abstract Background/Introduction Elevated levels of lipoprotein(a) [Lp(a)] are a strong risk marker of atherosclerotic cardiovascular disease (ASCVD), including myocardial infarction (MI), ischemic stroke, and peripheral arterial disease, as well as of aortic valve calcification and stenosis. However, few studies have assessed the prevalence of high Lp(a) levels in patients followed at a tertiary hospital specialized in cardiovascular diseases (CVD). In addition, there is scant information about Lp(a) concentrations in Brazilian individuals. Purpose The aim of the study was to describe the demographic characteristics and comorbidities of patients with at least one measure of Lp(a) at a tertiary treatment center for CVD in our city – Brazil. Methods Patients treated at a heart institute had their data extracted between the years 1999 and 2021. Data were obtained through direct electronic extraction of patients' medical records. The patients were categorized according to different Lp(a) cutoff levels (&amp;gt; 50 and &amp;lt; 70, &amp;gt; 70 and &amp;lt; 90, and &amp;gt; 90 mg/dL) and by quartiles. Results Of 4,970 unique patients included in the study, the mean age at baseline was 59.9 years (SD ± 14.5), 2,634 (53%) were male, and the median Lp(a) was 23.2 mg/dL (interquartile range 8.9 - 56.8 mg/dL). In the whole cohort, 460 (9.3%) had Lp(a) &amp;gt; 50 and &amp;lt; 70, 344 (6.9%) &amp;gt; 70 and &amp;lt; 90, 612 (12.3%) &amp;gt; 90 mg/dl and 138 (2.8%) &amp;gt; 150 mg/dL. Established ASCVD was reported in 1,223 (24%) of the individuals, with a progressively higher prevalence across the Lp(a) categories above (31.2%, 33.8%, 34.2%, respectively) (table 1). Moreover, the Lp(a) median (interquartile range) in mg/dL was significantly higher in those with baseline history of ASCVD (31.4 [10.8-71.2] vs 21.2 [8.3-52]), MI (27.8 [10.6-65.9] vs 22.3 [8.5-54.7]) and stroke (24.9 [10-69.5] vs 23.1 [8.9-56.5]), all p &amp;lt; 0.05 (table 2). Lp(a) was also significantly higher among those with LDL-C ≥ 100 mg/dL relative to LDL-C &amp;lt; 100 mg/dl (25.5[9.5-63.2] vs 21.4[8.4 vs 52.2] p &amp;lt; 0.05). Conclusions In this cohort of patients followed at a tertiary center specialized in CVD, approximately a third had Lp(a) levels above 50 mg/dL, a cutoff robustly associated with ASCVD. This finding likely represents an important source of cardiovascular residual risk, particularly in those with established ASCVD, exposing the need of further therapies.

Echocardiographic left and right ventricular strain reference values and their associated characteristics in a healthy adult population from the ELSA-Brasil Study

Abstract Background/Introduction Impaired left ventricular (LV) systolic function is a well-known predictor of cardiovascular morbidity and mortality. Global longitudinal strain (GLS) analysis has been shown a robust measure to detect early systolic dysfunction and a prognostic parameter beyond traditional echocardiographic systolic parameters. Standard reference values for echocardiography measures have been established by echocardiography societies. However, these data may not accurately represent diverse world populations. Purpose We aimed to describe, from a Brazilian multiethnic population, age and sex-specific reference values for left (LV) and right ventricles (RV) GLS in a sample free of cardiovascular disease and risk factors, and to describe the impact of these risk factors according to GLS distribution. Methods ELSA-Brasil is a prospective cohort to investigate cardiovascular disease and diabetes including 15,105 participants aged 35 to 74 years. A predefined representative randomly selected sample with echocardiographic exam was included. We categorized the sample in tertiles according to severity of LV and RV systolic function measured by GLS, and applied trend tests across ordered groups to illustrate the association between GLS and demographic characteristics and echocardiographic measures of cardiac structure and function. Results In the study population (n=527), the mean age was 50.2 years and 59% were women. The overall mean value of LVGLS was -19.0 ± 2.4%, while the mean value of RVFWLS was -28.35 ± 3.06%. Women had higher absolute values of LV and RV GLS compared to men. Conclusion Our study provided the reference ranges for LV and RV GLS in a large middle-aged healthy Brazilian sample, with sex-differences reflected on these values.Central FigureTable 1:Tertiles of LVGLS and RVFWLS

Prevalence and outcomes of American Heart Association stages of heart failure in an adult brazilian population of the ELSA-Brasil study

Abstract Aims Heart failure (HF) has a major impact on public health, affecting up to 2% of adult population. HF staging is helpful in capturing pre-clinical disease and its progression to advanced stages. We aimed to determine the prevalence and mortality of HF stages in the participants of a Brazilian adult cohort. Methods The ELSA-Brasil cohort comprises 15,105 adult public servants from 6 Brazilian capitals. In the initial evaluation of the study (2008-2010), ELSA carried out interviews and clinical, laboratory, and cardiovascular ancillary tests. In this analysis, we included participants who had electrocardiogram and echocardiogram performed at baseline visit, and additional information regarding risk factors and functional capacity. The HF stages were defined based on AHA guidelines criteria as follow: Stage 0 was defined as a healthy individual with no risk factors for heart failure. Stage A (at risk for HF) included those without cardiac structural or functional abnormality but with any of the following conditions: systemic hypertension; diabetes mellitus, obesity, history of myocardial revascularization, history of rheumatic fever, and seropositivity for Chagas’ disease. Stage B (pre-HF) was defined as asymptomatic participants with history of myocardial infarction or any major abnormalities on ECG or echocardiogram. Stage C (symptomatic HF) included participants with a clinical history of HF, or HF symptoms in the presence of structural heart disease (defined as in Pre-HF stage). Considering the community-dwelling profile of the sample, we did not expect to have advanced heart failure patients in our sample. Results We included the 3,267 participants (61±9 years; 53% women) with baseline data. Prevalences of HF stages were stage 0: 938 (29%) A: 1,385 (42%), B: 651 (28%) and C: 293 (9%), with different distribution between sexes (p&amp;lt;0.001). Older participants had higher prevalences of stages B and C (p&amp;lt;0.001), with the prevalence of stage C increasing from 1.8% at 35-44 years to 12.2% at 65-74 years. After 12 years of follow-up, total mortality rates of HF stages were Stage 0: 4%; A:10%. B: 16%, and C: 26%, and respective Cox proportional hazard ratios [95% CI] adjusted for age and sex were A: 1.94 [1.3-2.8], B:2.78 [1.9-4.1], and C: 5.39 [3.6-8.1] compared to stage 0. Conclusions The prevalence of HF in Brazilians reflects what is described in international literature, with a large proportion of individuals in pre-symptomatic stages. A notable shift in the sample toward pre-symptomatic and symptomatic HF occurred gradually and persistently across the age span studied. Mortality rates increase incrementally across the HF stages. This information is important for understanding and planning health policies for this syndrome.

Conceptual Model on Access to Food in the Favela Food Environment

The inequalities of Brazilian society are amplified in favelas, affecting access to basic sanitation, health, education services, and food. More research is needed to better understand the favela food environment and propose appropriate public food and nutrition policies to increase the availability of and access to healthy food. In this context, this study aimed to develop a conceptual model of the relationship between access to food and the favela food environment and its determinants. In developing the conceptual model, this study undertook a bibliographical survey of the food environment, and a preliminary version was submitted to an expert panel. The model represents a set of dimensions (individual, micro-environment, macro-environment, and decision-making) and elements that interact in a complex manner and help understand access to food in areas subject to multiple social vulnerabilities. This model can guide future research and aid policymakers in designing effective strategies to improve the food security and health of populations in areas of high socio-spatial vulnerability.

INTERNAÇÃO POR FRATURA DE FÊMUR NO BRASIL NO PERÍODO DE 2012 A 2022: ANÁLISE DE ACORDO COM A COR DA PELE

OBJECTIVE: To retrospectively analyze the total number of hospitalizations for femoral fractures in the elderly according to regions in Brazil and skin color, from 2012 to 2022. METHODS: Ecological and retrospective time series study that evaluated data on femoral fractures in the elderly, based on data available on the Ministry of Health websites. The following variables were evaluated: Total hospitalizations according to skin color, age group and type of service used. RESULTS: The number of white people was much higher in the private health service. Regarding brown skin color, the north and southeast had more people hospitalized in the public sector. Regarding hospitalization according to age group, all categories had the same behavior, with an increase in the number of hospitalizations as there is an increase in age magnitude. There was an increase in the number of hospitalizations over the years, only between 2019 and 2020, there was a slight decrease, observed especially in people with brown skin. CONCLUSION: There is a discrepancy in the number of hospitalizations for femur fractures in the elderly between Brazilian regions. This study shows that femoral fractures continue to be a health problem present in the Brazilian population, regardless of skin color and that their increasing behavior over the years reflects the aging of the population.

Child Separation and the Stolen Generation of Brazil: Indigenous Peoples’ (Un)Freedom in Amazonia

Abstract This article examines questions pertaining to Indigenous people’s citizenship status, the problematic definition of orphanhood, rule of law, and structural racism in Brazilian society. The definition of orphanhood was articulated in a way that allowed for the extralegal abuse and racialized exploitation of labor to continue long past the legal end of Indigenous slavery (1755). Indigenous persons’ legal status, the definition of orphanhood, and guardianship laws worked together to legitimate the permanence of child separation as a means for wealthier Brazilians to get free child labor. The article uncovers the ambiguities in defining Indigenous people’s legal status, making citizenship status a subjective determination contested on a case-by-case basis. With this foreground understanding, the article presents the practice of child separation and the created discourse to legitimize Indigenous, Black, and mixed-race children as unpaid criadas de casa (housemaids).

A DIFICULDADE DE REINSERÇÃO DE EX-DETENTOS NA SOCIEDADE: DESAFIOS E PERSPECTIVAS

The reintegration of former inmates into Brazilian society is a complex and challenging phenomenon involving a convergence of social, economic, and psychological factors that hinder their full integration. The social stigma associated with being an ex-inmate poses a significant barrier, as many face prejudice and discrimination, limiting their employment opportunities and access to support networks. Furthermore, structural barriers, such as a lack of available jobs and professional training, exacerbate the situation. A crucial aspect is the absence of adequate psychological support. The prison experience can leave deep psychological scars, and many former inmates struggle with trauma, anxiety, and adaptation issues, requiring specialized attention. The lack of effective public policies, combined with the precariousness of rehabilitation programs, significantly contributes to criminal recidivism. Many existing initiatives lack resources, continuity, and coordination across different sectors, resulting in a vicious cycle of marginalization. This paper aims to explore these issues in depth, analyzing the effectiveness of initiatives and programs implemented in Brazil in relation to the Penal Execution Law (Law No. 7.210/1984) and other relevant legislation. We propose a reflection on improvement strategies that emphasize the need for a holistic approach considering the various dimensions of reintegration. Promoting a culture of acceptance and inclusion, strengthening intersectoral public policies, and implementing vocational training programs are some alternatives that could provide new perspectives for former inmates. Ultimately, this study seeks to contribute to a deeper understanding of the challenges faced by former inmates and suggest pathways that could facilitate their reintegration into society, aiming for a significant transformation for both individuals and society as a whole. Social reintegration is not merely a matter of criminal policy, but a moral and social imperative that demands collective commitment to justice and human dignity.

Dental age estimation in adults using the Lamendin criteria: Validation of a bayesian model in the Brazilian population

Age estimation provides information for biological profile, which is used as an important data during the process of to aid in the identification of bodies of deceased persons. Lamendin et al. proposed a simplified dental age estimation technique for adults based on the analysis of periodontal recession height, root height, and root translucency height. These characteristics were used to build a multi-population database that served in the development of a Bayesian model, known as the Forensic International Dental Database (FIDB). However, before this research, this model did not incorporate dental information from the Brazilian population. The aim of this article was to validate the application of the FIDB Bayesian statistical model for estimating dental age in samples from the Brazilian population and compare it to Lamendin's technique. A cross-sectional study was conducted using 230 dental elements extracted for therapeutic reasons and stored in a biobank. Two independent and calibrated examiners collected the data, considering the randomization of dental samples. Intra- and inter-examiner reliability analysis included the re-evaluation of 20 % (n = 40) of the sample. For statistical analyses, the data were organized in Microsoft© Excel© 365 version 2204 (Microsoft Corp., Redmond, WA, USA) spreadsheets, and R version 4.0.2 (R Foundation, Vienna, Austria) and IBM® SPSS® version 23.0 (SPSS Inc., IBM, Chicago, IL, USA) software were used. After applying inclusion and exclusion criteria, the final sample comprised 200 intact dental elements from 84 male and 116 female individuals. According to the Kolmogorov-Smirnov test, the data did not show a normal distribution, and the Intraclass Correlation Coefficient indicated that intra- and inter-examiner agreements were adequate. Through the Mann-Whitney U test, statistically significant differences between sexes were not observed. In terms of overall accuracy, the Bayesian model and the original Lamendin´s technique showed a mean absolute error of 9.39 years and 9.95, respectively. Regarding bias, it was generally 0.15 years for the Bayesian model and 5.62 years for the original Lamendin´s technique. The Wilcoxon classification test revealed no statistically significant difference between chronological and estimated ages, but only for the Bayesian model. It can be concluded that the developed Bayesian statistical model was able to estimate the age of Brazilian adults satisfactorily, and overall, the error rates were acceptable.

A IMPORTÂNCIA DA LEITURA DE MUNDO NA VISÃO DE PAULO FREIRE NO COTIDIANO DOS ALUNOS DA 1ª SÉRIE DO NOVO ENSINO MÉDIO NA ESCOLA ESTADUAL RAIMUNDO PAZ/AM

In Brazilian society, the habit of reading is incipient. Transforming this reality and expanding the taste for reading is essential to improving the quality of education, access to knowledge and human development. It is a challenge that must be taken on by the entire society. The practice of reading contributes to the development of students’ cognitive skills, necessary to expand their oral and written communicative competence, making them more proficient in their mother tongue and enabling them to consciously and critically exercise citizenship. Due to this premise, a work to encourage reading was carried out at the Raimundo Paz State School, in Amazonas, with 1st year high school students, through interpretations and dramatizations based on the text “Uma voyage a Bonde”. 25 students aged between 15 and 16 participated in the research. The methodology used in this dissertation was action research. Regarding the research strategy adopted (action research), it can be said with certainty that it was the most appropriate for this type of study, contributing to the construction and improvement of the experimental model, as well as to joint learning between the researcher and the participants.

Unveiling the Landscape of Brazilian Clinical Oncologists: Challenges, Diversity, and Quality Care

AbstractCancer remains a significant public health challenge in Brazil, with an estimated 704 thousand new cases annually. Clinical oncology, a pivotal specialty in cancer diagnosis and treatment, has evolved since its formal establishment in 1946. Recent recognition by the Brazilian Federal Board of Medicine solidified its status, culminating in normative resolution nr. 2,162/2017. The present study aims to characterize Brazilian clinical oncologists and analyze their epidemiological and structural contexts using data from the Brazilian Society of Clinical Oncology's 2023 census and secondary sources, including the National Cancer Institute (Instituto Nacional de Câncer [INCA], in Portuguese) and Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatistica [IBGE], in Portuguese). A cross-sectional design employing qualitative-quantitative methods surveyed 761 clinical oncologists, revealing insights into demographics, workload, stress levels, and challenges. The results highlight regional disparities in cancer mortality rates despite the concentration of oncology services in the South and Southeast. Challenges include access to new treatments, late diagnoses, and systemic underfunding. Moreover, this study underscores gender and racial disparities within the specialty, indicating a predominantly white and heterosexual profile among practitioners. Addressing these issues is crucial for enhancing healthcare equity and improving patients' outcomes in oncology practice.

Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology - 2024.

Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology - 2024.

Determination of the Consumer Profile in Relation to New Food Products Based on Soy with Microalgae in Brazil

ABSTRACT Due to demand for functional foods and the increase of individuals adopting a vegetarian diet, the objective of this work was to investigate the preferences and consumption of soy products with microalgae among the Brazilian population. Employing an online questionnaire, participants reported consumption habits of meat and soy-based products with microalgae. The findings revealed that 74% of respondents did not have the habit of consuming soy. The majority had never consumed products with microalgae; however, those who had, reported good experiences, which indicates that the development of products with microalgae should be encouraged and explored.

The cost of obesity and related NCDs in Brazil: An analysis of hospital admissions, disability retirement benefits, and statutory sick pay

ObjectivesThis study analyses the prevalence of overweight/obesity in Brazil, and its costs regarding hospital admissions (HA), disability retirement benefits (DRB), and statutory sick pay (SSP) associated with obesity-related non-communicable diseases (NCDs). Study designTime-series study. MethodsThis study analyses data from the VIGITEL system (2010–2019) to calculate the body-mass index (BMI) of adult residents in Brazil's state capitals. Data on HA, DRB, and SSP were obtained from Brazil's SIH/SUS and AEPS Infologo systems. Pearson's correlation and linear regression models were applied. The study selected 23 diseases of the International Classification of Disease (ICDs) belonging to chapters C; E; I; and K. Cost values in BRL were deflated using IPCA. ResultsThe results showed a significant increase in overweight and obesity rates in Brazil, with BMI rising by 0.09 kg/m2 annually. Regression analysis revealed that each 1-point increase in the average BMI of the population is associated with an increase of 81,772 (BRL 237.51 million/year) new HA per year, 5541 (BRL 18.8 million/year) new DRB granted per year, and 42,360 (BRL 131 million/year) new SSP per year. Also, every 1 % increase in the share of the Brazilian population with obesity is associated with an increase of 16,973 (BRL 48.8 million/year) new HA per year, 1202 (BRL 3.97 million/year) new DRB granted per year, and 8686 (BRL 26.8 million/year) new SSP per year. Regressions for deflated values showed lower significance, suggesting a strong impact of inflation on health costs in Brazil. ConclusionsObesity prevalence in Brazil implies high direct and indirect costs for the Brazilian government, especially considering circulatory system diseases.

Whispers of genocide: racist and colonial legal practices of the Brazilian dictatorship towards Indigenous peoples

ABSTRACT Towards the end of the 1960s, as accusations of genocide against Brazil appeared in several national and international newspapers, a sense of growing unrest crept into the military dictatorship. In 1968, the United Nations organised the First International Conference on Human Rights in Tehran. The dictatorship’s legal argumentation was based on an assimilationist orientation directed at ‘civilizing’ the Indigenous population and ignoring genocide allegations. The military regime intertwined a tradition of civilising mission with an authoritarian ideology of national unity to produce racist and colonial legal practices towards Indigenous peoples in Brazil. Reports of genocide caused quite a stir among activists and academics, but the Tehran episode also illustrates how events unfolding in international arenas such as the Conference did not substantially vex the Brazilian dictatorship. Exactly seven months after the meeting, the regime passed the Institutional Act 5, which inaugurated the most repressive years of its history. To subsidise such points, we review documents found in the Brazilian Ministry of Foreign Affairs.