Prevention In Brazil Research Articles

Elder Abuse Prevention in Brazil, Norway and Slovakia: a Narrative Review

Abstract OBJECTIVES With the global population ageing, concerns about the incidence, prevalence and prevention of elder abuse have become increasingly pertinent. This study presents a narrative review of empirical research, investigating the elder abuse prevention implemented in public health policies in three selected countries. The narrative review aims to enrich academic critical discussion about the theme and provide insights for policymakers and professional practitioners working towards elder abuse prevention across different regions. METHODS Searches in the electronic database CINAHL, Medline, PsycINFO and Web of Science databases were performed to identify and synthesise studies reporting on research aimed at investigating elder abuse prevention. The studies that handle on all prevention levels, had to be published in a peer-reviewed journal, report on empirical research, and are available in full text in Portuguese, Slovak, English or Norwegian and published within a ten-year period (2012 to 2022) were included. A total of 981 studies were retrieved, of which 13 papers met the inclusion criteria for this narrative review. RESULTS The evidence indicated that proactive approach within primordial and primary prevention, interdisciplinary cooperation within primary and secondary prevention, and education for healthcare professionals within all forms of prevention were implemented to various extent as elder abuse prevention in Brazil, Norway and Slovakia. CONCLUSIONS There is a need to further enhance public awareness of elder abuse through campaigns and advocacy programs; additionally, the routine screening and assessments by healthcare providers for early detection and intervention in suspected abuse cases require improvement; and also, legal and health policy measures must be updated regularly. Elder abuse prevention should be a collective undertaking involving community leaders, healthcare providers, and governmental and non-governmental organisations.

A brief research report of suicide rates in the Brazilian elderly over a 12-year period: the lack of association of the "Setembro Amarelo" campaign for suicide prevention.

Aiming to disseminate information related to suicide prevention in Brazil, the "Setembro Amarelo" campaign has been conducted since 2015. The objective of this study is to assess the association between this campaign and elderly suicide rates over a 12-year period. Data were gathered from the Mortality Information System and the Notifiable Diseases Information System, established by public institutions in Brazil. An interrupted time-series framework was applied to assess the association between the "Setembro Amarelo" campaign and suicide mortality rates in the elderly population (60 et plus) in the southeastern region of Brazil. We consider three monthly outcomes: all suicides, suicides in males and suicide in females. We operationalize the campaign assuming three effects: short-term, declining and sustained. The period of analysis was from 2011-2022. The suicide-mortality rate over time has remained stable; the average rate in the pre-campaign period was 0.028 and increased slightly to 0.035. Regardless of the campaign's operationalization and the outcome used, results show no significant associations between the campaign and elderly suicide rates. The campaign was associated with non-significant decreased effects of 15% (P=0.532) in the short term, and 16% (P=0.446) assuming the campaign was sustained. There is a lack of association between the campaign and suicide rates, among the elderly in Brazil's southeastern region. As suicide is complex and multifactorial, more research is needed. The campaign, while raising awareness and reducing stigma, may not reduce suicides. To reduce the suicide rate in the elderly requires addressing social, economic and cultural factors, multisectoral interventions, and upholding basic human rights.

EE313 Cost-Utility of Apixaban for Secondary Stroke Prevention in Brazil

EE313 Cost-Utility of Apixaban for Secondary Stroke Prevention in Brazil

Cancer Prevention in Brazil

This article discusses possible dialogues between medical history and the history of concepts, suggesting that a “socio-conceptual-moral” history of medicine offers insightful elements for the historical analysis of conceptual change. Drawing mainly from Reinhart Koselleck’s Begriffsgeschichte and Ludwik Fleck’s theory of knowledge, I focus on three points of the “socio-conceptual-moral” perspective: the approach to medical statements as part of a semantic field, the interaction between a formulated concept and its practice, and negotiations about the meanings of medical concepts between different social arenas. I take the history of cancer prevention in Brazil as a case study to discuss these three aspects and emphasize the situated character of conceptual change. The article analyzes the period between the 1960s and the 1990s when substantial changes in the conceptual framework of cancer prevention confronted continuities in public health and medicine practices, policies, and institutions.

Knowledge of People about Câncer Prevention in Brazil

Several associations between cancer and some risk factors mainly concerning lifestyle, are well established. In view of the importance to convey this knowledge to the population for effective cancer prevention, this research was carried out to assess the level of information in a population in the countryside of Brazil. A survey by household interview was carried out in a probabilistic sample of four towns in order to obtain data on the knowledge of people about the association between tobacco, alcohol, certain types of food and sunlight, and the occurrence of cancer. The sample was obtained in a two phases process (blocks and houses) and every person older than 20 years was interviewed in the selected house. A total of 1084 persons were interviewed and their level of knowledge about the association between cancer and the risk factors was low (60% for tobacco, 45% for alcohol, 39% for certain foods and 67% for solar irradiation). This level increased with schooling and socioeconomic levei and decreased with age for people older than 60 years. This did not occur for alcohol, for which the trend went in the opposite direction regarding schooling and social class. The level of knowledge about these associations was higher for women. These data permitted us to identify population groups which could benefit from programs aimed to change their style of life.

Autonomy and Care in Context: The Paradox of Sex Workers' Acceptability of HIV Self-Tests in São Paulo, Brazil.

Cisgender female sex workers (CFSW) continue to face structural barriers to HIV prevention. We analyzed the acceptability of the oral HIV self-test (HIV-ST) among CFSW as part of a pragmatic trial on HIV prevention in Brazil. Data from in-depth interviews conducted with 12 women from diverse sex worker contexts and participant observation were analyzed using thematic analysis. CFSW valued autonomy in their workplaces and saw the HIV-ST as a possibility for self-care. Some feared clients’ reactions, manager reprimands, and a positive result. HIV and sex work stigma largely drove self-care practices and perceived acceptability of the self-test. We argue that the autonomy offered by the self-test presents a paradox: increasing autonomy on the one hand while risking sidestepping structural dimensions of HIV vulnerability on the other. These nuances must be considered in interventions promoting the HIV-ST by considering the specificities of sex worker contexts, addressing stigma, and effectively involving CFSW and their organizations in intervention development.

A Critical Review on New Approaches for Chronic Disease Prevention in Brazil and Canada: From Wholistic Dietary Guidelines to Physical Activity Security.

In light of new evidence on the prevention of chronic diseases and the elevated rates of overweight and obesity in Brazil and Canada, this critical review aims to interpret and synthesize current aspects regarding dietary and physical activity initiatives in both countries and make future recommendations. The pioneering work presented in the last Brazilian dietary guidelines has been called a model that can be applied globally, given its conceptualization of healthy eating that translates easily to practical guidance. The new Canadian Food Guide has incorporated similar aspects, also putting the country as a leader in dietary guidance. With these new recommendations, citizens in both Brazil and Canada have access to impactful evidence-informed nutritional guidelines. Both documents propose eating patterns that focus not only on health benefits, such as chronic disease prevention, but also incorporate well-being concerning cultural, economic, sociodemographic, biological, and ecological dimensions. A similar approach is required for physical activity to allow individuals to have attainable health and life goals and thereby fully enjoy their lives, regardless of geographical location, health status, and socioeconomic condition, a concept recently described as physical activity security. The wholistic dietary guidelines from both countries represent a change in paradigm in public health. Likewise, national evidence-based policies are warranted to reduce disparities in physical activity, allowing healthier and more active lifestyles for everyone.

The adherence to school meals is associated with a lower occurrence of obesity among Brazilian adolescents

This study aimed to verify the association between adherence to meals from the Brazilian National School Feeding Program (PNAE) and obesity indicators among adolescents. Data from 12,373 students attending public schools from the 2015 National Survey of School Health were used. Adherence to school meals was assessed using a self-administered questionnaire and classified as null (zero/rarely), low (1-2×/week), moderate (3-4×/week), and high (5×/week). Weight and height were measured and classified based on the World Health Organization's reference for Z-scores of body mass index (BMI) for age, overweight (≥ + 1 Z-score) and obesity (≥ + 2 Z-score). Linear and Poisson regression models adjusted for potential confounding factors (gender, race/ethnicity, age, region, goods score, maternal education, living with parents, eating outside of school profile and physical activity) were performed to assess the association between adherence to school meals and the indicators (Z-score, overweight and obesity). The prevalence of high adherence was 21.6% and obesity, 8%. An inverse and dose-response association were observed between adherence to the PNAE meals and obesity indicators. Adolescents with high adherence to school meals (5×/week) had a 0.10 lower BMI Z-score (coefficient = −0.10, CI -0.17;-0.03), 11% less prevalence of overweight (PR = 0.89, CI 0.80;0.99) and 24% less prevalence of obesity (PR = 0.76, CI 0.62;0.93) than those with a lower adherence (<5×/week). Our results showed that the adherence to PNAE meals may contribute to obesity prevention in Brazil.

Suicide Prevention in Brazil: General concepts and the Experience of a Life Support Program (PRAVIDA)

Suicide Prevention in Brazil: General concepts and the Experience of a Life Support Program (PRAVIDA)

The social epidemiology of Zika: stigma, transmission, and prevention in Brazil

Abstract Zika Virus continues to pose a threat to public health in Brazil. In the absence of an infrastructure-focused approach to eradication, it is crucial to understand points of intervention that may increase preventative action in the population. There has been a lack of studies on how socioeconomic and demographic factors relate to attitudes and behaviors surrounding Zika. The purpose of this study was to investigate factors influencing stigma, transmission knowledge, and prevention method use in Brazil. This study relied on nationally-representative data collected for the 2016/2017 AmericasBarometer survey. A multi-stage national probability sample design was used, yielding 1,532 participants. Items were selected representing three thematic categories: stigmatizing attitudes, accuracy of transmission knowledge, and the frequency of prevention method use. Multi-level modeling was used to assess the relationship between each item and gender, urban/rural living, income, and education, nested by region. Education level was the strongest and most common predictor overall in this study. Higher levels of education were associated with less stigma against those with Zika, t(677)= 3.41, p &amp;lt; 0.01, and more accurate transmission knowledge, t(1326)=5.31, p &amp;lt; 0.001. For prevention method use, female gender was the strongest predictor, t(1408)=4.85, p &amp;lt; 0.001. These relationships did not differ significantly by region. The governmental response to Zika thus far has focused primarily on vector control. This has had limited success and placed the burden of prevention primarily on women and girls. The results of this study suggest that, in the absence of structural change, targeted interventions may be necessary to increase the accuracy of Zika-related knowledge and prevention method use. In addition to community-level interventions, advocacy for equitable access to education and increased availability of comprehensive family planning are critical. Key messages There are multi-level barriers to Zika knowledge and prevention use that will require structural, community, and individual-level interventions. Severe weather events driven by climate change will further damage fragile water/sanitation infrastructures in Brazil. Multi-sector collaboration is needed for environmental and population health.

Multicomponent positive psychology intervention for health promotion of Brazilian retirees: a quasi-experimental study

This study evaluated the effects and impact of a multicomponent positive psychology program for health promotion of retirees. A quasi-experimental longitudinal design was used, and the baseline and end of intervention evaluations were analyzed. The intervention consisted of six weekly group sessions for 2 h each. Eighty-eight retirees (females = 72) aged 49–86 (M = 65.66, SD = 7.53) from South Brazil took part in the study, 54 (females = 48) in the experimental group (M = 66.37 years old, SD = 7.42), and 34 (females = 24) waitlist controls (M = 64.53 years old, SD = 7.68). The instruments used were a sociodemographic questionnaire and the Brazilian version of the scales: Interpersonal Reactivity Index; 12-item General Health Questionnaire; Life Orientation Test-Revised;14-item Perceived Stress Scale; Resilience Scale; and Satisfaction with Life Scale. Mixed factorial ANOVA models revealed significant decrease in depression and anxiety symptoms and perceived stress levels, whereas improvement in life satisfaction and resilience was detected in the experimental group at the end of the program. No main effect was found for empathy and optimism. Interaction effects yielded significant difference between groups for measures of empathy, optimism, depression, and anxiety symptoms after the program. There was no significant interaction effect for the other outcome variables. The usefulness and applicability of this model of intervention to aid future health practices and policies are discussed. Contextual issues in the fields of health promotion and disease prevention in Brazil are also problematized.

Preventable fractions of colon and breast cancers by increasing physical activity in Brazil: perspectives from plausible counterfactual scenarios

BackgroundPhysical activity is associated with lower risk of colon and breast cancers. Herein we estimated preventable fractions of colon and breast cancers in Brazil by increasing population-wide physical activity to different counterfactual scenarios. MethodsWe used data from a representative national survey in Brazil and corresponding relative risks of colon and postmenopausal breast cancers from a meta-analysis. Estimated cancer incidence was retrieved from GLOBOCAN and Brazilian National Cancer Institute. Five counterfactual scenarios for physical activity were considered: (i) theoretical minimum risk exposure level (≥8,000 metabolic equivalent of tasks-minute/week – MET-min/week); (ii) physical activity recommendation (≥600 MET-min/week); (iii) a 10% reduction in prevalence of insufficient physical inactivity (<600 MET-min/week); (iv) physical activity level in each state equals the most active state in Brazil; (v) closing the gender differences in physical activity. ResultsAbout 19% (3,630 cases) of colon cancers and 12% (6,712 cases) of postmenopausal breast cancers could be prevented by increasing physical activity to ≥8,000 MET-min/week. Plausible counterfactual scenarios suggested the following impact on cancer prevention: reaching physical activity recommendation: 1.7% (1,113 cases) of breast and 6% (1,137 cases) of colon; 10% reduction in physical inactivity prevalence: 0.2% (111 cases) of breast and 0.6% (114 cases) of colon; most active state scenario: 0.3% (168 cases) of breast and 1% (189 cases) of colon; reducing gender differences in physical activity: 1.1% (384 cases) of breast and 0.6% (122 cases) of colon. ConclusionsHigh levels of physical activity are required to achieve a sizable impact on breast and colon cancer prevention in Brazil.

Some Conceptual Basis for Crime Prevention in Brazil and USA: Generic Public Policies and Control Crime Programs

This paper is a comparison in crime prevention between Brazil and United States, specially regarding the role of local programs vis a vis generic social policies. In Brazil, there is a tendency to design more generic strategies of crime control. In USA, there is a style of using a more specific approaches. These differences have implication on the evaluations on crime prevention made in each country

Educação para prevenção de desastres: a persistência do conhecimento tecnocientífico e da individualização do risco

A recente Política Nacional de Proteção e Defesa Civil Brasileira (Lei n’ 12.608/2012) ressaltou a cultura de prevenção e sua inserção no currículo escolar nacional. Este artigo apresenta os resultados da pesquisa, exploratória e qualitativa, sobre o estado da arte de conteúdos e abordagens educativas para a prevenção de desastre no Brasil. Os dados foram obtidos por pesquisa bibliográfica, documental e observação participante, a partir de 3 recortes: temático (inundações/enchentes e deslizamentos), temporal (de 2011 a 2014) e geográfico (região metropolitana do ABC Paulista). O corpus foi composto por materiais impressos/digitais e atividades de informação/capacitação. Por meio do método da análise de conteúdo, identificamos dois conteúdos (conhecimentos tecnocientíficos e comportamentos/atitudes de prevenção e auto-proteção) e duas abordagens (transmissão-assimilação e individualização do risco), que perpetuam uma “inquestionabilidade do risco”, alheia às causas profundas do risco, o que fragiliza as ações de redução de risco baseada na comunidade.

Pre-travel malaria chemoprophylaxis counselling in a public travel medicine clinic in S\xe3o Paulo, Brazil

BackgroundMalaria is one of the most prevalent parasitic diseases in the world and represents a threat to travellers visiting endemic areas. Chemoprophylaxis is the prevention measure used in travel medicine, avoiding clinical manifestations and protecting against the development of severe disease and death.MethodsRetrospective and descriptive analysis of malaria prevention data in travellers was recorded from a travel medicine clinic in São Paulo, Brazil, between January 2006 and December 2010. All the medical records of travellers, who had travelled to areas with risk of disease transmission, including Brazil, were analysed. Demographic characteristics of travellers, travel details and recommendations for preventing malaria were also seen.ResultsDuring the study period, 2836 pre-travel consultations were carried out on 2744 individuals (92 were consulted twice). The most common reasons for travelling were tourism and work. The most common destinations were Africa (24.5%), Europe (21.2%), Asia (16.6%) and locations within Brazil (14.9%). In general prophylaxis against malaria was recommended in 10.3% of all the consultations. African destinations vs Asian, Brazilian and other destinations and length of stay ≤30 days were independently associated with the higher odds of chemoprophylaxis recommendation after the logistic regression.ConclusionThe prophylaxis against malaria was recommended in 10.3% of the consultations. The authors believe that a coherent measure of malaria prevention in Brazil and for international travellers would be to recommend for all parts of the North Brazil, avoidance of mosquito bites and immediate consultation of a physician in case of fever during or after the journey is recommended.

HIV Prevention in Brazil

HIV Prevention in Brazil

O Estado da Arte da Pesquisa em Prevenção em Saúde Mental no Brasil: uma Revisão Sistemática

Realizou-se uma revisão sistemática de literatura sobre a pesquisa em prevenção no Brasil conforme asetapas do ciclo de investigação na área: análise do problema, identificação de fatores de risco e proteção,intervenção-piloto, teste avançado, avaliação de efetividade e difusão. Foram encontrados 4.1 31 artigos,dos quais 31 (0,75%) descreviam programas preventivos e 11 destes (35,4%) eram sistematicamenteavaliados, com a foco em prevenção de comportamento antissocial, rejeição por pares, violência e abusode substâncias. Os estudos se concentram nos estágios iniciais do ciclo proposto, praticamenteinexistindo estudos nos estágios finais. Recomendam-se desenvolvimento de medidas de avaliação,interlocução entre prevenção e promoção de saúde mental, fortalecimento de rede de pesquisadores eintercâmbio com políticas públicas para avanço da área.

A new Leishmania-specific hypothetical protein and its non-described specific B cell conformational epitope applied in the serodiagnosis of canine visceral leishmaniasis.

The serodiagnosis of canine visceral leishmaniasis (CVL) presents problems related to its sensitivity and/or specificity. In the present study, a new Leishmania-specific hypothetical protein, LiHyD, was produced as a recombinant protein (rLiHyD) and evaluated in ELISA experiments for the CVL serodiagnosis. LiHyD was characterized as antigenic in a recent immunoproteomic search performed with Leishmania infantum proteins and the sera of dogs developing visceral leishmaniasis (VL). Aiming to compare the efficacy between whole proteins and synthetic peptides, two linear and one conformational B cell epitopes of LiHyD were synthesized and also evaluated as diagnostic markers. The four antigens were recognized by the sera of dogs suffering VL. On the contrary, low reactivity was observed when they were assayed with sera from non-infected healthy dogs living in endemic or non-endemic areas of leishmaniasis. In addition, no reactivity was found against them using sera from dogs experimentally infected by Trypanosoma cruzi, Babesia canis, or Ehrlichia canis, or sera from animals vaccinated with the Leish-Tec® vaccine, a prophylactic preparation commercially available for CVL prevention in Brazil. As comparative diagnostic tools, a recombinant version of the amastigote-specific A2 protein and a soluble crude Leishmania extract were studied. Both antigens presented lower sensitivity and/or specificity values than the LiHyD-based products. The rLiHyD presented better results for the CVL serodiagnosis than its linear epitopes, although the peptide recreating the conformational epitope resulted also appropriate as a diagnostic marker of CVL. To the best of our knowledge, this is the first study showing the use of a conformational epitope derived from a Leishmania protein for serodiagnosis of CVL.

Environmental and economic assessment of a pilot stormwater infiltration system for flood prevention in Brazil

Green and grey stormwater management infrastructures, such as the filter, swale and infiltration trench (FST), can be used to prevent flooding events. The aim of this paper was to determine the environmental and economic impacts of a pilot FST that was built in São Carlos (Brazil) using Life Cycle Assessment (LCA) and Life Cycle Costing (LCC). As a result, the components with the greatest contributions to the total impacts of the FST were the infiltration trench and the grass cover. The system has a carbon footprint of 0.13kgCO2eq./m3 of infiltrated stormwater and an eco-efficiency ratio of 0.35kgCO2eq./USD. Moreover, the FST prevented up to 95% of the runoff in the area. Compared to a grey infrastructure, this system is a good solution with respect to PVC stormwater pipes, which require a long pipe length (1070m) and have a shorter lifespan. In contrast, concrete pipes are a better solution, and their impacts are similar to those of the FST. Finally, a sensitivity analysis was conducted to assess the changes in the impacts with the varying lifespan of the system components. Thus, the proper management of the FST can reduce the economic and environmental impacts of the system by increasing its durability.

A priority health index identifies the top six priority risk and related factors for non-communicable diseases in Brazilian cities.

BackgroundIn Brazil, 72% of all deaths in 2007 were attributable to non-communicable diseases (NCD). We used a risk and related factor based index to prioritize NCD prevention programs in the combined 26 capital cities and the federal district (i.e., Brasilia) of Brazil.MethodsWe used 2006–2011 data (adults) from census and Brazil's surveillance of 12 NCD risk factors and 74 disease group mortality. The risk and related factors were: smoking, physical inactivity, overweight-obesity, low fruits and vegetables intake, binge drinking, insufficient Pap smear screening (women aged 25 to 59 years), insufficient mammography screening (women aged 50 to 69 years), insufficient blood pressure screening, insufficient blood glucose screening, diagnosis of hypercholesterolemia, diagnosis of hypertension and diagnosis of diabetes. We generated six indicators: intervention reduction of the risk factor prevalence, intervention cost per person, prevalence of risk factor, deaths attributable to risk factor, risk factor prevalence trend and ratio of risk factor prevalence between people with and without a high school education. We transformed risk and related factor indicators into priority scores to compute a priority health index (PHI). We implemented sensitivity analysis of PHI by computing it with slightly altered formulas and altering values of indicators under the assumption of bias in their estimation. We ranked risk factors based on PHI values.ResultsWe found one intermediate (i.e., overweight-obesity) and six top risk and related factors priorities for NCD prevention in Brazil's large urban areas: diagnosed hypertension, physical inactivity, blood pressure screening, diagnosed hypercholesterolemia, smoking and binge drinking.ConclusionBrazil has already prioritized the six top priorities (i.e., hypertension, physical inactivity, blood pressure screening, hypercholesterolemia, smoking and binge drinking) and one intermediate priority (i.e., overweight-obesity) for NCD prevention identified in this report. Because effective interventions to reduce disease burden associated with each of the six priority risk factors are available, strategies based on these interventions need to be sustained in order to reduce NCD burden in Brazil. PHI can be used to track NCD prevention and health promotion actions at the local and national level in Brazil and in countries with similar public health surveillance systems.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1787-1) contains supplementary material, which is available to authorized users.