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Health care challenges in remote rural municipalities (RRMs) emphasize the importance of primary health care (PHC) and require an expanded scope of practice. Doctors are key actors in this context. The aim of this study was to explore the level of integration of doctors in RRMs and working practices. We conducted a qualitative study involving semi-structured interviews with 46 PHC doctors working in 27 RRMs in Brazil. Content analysis was performed, resulting in the identification of categories of analysis grouped under three core dimensions: doctor training and experience; comprehensive care and timely access; and the community-based approach. Doctors working in RRMs were mainly recent graduates with limited experience who had undertaken their degree outside Brazil, and care was focused on the individual. The findings also revealed weak sociocultural adaptation and a harsh working environment and issues related to social status that reinforced prejudice against rurality and poverty. Practice was limited in scope and care tended to be oriented towards acute problems, disease-centered and focused on the biomedical model of medicine. Barriers to the delivery of comprehensive care include both structural constraints, such as poor facilities and centralization of services in administrative centers, and the lack of professional competencies necessary for PHC in these areas. The findings point to the need to promote an expanded scope of practice in PHC delivery in RRMs, with major public investment in the promotion of training and strengthening career pathways in these areas. [ABSTRACT FROM AUTHOR]

Several smallholder pig farms exist in Brazil in parallel with industrial pig farming, which is carried out on large-scale farms. This study aimed to describe the smallholder pig production systems in the Metropolitan Area of Curitiba. For this, a questionnaire was applied in loco by interviewing 362 farmers. The labor force was exclusively family-oriented (93.4%), 50% of the farms had between 1.1 and 10 acres, 98.3% raised other animal species (i.e., poultry), and in 80.9% of the properties they cultivated mainly corn. Farrow-to-finish operations were developed in 57.2% of the farms, the swine were kept in a confined system in 62.5%, and the swine were kept outdoors in 20.7%. Of the farrow-to-finish operations, 40.1% had between 11 and 20 pigs, while in the fattening farms, 88.4% had up to 5 pigs. Most of the visited properties (79.6%) had pigs with undefined breeds. In terms of feeding practices, corn, and locally available vegetables were the most commonly used. In addition, 38.1% of farmers used commercial concentrate, usually with other feed. Reproduction was exclusively by natural mating, and the most frequently weaning age (46.9%) was two months. All the interviewees raised swine primarily for their consumption, with 78.7% also selling the animals. In the studied region, farmers obtained their family income by combining farming with other activities and stated that pig production contributed little to this income, and was developed mainly as a family tradition. [ABSTRACT FROM AUTHOR]

This study describes characteristics of academic inbreeding in the Brazilian higher education system. Results show the rate of inbreeding significantly differs among distinct types of institutions, fields of knowledge, states and university ranking tiers. According to this study, inbreeding is most likely to be found in established elite research institutions, concentrated in the Southeast of Brazil, in the STEM fields. These also happen to be the main providers and most prestigious consumers of the well‐trained local academic workforce, supporting the conclusion that both internal and external factors could be influencing the high concentration of inbred scholars at prominent alma maters. It contributes to international literature by evaluating the role of individual characteristics and by showing how the expansion of higher education to more geographically distant areas may establish different patterns of inbreeding. [ABSTRACT FROM AUTHOR]

The present article analyses the brazillian income distribution, with special attention to State of Paraná. To accomplish the task, it presents an overview of income distribution in Brazil and explores possible causes of its territorial differences in the last decade. Amongst these ones are education attainment levels of the labor force and productive features of regions and states. Based on this scheme, the inequality question is verified at Paraná in comparison to the other areas, particularly in South Region. At a final section, it is drawn some expectations for the inequality issue in Paraná in the medium and long term and respective implications for its social policies. [ABSTRACT FROM AUTHOR]

Primary health care (PHC) in Brazil is based on Family Health Strategy (FHS) teams. These teams are supported by Expanded Family Health and Primary Care Centers (Nuclei) (NASF-AB) whose services are backbone elements for comprehensive health care within PHC. NASF-AB encompass several professional groups that aim to increase the responsiveness and scope of actions of the FHS teams. The objective of this study was to identify the dimensions of collaboration in the work dynamics of NASF-AB in the capital of Northeast Brazil. The study was a descriptive and exploratory research using a qualitative approach through semi-structured interviews with nine NASF-AB workers and three district health managers. Three analytical categories were identified following content analysis: "Interprofessional and inter-organizational collaboration," "Mainstays of collaboration in the relationship between NASF-AB and FHS," and "Challenges for a culture of collaboration in health care work." The results revealed important characteristics for interprofessional collaboration, including recognition of the attributions of the different teams and the key role of communication and planning. Participants highlighted roadblocks for interprofessional collaboration that hampered comprehensive care, such as the shortage of manpower and material resources, work overload, and lack of availability of professionals for effective teamwork. [ABSTRACT FROM AUTHOR]

Community health workers (CHWs) are framed as the link between communities and the formal health system. CHWs must establish trusting relationships with the community and with the broader health service. How to find the optimal balance between the various strands of work for CHWs, and how to formalise this, has been the focus of different studies. We performed an extensive documentary analysis of federal legislation in Brazil to understand the institutionalisation of the CHW workforce in Brazil over the last 3 decades. The paper offers three contributions to the literature: the development and application of an analytical framework to consider the institutionalisation process of CHWs; a historical analysis of the professional institutionalisation of CHW in Brazil; and the identification of the paradoxes that such institutionalisation faces: firstly, institutionalisation focused on improving CHW remuneration created difficulties in hiring and paying these professionals; when CHW are incorporated within state bureaucracy they start to lose their autonomy as community agents; and that the effectiveness of CHW programmes depends on the improvement of clinical services in the most deprived areas. [ABSTRACT FROM AUTHOR]

Objective: Understanding the structures involved and the possible effects of policies to expand the supply of graduate labor on the innovation potential of Brazilian companies. Methodology: For this understanding, the causal diagram technique was used with soft modeling of the System Dynamics approach using the Vensim software. Originality: The relationship between the supply of qualified labor force for research and the increase in the innovative capacity of organizations does not present a linear relationship but depends on factors that go beyond the determinants of the academic sector. This work responds to the need to theorize about the complexity existing in the relationship between the public support of graduate studies and their returns through applying the scientific workforce in Research and Development activities in the productive sector. Main results: A conceptual model representing a system formed by the convergence between the structures of the Graduate Program Market and the Graduates' Market was presented. This proposal offers an overview of causal structures formed by the main variables involved in supply/demand by graduates in Brazil. Theoretical/methodological contributions: The knowledge and use of the System Dynamics approach support understanding complex phenomena, learning, and constructing viable solutions to public problems. Furthermore, it is an approach still incipient in Latin America, such as Brazil, and it is valuable for forming agendas and evaluating public policies. Practical contributions: Notably, this work encourages an urgent reflection on graduate and research policies articulated with the innovation context, bringing possible implications for the transfer of technologies. A potential instrument for analyzing and projecting the possible effects of these public policies in the context studied was proposed. [ABSTRACT FROM AUTHOR]

We aimed to investigate the relationship between workforce [força de trabalho (FT)] and earnings management in the Brazilian capital market and, additionally, identify whether operating activities management is a substitute for management by accruals. Evidence of the effect of the FT on earnings management practice is controversial, sometimes showing an effect on the reduction or smoothing of profit or even no effect. In Brazil, there are no studies that investigate how the intensity of the FT affects the managers’ behavior regarding the manipulation of profit. The research is relevant to the regulatory bodies because it brings empirical evidence of the incentives generated by the pressure of the FT so that the top executives reduce the result of the period, in a substitute way, to the manipulation of the company’s operational activities. In addition, it is relevant for users of accounting information, as it demonstrates that the FT influences the recognition of results, affecting the quality of accounting information. The findings may assist regulatory bodies and investors, as it demonstrates that pressure from the FT is an important incentive for decision-making by executives and workers at the operating levels of companies and can support the improvement of labor regulations. Following Pae (2005), we use Jones’ modified model (1991) with lagged accruals to detect earnings management. To capture the FT intensity, we employed the proxies presented by Hilary (2006) and a variable calculated from the statement of value added [demonstração do valor adicionado (DVA)]. We analyzed 119 companies listed on the Brazilian stock exchange during the period 2012-2018. It were found that the intensity of the FT negatively influences earnings management by accruals [gerenciamento de resultados por accruals (GRA)], expanding the evidence on the effects of workers’ bargaining power on accounting choices. [ABSTRACT FROM AUTHOR]

The formation and construction process of the Amazon region intensifies and transforms after the mid-twentieth century, guided and organized by the State and the market. Parauapebas, located in the Southeast of Pará, arose from a new economic frontier, focused on an industrial project for mining that attracted workers from all regions of Brazil, during the period of the military government, called Programa Grande Carajás (PGC), at the end of the 1970s. Through globalization, the municipality is inserted into the modern economic-political system. Our general objective is to critically analyze the offers of technical courses in a city economically marked by mineral extraction. Thus, we analyzed the labor market for the years 2018 and 2019, related to the 10 technical-level occupations with the highest employment balance. The data from the General Register of Jobs and Unemployed (CAGED) showed that, in general, all the occupations had a positive balance. This is important to think about, replan, and offer courses for these occupations at the Federal Institute of Pará (IFPA), being able to replace those that have low employability for courses that are demanding manpower, highlighting the need for courses in the areas of Forestry Technician and Technician in Environmental Control, as well as undergraduate teaching courses. [ABSTRACT FROM AUTHOR]

The impact of a large influx of refugees (or migrants) on the local labor market has long been an important topic among economists. In this study, we investigate the economic impact of the Venezuelan migrant inflow on labor market outcomes in Brazil. We employ the synthetic control method to exploit the concentration of a large inflow of Venezuelans in the Brazilian state of Roraima, which shares a land border with Venezuela. Results indicate that the inflow of Venezuelan refugees lowered labor force participation and employment rate but did not have a significant impact on hourly wages in Brazil. Our estimates show that labor force participation among less educated individuals decreased by a larger magnitude, while females lost jobs in informal and self‐employed sectors. These findings contribute to a better understanding of the short‐term economic consequences of hosting refugees in developing countries. [ABSTRACT FROM AUTHOR]

The dearth of child and adolescent mental health services (CAMHS) is a global problem. Integrating CAMHS in primary care has been offered as a solution. We sampled integrated care perspectives from colleagues around the world. Our findings include various models of integrated care namely: the stepped care model in Australia; shared care in the United Kingdom (UK) and Spain; school-based collaborative care in Qatar, Singapore and the state of Texas in the US; collaborative care in Canada, Brazil, US, and Uruguay; coordinated care in the US; and, developing collaborative care models in low-resource settings, like Kenya and Micronesia. These findings provide insights into training initiatives necessary to build CAMHS workforce capacity using integrated care models, each with the ultimate goal of improving access to care. Despite variations and progress in implementing integrated care models internationally, common challenges exist: funding within complex healthcare systems, limited training mechanisms, and geopolitical/policy issues. Supportive healthcare policy, robust training initiatives, ongoing quality improvement and measurement of outcomes across programs would provide data-driven support for the expansion of integrated care and ensure its sustainability. [ABSTRACT FROM AUTHOR]

Objective: to evaluate the adherence of Brazilian long-term care facilities to the World Health Organization Infection Prevention and Control guidance, and assess the association of their size with the adherence to these recommendations. Method: cross-sectional study conducted with facilities' managers. Authors developed a 20-item questionnaire based on this guidance, and a global score of adherence, based on the adoption of these recommendations. Adherence was classified as (1) excellent for those who attended ≥14 out of 20 recommendations; (2) good for 10 to 13 items; and (3) low for those with less than ten items. Facilities' sizes were established as small, intermediate, and large according to a two-step cluster analysis. Descriptive statistics and chi-square tests were used at a 5% significance level. Results: among 362 included facilities, 308 (85.1%) adhered to 14 or more recommendations. Regarding its size, adherence to screening COVID-19 symptoms of visitors (p=0.037) and isolating patients until they have had two negative laboratory tests (p=0.032) were lower on larger ones compared to medium and small facilities. Conclusion: adherence to COVID-19 mitigation measures in Brazilian facilities was considered excellent for most of the recommendations, regardless of the size of the units. [ABSTRACT FROM AUTHOR]

Short-run income shocks can negatively impact school attendance when children are pulled out in order to work, either based on the need for greater income during negative shocks or the increased opportunity cost of child time during positive shocks. This paper proxies for income shocks using fluctuations in local rainfall and evaluates its impact on child schooling, labour force participation, and domestic work. We then investigate whether conditional cash transfers are able to protect school attendance during these temporary shocks. Using data on Brazil's Bolsa Família programme along with municipal-level rainfall data, we find that positive rainfall shocks cause children to increase the likelihood of paid labour but Bolsa partially mitigates these effects, though less so among boys and older children. Furthermore, we find evidence that even when children do not drop out of school during these shocks, Bolsa may not fully maintain their intensity of school attendance and shocks may hinder academic progress. These results suggest that higher wages cause children to substitute time away from schooling, but that Bolsa acts as a partial safety net that stabilises human capital investments during short-run shocks and may help produce larger long-run benefits. [ABSTRACT FROM AUTHOR]

The article aims to analyze the context in which the Dom Avelar Brandão Vilela Federal Agrotechnical School was conceived and implemented in Petrolina (PE) in 1988, and the possible relationship with the institutionalization of technical-vocational education in Brazil and, specifically, of agricultural education. This analysis is carried out based on the concepts of field and forms of schooling, in a relational and sociohistorical perspective, by means of bibliographic and documental research. The article approaches the roots of technical education in Brazil, the slave and labor force relations; the Schools of Apprentice Artisans and the standardization of agricultural education; the Federal Agrotechnical Schools, concluding with the idea that it is possible to perceive a confluence of elements in the genesis of this institution and the Dom Avelar Brandão Vilela School. [ABSTRACT FROM AUTHOR]

In the early 1950s, the Italian government experimented with organized rural settlement in Brazil and the rest of Latin America. Part of a general effort to ease Italy's "overpopulation," rural settlement abroad had special meanings for both Italian and Brazilian elites. These experiments resonated with the memories of mass emigration at the turn of the twentieth century and with the legacy of colonial settlement in Libya and East Africa. These projects also fulfilled ongoing racial and eugenic aspirations in Brazil. Italian rural settlement in Brazil took the form of both employment in the coffee fazendas (estates) and the foundation of relatively homogenous "colonies." However unsuccessful on their own terms, these experiments provide evidence of the links between colonial knowledge and development practices, and they challenge the widespread assumption that Italians simply repressed their colonial past after the end of fascism and military defeat. [ABSTRACT FROM AUTHOR]

Objective: analyze the publications of Twitter users directed to the campaign of valuation of Nursing, driven by the terms #LuteComoUmaEnfermeira and #EnfermagemEuValorizo. Method: quantitative research, based on digital methods. The search was realized using the hashtags #LuteComoUmaEnfermeira and #EnfermagemEuValorizo for tweets extraction. 2,613 tweets were selected for analysis. Results: 22.5% of publications are located in the Brazilian Southeast region and 9.3% in the Northeast region. There were more than 18,000 interactions (likes and shares), and the authors of the posts reach an estimated audience of about 7 million people). The content of the posts mainly related to the regulation of working hours, Personal Protective Equipment, the fight against COVID-19, the defense of the majority female workforce and the fight for rights. Conclusion: the realization of the virtual campaign had important visibility in the national territory and presented great visibility to the profession in number and reach on the Internet. [ABSTRACT FROM AUTHOR]

After a period of falling child labor rates, Brazil has witnessed an increase in its incidence. There are two main federal policies against child labor in the country. The Child Labor Eradication Program (PETI) was created in 1996, designed with a conditional cash transfer approach that requires families to pull their children from labor situation and to have them attend school. The Bolsa Família Program (PBF) targets families living in poverty and extreme poverty via cash transfers conditional on school attendance and vaccination of children. Despite the PBF not directly addressing child labor, the two programs have been in integrated management since 2005. We use a comprehensive dataset covering the entire Brazilian population in 2010 to estimate the effect of each program individually on labor supply of children, both in terms of the extensive margin (probability of labor) and the intensive margin (weekly hours worked conditional on working). We adopt a Propensity Score Matching methodology, flexibly selecting covariates among a wide list of variables related to demographics and socioeconomic indicators of the children and their households, using the algorithm proposed by Imbens (2015) based on the repeated estimation of likelihood ratio tests. In order to consider possible heterogeneous effects, we also perform all estimation procedures separately for each Brazilian region. Our results suggest that the PBF is only able to reduce the probability of child labor in the South region, while the PETI only does so in the Southeast region. Disturbingly, both programs seem to increase the likelihood of child labor in the North and Northeast regions, which are the poorest in the country. On the other hand, when considering the intensive margin of child labor, we find that both PBF and PETI seem to be effective in diminishing weekly hours worked among children in the entire country (except for PETI in the South and Midwest, with less precise estimates). Our estimates also suggest that PETI conditionalities are not closely monitored. Furthermore, with the evidence indicating the programs can only partially reduce hours worked but are unable to remove children from the labor market, we interpret that cash transfer amounts might be insufficient to discourage child labor, especially those from PETI, which have not been updated since 1996. [ABSTRACT FROM AUTHOR]

Background: The ways of life in the Amazon are diverse and not widely known. In addition, social inequities, large geographic distances and inadequate health care network noticeably limit access to health services in rural areas. Over the last decades, Brazilian health authorities have implemented fluvial mobile units (FMU) as an alternative to increase access and healthcare coverage. The aim of the study was to identify the strategies of access and utilization of primary health care (PHC) services by assessing the strengths and limitations of the healthcare model offered by the FMU to reduce barriers to services and ensure the right to healthcare. Methods: Qualitative and ethnographic research involving participant observation and semi-structured interviews. Data collection consisted of interviews with users and health professionals and the observation of service organization and healthcare delivered by the FMU, in addition to the therapeutic itineraries that determine demand, access and interaction of users with healthcare services. Results: Primary care is offered by the monthly locomotion of the FMU that serves approximately 20 rural riverside communities. The effectiveness of the actions of the FMU proved to be adequate for conditions such as antenatal care for low-risk pregnancy, which require periodic consultations. However, conditions that require continued attention are not adequately met through the organization of care established in the FMU. The underutilization of the workforce of community health workers and disarrangement between their tasks and those of the rest of the multi-professional team are some of the reasons pointed out, making the healthcare continuity unfeasible within the intervals between the trips of the FMU. From the users' perspective, although the presence of the FMU provides healthcare coverage, the financial burden generated by the pursuit for services persists, since the dispersed housing pattern requires the locomotion of users to reach the mobile unit services as well as for specialized care in the urban centers. Conclusions: The implementation of the FMU represents an advance in terms of accessibility to PHC. However, the organization of their activity uncritically replicates the routines adopted in the daily routine of health services located in urban spaces, proving to be inadequate for providing healthcare strategies capable of mitigating social and health inequalities faced by the users. [ABSTRACT FROM AUTHOR]

The present work aims to make a continuous analysis of PNAD at the level of Brazil and Mato Grosso with a focus on the labor market between the years 2012 and 2019. The number of employed persons grew steadily throughout. The growth was 7.89% in Brazil and 15.95% in Mato Grosso. There was an increase of the workforce over the series analyzed in Brazil of 11.54% and in Mato Grosso of 13.55%. The unemployment rate values (%) are lower in the whole series at the level of Mato Grosso, in relation to Brazil. The range of 40 to 44 hours is the one with the greatest increase in people in Brazil and Mato Grosso. In both Brazil and Mato Grosso, the number of workers increases throughout the series up to the range of 40 to 44 hours. The percentage of increase in hires for an indefinite period in Brazil is 5.65%. In Mato Grosso, 13.76%. Considering the time ranges in search of work in Brazil, the range up to 1 month accounts for 16% of the total number of people in search of work; from 1 month to 1 by 44.79%, from 1 to 2 years by 14.18% and 2 years or more by 64%. In Mato Grosso, respectively: 22.41%; 46.69; 12.93% and 18.96%. The mass of income grows at 77.98% at Brassil level. I kill in 69.89%. Mato Grosso accounted for 1.8% of the national income mass at the beginning of the series. In the end by 1.76%. [ABSTRACT FROM AUTHOR]

The recyclable materials pickers can be seen as key elements in the process of environmental sustainability, performing important activities for the adequate treatment of solid waste. This study aims to analyze the dynamics of both work and health conditions of waste collectors in Brazil in the year of 2013 and to establish comparisons with the total number of workers in other professions. Was used the quantitative data of the 2013 National Health Survey were explored through statistics models. The results show that men, older, with less education, from black or brown color/race, with low salary and use tabaco and/or drink alcohol on a daily basis present a higher chance of occupying profession of a waste collector. The results show that the workers who collect recyclable materials constitute a fraction of the work force very vulnerable It is necessary that the government health agents face the problematic conditions of both the work and health of the collectors. [ABSTRACT FROM AUTHOR]

This paper analyzes a dimension of the agricultural production in Brazil, highlighting the one carried out downtown or by its inhabitants in the suburb areas. Geographic and other fields of knowledge approaches were dealt with to underline the peculiarities of urban alimentary supply, among them, the frequent supply shortages, which used to drive citizens to produce a part of the items for self-consumption and another for the local commerce. The exportation economy characteristics, with consequent land and work force concentration, allied to restrictive social and territorial division of urban work in the colonial and imperial periods are fundamental for understanding the production process downtown or in suburb areas. At last, we highlight the structural shift which took place in the country due to the consolidation of an internal alimentary production as well as to transformations in towns growth logic which had a peak with the urban agricultural producers' reduction. [ABSTRACT FROM AUTHOR]

This article results from research carried out between March and December 2018 on the process of platformization of labor based on Uber's activities in Brazil, and the experiences and perceptions of Uber drivers. This study employed mixed and experimental methods that combined in-depth interviews with four Uber drivers from Belo Horizonte, in-depth observation of groups of drivers on Whatsapp and Facebook, and an analysis of the technical materiality (interface and interaction mechanics) of Uber Driver, the app that manages the drivers' workforce. This article reviews the concept of "uberization of labor" in the light of Platform Studies, and characterizes the phenomenon as an example of algorithmic and platform labor. We call for an understanding of this phenomenon based on the singularities of the technical mediations entailed in Uber drivers' labor and the algorithmic management of the workforce. [ABSTRACT FROM AUTHOR]

Objective: To describe experience of workers/researchers in performing the Webinar: Obstetric Nursing and its workforce in COVID-19 pandemic: a portrait of actions in Brazil. Method: Experience report on there flections regarding the work force of Obstetric Nurses represented by five regions of Brazil in Webinar of the actions of the Brazilian Association of Obstetrics and Nurses Obstetricians. Results: The experience demonstrated the work force of Obstetric Nursing articulated to the women's health rights in reproductive phase in COVID-19 pandemic from critical thinking, communication, collaboration, and creativity. Conclusion: The need for interaction, through the use of available technologies, among obstetric nursing professionals from all regions of the country is fundamental, in order to share experiences and find new possibilities for the care of women in pregnancy and postpartum a this time of crisis. [ABSTRACT FROM AUTHOR]

This paper analyzes the recent productive restructuring process inside the Imperatriz state of Maranhão territory, by the production chain of paper and cellulose. To achieve this objective, it presents the transformations created by this process from three strands: increase of the plantation area to grow eucalyptus, the mobility of the capital by the transportation facilities of raw material and labor force specialization, presenting the data of the cities that produce eucalyptus and its expansion based in the plantation area increase. Besides that, it maps the expansion of the paper and cellulose industries in Brazil and its logistics that transports the raw material. In addition, it presents the data of labor transformations based on the changes in the labor market, technical and college education. This is achieved presenting the cartographic and photo production, from statistical data of the Brazilian wood industry, from the annual report of social information, from the general registry of employed and unemployed people, labor statistics dissemination program and local teaching institutions. [ABSTRACT FROM AUTHOR]

This paper exposes the events of the transition period from slavery to wage labor as fundamental to the compulsory location of blacks in the reserve army of labor and consequent subaltern insertion in the labor market in Brazilian capitalist society. With emphasis on factors that contributed to streamline this process, in the legal-political, economic, and ideological fields, which aims to provide the production of a constant alienation of the black people. This set of determinations gave rise to the necessary presupposition for the existence of the workforce over-exploitation regime in Brazil, with sharper effects on the black people of the Brazilian proletariat. [ABSTRACT FROM AUTHOR]

Introduction: Many countries are employing strategies intended to reduce maldistribution of health workers and inequities. The purpose of this study was to analyse the impact of expansion policies of medical schools on regional inequalities in the distribution of undergraduate class sizes, and the capacity to attract and retain doctors and to expand health facilities. Methods: We conducted a descriptive analysis to compare the distribution of undergraduate places in 2007 and 2016 to determine the impact of targeted expansion policies on inequalities in access to medical education in Brazil. A group of municipalities with new medical schools (n = 54) and a control group without medical schools (n = 408) were compared to analyse impacts of expansion in the health sector. We compared the increase in the number of physicians per 1000 inhabitants and health establishments per inhabitants between 2007 and 2016 based on these two groups. We also analysed the relationship between geographic distance from the state capital and capacity to attract physicians. Results: There was a decrease in the regional inequalities of undergraduate places in medical schools; the greatest increase in the places per 1000 inhabitants was in municipalities of between 50 000 and 100 000 inhabitants. Municipalities with new medical schools showed an increase in physicians per 1000 inhabitants and in health establishments per inhabitant ratio, demonstrating the potential to attract and retain doctors, as well as strengthening the health infrastructure. Municipalities more distant from state capitals showed a greater increase in physician : inhabitant ratio. Discussion: Countries with health workforce shortages and inequalities in their distribution might consider public financing and regulation policies for expansion of medical schools as a strategy to attract and retain professionals. Early results in Brazil showed that such strategies could strengthen service networks in deprived areas, supporting implementation of Universal Healthcare Coverage. How can medical schools influence regional inequities in access to medicine? This paper describes how expansion policy impacts upon the distribution of the medical workforce and the capacity to attract doctors to underserved areas. [ABSTRACT FROM AUTHOR]

Brazil fell behind in higher education attainment for the cohorts born in the 1950s and 1960s. We jointly model educational choices, labor force participation and wages, and compute the average, marginal and internal rate of returns to schooling after controlling for changes in ability composition at all levels of education. We find very high returns to college, which indicate that the disappointing trend in higher education could reflect binding credit constraints, psychic costs or uncertainty about future earnings gains from schooling. [ABSTRACT FROM AUTHOR]

Background In Brazil, the number of physical therapy education programs and, consequently, of professionals has been growing for the past 20 years. Objectives The objective of the study was to describe the evolution and distribution of physical therapist education programs in Brazil and to analyze the impact of workforce growth on the labor market for these professionals. Design This was a descriptive, exploratory, quantitative study. Methods Secondary data collected from official sources in Brazil were used. Results The first physical therapist education program was created in 1958, and, after significant growth, 536 programs were active in 2014. The historical series (1996–2014) shows a corresponding increase in the number of admissions by higher educational institutions. This expansion resulted in an increase in the number of professionals, with an impact on the labor market. The workforce in physical therapy is predominantly female, and women increased their participation in this labor market from 59% in 1996 to 81% in 2014. An increase in nominal monthly salaries was observed over the years from US $797.00 in 1996 to US $1056.00 in 2014. Nevertheless, the real average salaries, that is, salaries adjusted to inflation, have followed a trend of devaluation. Limitations Results of this study must be interpreted in terms of overall trends rather than as precise absolute numbers due to the inherent nature of the varied secondary data sources. Conclusions These data can support further discussion on training and the labor market in the field of physical therapy. [ABSTRACT FROM AUTHOR]

The present study aims to make a preliminary analysis of the indicators of PNAD for Brazil, Mato Grosso, Cuiabá River Valley Metropolitan Region and Cuiabá Municipality between 2012 and 2018, conducted by the Brazilian Institute of Geography and Statistics - IBGE, with a focus on schooling. The results of the state show that there is a strong predominance in the labor force of people above 14 in Brazil with full secondary education and the number of unemployed persons is always higher for this level of education. In most quarters analyzed at all geographic levels, the ratio of persons 14 years old and above, unemployed and the workforce (%) has lower values for those who have completed higher education. Throughout the periods and geographic levels studied, the yield of the complete upper level is higher than the full secondary level which is higher than that observed at the complete fundamental level. In the analyzed period, people with higher education had an average number of hours worked less than the average and fundamental levels [ABSTRACT FROM AUTHOR]

We report a review of interprofessional education (IPE) for health in Brazil with the objective of identifying experiences and good practices related to the different contexts of changing education and health systems. Our approach is an integrative bibliographic review using surveys and analysis of documents related to IPE in the Virtual Health Library scientific data base. The Brazilian scenario on IPE is still rudimentary, lacking clarity in its definition and scientific progress. Records of successful experiences of IPE and collaborative practices show some growth, with a tendency toward great adherence of professionals, students and teachers in the training model reshuffle. Collaborative practices are strategically used as innovative pedagogical approaches to foster the establishment of integrated teaching-service-community curricula, which coexist with traditional ones. IPE initiatives and collaborative practices have existed in Brazil since the mid-twentieth century. However, the dynamics of training models have not been accompanied by the same pace of change in health services, even under pressure to expand the primary health care (PHC) network and international influence for changes in educational models. The main challenge in this context is to make changes in the three components of training programmes: theoretical orientation, pedagogical approach and scenarios of practices, responding to population health needs and improving people's quality of life. [ABSTRACT FROM AUTHOR]

Background: This study describes the effects of common health conditions associated with absenteeism and presenteeism in a population-based sample of workers in Brazil. Methods: Data were analyzed from the cross-sectional Sao Paulo Megacity Mental Health Survey on 1737 employed residents aged more than IS years old conducted from 2005 to 2007. Results: Physical diseases and mental disorders are highly prevalent among Brazilian workers. The prevalence of absenteeism was 12.8%, and the prevalence of presenteeism was 14.3%. The condition most commonly associated with work impairment was mood disorder. Conclusions: Improving access to care and increasing detection and management of mental disorders should be a priority in Brazil. Occupational health programs and services can play a key role in increasing the productivity of the Brazilian workforce. [ABSTRACT FROM AUTHOR]

Low‐ and middle‐income countries (LMIC) are faced with disproportionately high levels of unmet child mental health needs. This study explored through interviews the perspectives of 17 inter‐agency service stakeholders from Brazil, Indonesia, Kenya, Pakistan, Rwanda and Turkey on existing supports and challenges. Four themes emerged on the holistic nature of children's mental health needs linked with disadvantage; limited resources and skilled workforce; stigma; and strategies for future implementation, including awareness, parental engagement, skills‐based programmes and cultural adaptation. Stakeholder input is essential in conceptualising, developing and evaluating culturally appropriate interventions for vulnerable children in LMIC. [ABSTRACT FROM AUTHOR]

Objective: to identify the average direct cost of maintaining the patency of totally implanted central venous catheter with heparin at a Day Hospital of a public hospital of high complexity specialized in the treatment of cancer patients, and estimate the average direct cost of replacing heparin with sodium chloride 0.9%. Method: quantitative, exploratory-descriptive study, with a sample of 200 non-participant observations of the maintenance of totally implanted central venous catheters with heparin. The average direct cost was calculated by multiplying the (clocked) time spent by professionals to complete the procedure by the direct unit cost of workforce, added to the cost of materials and solutions. Results: the estimated total direct cost of catheter maintenance with heparin was US$ 9.71 (SD=1.35) on average, ranging from US$ 7.98 to US$ 23.28. The estimated total direct cost of maintenance with 0.9% sodium chloride in the place of heparin was US$ 8.81 (SD=1.29) on average, resulting in a reduction of US$ 0.90 per procedure. Conclusion: the results contributed to propose strategies to assist in cost containment/minimization in this procedure. The replacement of heparin by 0.9% sodium chloride proved to be an option to reduce the total average direct cost. [ABSTRACT FROM AUTHOR]

The National Curricular Guidelines (NCGs) are important documents for understanding the history of academic health professions education in Brazil. Key policies within the NCGs have helped to reorient health professions education and have stimulated curricular changes, including active learning methodologies and more integrated teaching-service environments, and, more recently, have introduced interprofessional education (IPE) in both undergraduate and postgraduate sectors. This article presents the findings of a study that examined the NCGs for nursing, dentistry, and medicine courses as juridical foundations for adopting strategies that promote IPE across higher education institutions in Brazil. We employed a comparative and exploratory documentary analysis to understand the role of IPE and collaborative practices in NCGs for the three largest professions in Brazil. Following a thematic analysis of these texts, four key themes emerged: faculty development; competencies for teamwork; curricular structure; and learning metrics. Key findings related to each of these themes are presented and discussed in relation to the wider interprofessional literature. The article goes on to argue that the statements contained in the NCGs about adoption of IPE and collaborative practices will have an important influence in shaping the future of health professions education in Brazil. [ABSTRACT FROM PUBLISHER]

Gender gaps in the labor force take three main forms: participation, job type, and earnings. However, research has shown that increasing women's participation in the labor force can have a net positive impact on gross domestic product (GDP). One research study estimated a net impact of 9 percent on Brazil's GDP if female participation in the workforce reached similar levels to male participation. This article explores the main reasons why 40.6 percent of Brazilian women are not participating in the labor market, the reach of the legal reforms and social programs in the country, and present policy recommendations to increase women's participation in the labor force. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to evaluate skilled labor demand determinants in Brazil, considering alternatives explanations: changes in relative wages, non-homothetic technology output growth and skill-biased technical change.Design/methodology/approach This study relies on a rich and unique matched employer-employee data set for manufacturing sector, from 1996 to 2003. The analysis considers a translog functional form labor demand system estimated using seemingly unrelated regression and instrumental variables to control for possible measurement errors and wages and output endogeneity.Findings The demand function estimates suggest that: labor demand underlying technology is non-homothetic, research and development investment is biased toward skilled workers, the non-homothetic technology is not skill biased so output changes contributed positively for skilled labor increase, relative wages played a significant role and international trade has little explanatory power explaining labor demand shifts.Originality/value This is the first paper that considers alternative explanations for the increase in the demand of skilled workers for manufacturing in Brazil simultaneously: changes in relative wages, output changes with non-homothetic technology, skill-biased technical change and, to a lesser extent, international trade. The study challenges current empirical evidence that considers trade and trade liberalization as the main factor explaining labor demand shifts. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to present evidences on the spillover effects of a cash transfer addressed to poor elders in Brazil.Design/methodology/approach Using the Brazilian National Households Survey (PNAD) the authors assess the effects of an income transfer to the elders on household composition and the labor supply of elders and co-residing relatives, under a regression discontinuity design.Findings The authors do not find strong evidences of changes in the household composition due to the program. However the authors found reductions in the elders’ labor force participation, indicating that the program allow elders to retire. Moreover, the transfer yields a decrease in the labor force participation of co-residents, depending on their age. The authors also observe decreases in child labor.Originality/value Along with the cash comes context-dependent effects, showing there are many latent aspects of these transfers yet to be uncovered. [ABSTRACT FROM AUTHOR]

The article aims to analyze the general aspects of the nursing staff labor market, as the way they operate in structuring sectors of the health sector, that is, (public, private, philanthropic and education). It is a cross-sectional study whose target population consists of all nurses, technicians and nursing assistants from Brazil, which have active registration with the Federal Nursing Council (COFEN). The study has a national presence, being able to generate results for each state. The results point to the hegemonic employment in the public sector; concentration of the Nursing Workforce (FTEn) in large urban centers; shortage of nurses in the country's interior; intra-composition new categories. Signal yet for an extensive working hours, precarious links, monthly income below the basics for a decent job, sub journeys, sub wages and underemployment. A team that sum 1.8 million professionals, 414,000 nurses and 1.4 million technicians and assistants, namely 65% of the health team working in the system, brings a diversity and complexity analysis. The survey data may subsidize the construction of public policies adequate to the reality of the huge number of workers, essential for the Health System. [ABSTRACT FROM AUTHOR]

Hierarchical forecasting methods take advantage of the hierarchical structure of the data through base forecast reconciliation, generating results that are usually unbiased and more accurate than those provided by benchmark methods. When combining base forecasts through regression-based reconciliation strategies, however, some forecasts may behave like outliers, causing distortions to the reconciliation process. This work introduces the concept of robust estimation for hierarchical forecast reconciliation methods. We formalize two different robust-based approaches applied to unemployment data from multiple labor force surveys in Brazil. In doing so, we address a significant gap in the modelling and forecasting of unemployment, taking into account the hierarchical structure of the data. To demonstrate the potential and validity of the proposed approaches, we compare their performance with those from traditional and state-of-the-art methods. Overall, the robust approaches show promising forecasting results under multiple settings and through the lens of different evaluation metrics. Furthermore, the methodology developed herein is flexible, in the sense that it can be readily applied to other time series and deliver equally reliable results. • Brazil's unemployment hierarchical forecasting. • Forecasting multiple labor force surveys in Brazil. • Robust estimation for hierarchical forecast reconciliation methods. [ABSTRACT FROM AUTHOR]

• We analyze a massive administrative dataset containing information on all recipients and applicants of Brazil's Bolsa Família program. • We use the presence of Multiples (twins, etc.) as an instrument for receiving the Bolsa Família stipend. • Receiving the stipend does not offset the cost of an exogenous increase in family size. • Receiving the stipend also not reduce child laborers' participation in the workforce and does not improve educational outcomes for child laborers. • Instead, contextual and familial factors appear to shape program efficacy in mitigating this troubling child labor. Child labor is a pernicious problem throughout the developing world, but conditional cash transfer programs (CCTs) could reduce the number of working children. We evaluate the effectiveness of CCTs at attenuating child labor based on our analysis of a massive administrative dataset on Brazil's applicants to social programs between 2001 and 2015. We use Multiples (twins, triplets, etc.) as an instrument for receiving the Bolsa Família stipend. Receiving the stipend does not offset the cost of an exogenous increase in family size, does not reduce child laborers' participation in the workforce and does not improve educational outcomes for child laborers in households with Multiples births. Instead, contextual and familial factors appear to shape program efficacy in mitigating this troubling practice. [ABSTRACT FROM AUTHOR]

Commenting on Figueiredo's exploration of national expansion policy, O'Sullivan and Chater further the discussion of what medical schools can contribute to the reduction of healthcare inequalities. [ABSTRACT FROM AUTHOR]

The article highlights the case for strengthening healthcare systems by building inter professional education (IPE) into workforce strategies. It discussed that the government's work for allied health, nursing, and social work students to learn collaborative competence and also mentions the incoming Labour Government of the century called for common learning across all health and social care professions to deliver a workforce responsive to its policies to modernize the public services.

This article explores the mobilization of power by health workers during policy implementation, showing how in a context of discretion and resource scarcity they can reproduce inequalities in access to health services. The argument innovates theoretically by supplementing the 'street-level bureaucracy' literature, which emphasizes frontline worker discretion, with a conceptualization of power as domination encompassing the shaping of behavior, the constitution of subjects and the reproduction of inequality. Empirically, the article focuses on Brazilian community health workers (agentes comunitários de saúde , CHWs). CHWs are a neglected but highly important segment of the health workforce that traditionally functions as a link between the health system and disadvantaged groups. The article examines how Brazilian CHWs act as street-level bureaucrats mobilizing power in their interactions with users. They operate within a severely under-resourced public health system, the Sistema Único de Saúde , which places constraints upon their action and forces them to make allocation decisions with little training and support. The article highlights the ways in which inequalities in access to health services are reproduced (inadvertently or not) through the practices, discursive styles and classifications of CHWs. Methodologically, the paper is based on ethnography with 24 CHWs and interviews with 77 other CHWs in Brazil. • Develops a novel framework for analysing health worker discretion and power. • Supplements the street-level bureaucracy approach with the concept of domination. • Explores the mobilization of power by Brazilian community health workers. • Shows how policy implementation can reproduce inequality in access to healthcare. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer collects the highest survival benefit from radiotherapy (RT) among all malignancies. A large gap between oncological demand and RT availability exists for cervical cancer in Brazilian Public Health System (BPHS). Aim: To evaluate cost-effectiveness of universal access to RT and chemo-radiation (CRT) for untreated cervical cancer patients in the BPHS. Methods: The incremental cost was calculated based on the direct medical cost from a payer's perspective and the proportion of new cases with unmet RT/CRT needs in 2016. The incremental effectiveness was evaluated by life-year (LY) gain based on life expectancy, cervical cancer incidence and the number of cancer deaths due to lack of RT/CRT access as previously described. The incremental cost-effectiveness ratio (ICER) was calculated from direct medical costs and LYs. The indirect costs from mortality-related productivity loss (MRPL) were estimated based on life expectancy, wage and labor force participation rate. The MRPL was compared with direct medical cost. All costs and effectiveness were age-adjusted based on 2016 Brazilian data and discounted at 3% per year. Costs were adjusted to 2016 U.S. dollars. One-way sensitivity analysis was performed to assess the robustness of the model. Results: The annual cost to close RT gap was $14.3 million, with additional cost of $4.1 million to close the CRT gap. The average years of potential life lost per death was 20.5. Cost per life saved was $10,820 for RT alone (ICER: $528/LY) and $18,919 for CRT (ICER: $584/LY), respectively. The MRPL due to shortage of RT/CRT were 70/81 million respectively. Conclusion: Providing universal access to RT/CRT for cervical cancer patients in the BPHS will incur low cost per life-year saved and provide large economical gain by saving thousands of lives. [ABSTRACT FROM AUTHOR]