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In this study we designed, implemented, and evaluated a Problem-based Learning (PBL) course to teach undergraduate students about Viral Hepatitis from a Health Geography perspective. The course was attended by undergraduate students with no previous experience with PBL from a college in the Brazilian Amazon state of Acre. The course design was based on a combination of features from different PBL frameworks, allowing the students to gradually switch from a content-centered educational environment to a student-centered one. The PBL unit was based on an ill-structured real-life problem concerning the division of a hypothetical budget among actions to fight Viral Hepatitis in the state's municipalities. Student problem solutions indicated that they learned basic Viral Hepatitis and Health Geography concepts. Furthermore, perceptions of their own learning demonstrated that students regarded their acquired problem-solving skills and their knowledge of the course subject as their main educational outcomes. We argue that the combination of different PBL frameworks, the gradual transition from lectures to active learning and the social relevance of the course subject to students are among the putative factors that contributed to the course's success. This study, therefore, provides insights into the design of PBL courses for students inexperienced in active learning.

Research Findings: The Early Childhood Environment Rating Scale--Revised (ECERS-R) is widely used to evaluate the quality of early childhood education and its association with child development. However, the psychometric properties of the ECERS-R are not well established. Consequently, in this study we tested 3 different factor solutions of the ECERS-R using models sourced from the existing literature (featuring 1-, 2-, and 3-correlated-factor solutions) and applying confirmatory factor analysis to data from the epidemiological sample of the Embu Pre-school Mental Health Study (n = 1,292 children). Alternative measures of child education quality (such as teacher-to-child ratio) were also analyzed. The confirmatory factor analysis returned good fit indices for both the unidimensional and 3-correlated-factor solution models. Practice or Policy: This study showcases different applications of the ECERS-R, both the full and shortened versions. These findings are particularly important for improving ECERS-R guidelines for researchers, professionals, and policymakers.

Introduction: Web-based epidemiologic surveys are being widely used, but still present lower response rates compared to traditional methods. Their design can influence survey response rates. Objective: Analyse the influence of questionnaire length, frequency of reminders, and the interaction between them, on the response rates of five web-based questionnaires. Methods: This is a 2×2 factorial study. Participants registered into the "coortesnaweb" platform (n=1,277) were randomly assigned to respond to short or long questionnaires, and to receive high or low frequency of reminders. We analysed the influence of these factors on the response rates of five web-based questionnaires applied in a longitudinal manner. The relative risk of responding to an additional questionnaire was also analysed. Results: The mean response rate was 54.3%. Sending reminders more frequently was positively associated with the response rates for the first questionnaires. Questionnaire length did not influence response rates. We found no interaction between questionnaire length and frequency of reminders. Women and highly educated participants had, respectively, 13.0% and 28.0% increased probability of responding an additional questionnaire. Conclusions: We obtained high response rates for the first questionnaires. Sending reminders more frequently and providing conditional incentives should be employed. Long questionnaires did not jeopardize response rates of web-based questionnaires.

This article examines student engagement in an inquiry-based learning activity, planned to provide students with elements in the social, epistemic, and conceptual dimensions related to the scientific practice in immunology. The activity was applied to 39 groups of students enrolled in immunology or biochemistry courses in a public university in Brazil. Students performed data-collection through the execution of an "in vitro" assay. We analyzed how students represent data and use them to support their claims in their written constructs. To clarify which are the productive epistemologies in students' reports, we developed a framework for epistemic practice analysis. Our findings point to a pattern of several epistemic practice categories in their written text, mostly related to the particular contingences of data analysis, rather than to theoretical concepts. In addition, we observed that students performed literary inscriptions to represent their data; however, they tended not to cite all data obtained in their written texts. These results suggest that immunology education strategies should provide students with approaches that explore the role Epistemology of data representation in the scientific text rhetoric.

First-aid methods recommended for snakebites are included in Science textbooks in Brazil. Books published before 1996 provided misleading information in this respect and it is possible that such recommendations derived from North-American experiences conducted at the beginning of the 20th Century. The official evaluation of textbooks carried out by the Ministry of Education in 1996 initiated a major public discussion on the several mistakes which had been present in Brazilian educational materials, mainly those relating to mistaken snakebite first-aid procedures. As from 1996, a significant decrease in the number of casualties from snakebites was reported, both in the total number of deaths and among the patients who had received medical assistance. The official data showed this decrease was consistent and remained so for the following ten years. The number of deaths might be associated with the reduced number of victims who developed complications resulting from improper first-aid procedures. This article is intended to relate the changes implemented in textbooks as a result of the first national evaluation and the great impact caused by the publication of the serious mistakes found in these materials, with the reduction in the number of casualties from snakebites in the same period. (Contains 3 figures and 2 tables.)

The Brazilian Ministry of Sports organized a system of volunteers to receive the visitors during the Fédération Internationale de Football Association (FIFA) Football World Cup. The instructional material to capacitate these volunteers focused on environment and sustainability issues and it was developed in an integrative systemic framework supported by concept maps. The development procedures were organized in a hierarchical structure, addressing the main zero level, zero plus one level, zero minus one level and the subsequent downscaling levels. The main knowledge issues that were integrated were: biome concept, climate, biodiversity and endangered species, protected areas, public health, epidemiology, sanitation, sustainable tourism, social responsibility and local welfare. The instructional material was adapted to the virtual learning environment and the capacitation was concluded. This article highlights the use of concept maps for integrative planning and promoting an interdisciplinary approach to the environmental and sustainability issues related to tourism and health.

Objective: To describe the prevalence of DSM-IV disorders and the pattern of comorbidity in a population-based sample of 7- to 14-year-old Brazilian schoolchildren. Method: Random sampling of schools (stratified into private, public rural, and public urban) was followed by random sampling of pupils from school lists. In 2000-2001, a total of 1,251 children were assessed for DSM-IV diagnoses using the Development and Well-Being Assessment, a structured multiinformant assessment supplemented by verbatim reports reviewed by clinicians. Results: The response rate was 83%. The overall prevalence of DSM-IV disorders was 12.7% (95% confidence interval = 9.8%-15.5%), with 3.5% of children being assigned as not otherwise specified rather than operationalized diagnoses. The overall prevalence of psychiatric disorder was significantly higher than in a British study with the same measures and diagnostic procedures (12.7% versus 9.7%, p = .02). Conclusions: Approximately one in eight schoolchildren in the study area in the southeast of Brazil have psychiatric disorders involving a level of distress or social impairment likely to warrant treatment. The gulf between need and provision is currently vast. J. Am. Acad. Child Adolesc. Psychiatry, 2004;43(6):727-734. Key Words: epidemiology, child psychiatry, prevalence, Brazil, Latin America.

Background: This investigation aimed at examining, through an epidemiological study, the social demographic, family and individual determinants of behaviour problems in preschool children. Method: Six hundred and thirty-four children, age four years, and their mothers, belonging to a cohort of 5,304 children being followed from birth, took part in the study. During a home visit, the child's behaviour problems and IQ were examined, as well as the prevalence of maternal psychiatric disorder, the quality of the home environment, and other social demographic, family and individual factors. Results: The results revealed a prevalence of children's behaviour problems of 24% (clinical and borderline groups). Regression analysis showed that maternal psychiatric disorder, education and age, number of younger siblings and quality of the home environment explained 28% of the variance of the child's behaviour problems. Conclusions: The results point to the multi-determination of child behaviour problems.

The common cold is the primary cause of illness in the community, with over 200 viral strains identified, and rhinovirus infections being the most prevalent. Coronavirus Disease 19 (COVID-19) is also a significant cause of severe illness. The burden of acute respiratory infections has a significant impact on the economy, resulting in absenteeism from work and school. Rhinovirus infections can exacerbate asthma and other chronic diseases, leading to hospitalization. The objective of this study is to investigate the factors associated with death and survival in patients hospitalized for rhinovirus in Brazil in 2022. This is a retrospective cohort study using data from the national surveillance of Severe Acute Respiratory Syndrome (SARS) in 2022 in Brazil, with all the norrifications. We analysed and compared clinical and epidemiological factors and outcomes between survivors and deaths in patients hospitalised for rhinovirus. The absolute and relative frequencies were calculated according to the states. Bivariate analysis was performed using chi-squared test and Fisher's exact test, while multivariate analysis was performed using COX regression. Out of 8,130 cases of SARS caused by rhinovirus, 291 (3.58%) resulted in death while 7839 (96.47%) patients survived. The factors associated with death were invasive ventilation (p- < 0.001 HR 4.888 CI 95% 3.816–6.262), bocavirus (p- < 0.001 HR 4.204 CI 95% 2.595–6.812), immunodepression/Immunosuppression (p- < 0.001 HR 2.417 CI 95% 1. 544–3, 786), COVID-19 (p- < 0.001 HR 2.167 CI 95% 1.495–3.142), chronic neurological diseases (p-0.007 HR 1.610 CI 95% 1.137–2.280), abdominal pain (p-0.005 HR 1.734 CI 95% 1.186–2.537), age (p- < 0.001 HR 1.038 CI 95% 1.034–1.042). The survival factors identified in this study were dyspnea (p = 0.005; HR 0.683; CI 95% 0.524–0.889), cough (p < 0.001; HR 0.603; CI 95% 0.472–0.769), and asthma (p = 0.052; HR 0.583; CI 95% 0.339–1.004). Additionally, the study found that receiving a COVID-19 booster dose was also a significant survival factor (p = 0.001; HR 0.570; CI 95% 0.415–0.784). The factors associated with death were similar to those in the literature, and the factors associated with survival were also similar, except for the booster dose of the COVID-19 vaccine, which we didn't find in any studies. Our study is the first to associate the full course of the COVID-19 vaccine with survival in those hospitalized for rhinovirus, regardless of COVID-19 and rhinovirus co-detection. [ABSTRACT FROM AUTHOR]

We report acute Oropouche virus infections in 2 previously healthy women from a nonendemic region of Brazil outside the Amazon Basin. Infections rapidly progressed to hemorrhagic manifestations and fatal outcomes in 4-5 days. These cases highlight the critical need for enhanced surveillance to clarify epidemiology of this neglected disease. [ABSTRACT FROM AUTHOR]

Objective: To characterize the epidemiology, identify trends in prevalence, seasonality, and risk factors for orofacial clefts (OFC), selecting the São Paulo state (SPS) population database. Design: A population-based study to estimate the OFC prevalence trends in recent years, stratified by maternal age and SPS geographical clusters. Setting: All live births (LB) with OFC in SPS from 2008-2019. Patients: 5342 cases of OFC among 7 301 636 LB. Interventions: Not applicable. Main outcome measures: OFC prevalence trends, annual percent change (APC) with a 95% confidence interval, and seasonality. Results: We found an OFC prevalence of 7.3/10 000LB in SPS, Brazil. Among all the cases, the majority were male (57.1%), Caucasian (65.4%), 77.8% born at term, 75.8% weight >2500 g, 97.1% singleton, and 63.9% of births were by cesarean section. From 2008-2019, SPS presented a stationary OFC prevalence trend; in São Paulo city, the highest APC was observed (0.05%); the maternal age group with the highest OFC prevalence rate was ≥35 years (9.2/10 000LB). We identified the existence of seasonal variation based on the conception date in the final months of the year, corresponding to the spring season (P <.001). Conclusion: OFC had a stationary prevalence trend in recent years, with the highest prevalence in the Central North Cluster and ≥35 years maternal age group. Seasonality was observed in the spring season, and congenital malformation of lips was the most common associated pathology. This population-based study is the first to summarize the current epidemiology of OFC in SPS. [ABSTRACT FROM AUTHOR]

Leprosy is a chronic infectious disease that has a slow evolution and is characterized by dermatoneurological involvement. The health challenges surrounding this disease are closely related to the stigma that results from the physical disabilities it causes. This is due to its high rate of late diagnosis and the peculiar deformities that occur in its advanced stage. Evaluate the clinical and epidemiological aspects of patients with plantar lesions who were treated for leprosy in a dermatology referral unit. This is a cross-sectional exploratory field study that was conducted at the Reference Center in Tropical Dermatology and Venereology Alfredo da Matta (FUHAM), in Manaus, Amazonas, Brazil. We evaluated 36 patients with disabilities as a result of leprosy and who had plantar lesions. The most common ulcer site was the medial region of the plantar surface, which presented dryness and maceration with yellowish seropurulent exudate, fibrinous tissue and grade 2 depth. The study made it possible to observe the evolution of plantar ulcers resulting from the disease process, then evaluate them and discuss recommendations regarding the treatment and prevention of this type of physical disability. [ABSTRACT FROM AUTHOR]

This study determined the frequency of positive tests for bovine tuberculosis in animals and breeders/establishments in Rio Grande do Norte, Brazil. Data were provided by the Instituto de Defesa e Inspeção Agropecuária do Rio Grande do Norte (IDIARN), from its Unidade Local de Sanidade Animal e Vegetal (ULSAV'S), acquired in monthly reports issued by qualified Veterinarians under the National Program for the Control and Eradication of Brucellosis and Animal Tuberculosis (PNCEBT), from June 2012 to December 2021. For diagnosis, the comparative cervical test was used as a routine and confirmatory test. A total of 45,804 cattle were tested, 53 (0.1%) of which tested positive. Secondary data are essential in the evaluation of sanitary measures, allowing rapid generation of hypotheses about diseases and providing support for decision-making. Measures such as raising awareness among producers, sanitary control in the acquisition and sale of cows for reproduction, inspection of sanitary barriers, and conducting epidemiological surveys to understand the actual situation of this disease in the state of Rio Grande do Norte are crucial. [ABSTRACT FROM AUTHOR]

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Dysphagia is common, but there is limited information about its prevalence and patient preferences regarding dosage forms (oral solids, liquids, topical, etc.) in Brazil, China, the United Kingdom (UK), and Indonesia. Methods: We conducted an online survey of 1000 adults from each country, without any required disease, to estimate the prevalence of dysphagia in these four nations and the dosage form preferences among UK patients. Results: A total of 36.9%, 40.5%, 54.9%, and 64.5% from the UK, Indonesia, Brazil, and China, respectively, had an Eating Assessment Tool (EAT-10) score of ≥3 (indicative of dysphagia). Only 2% of UK respondents and 5% of Brazilian respondents reported a formal diagnosis of dysphagia. Indonesian (74%) and Chinese respondents (77%) were more likely than Brazilian (52%) and UK respondents (45%) to report that their swallowing problems affected their ability to adhere to medication instructions. Liquids were the oral medication formulation most preferred by those who reported difficulty swallowing. Conclusions: To conclude, substantial populations have difficulty swallowing, which can translate into an access issue for medical treatment. The availability of people's preferred dosage forms may help alleviate the adherence issues associated with difficulty swallowing and the concomitant effects on health outcomes. [ABSTRACT FROM AUTHOR]

Simple Summary: Bladder cancer is an economically costly cancer, especially in Brazil, where treatment and diagnosis vary greatly across regions. This study revealed that, after the age of 50, mortality from this disease increases, and is more common among white people and residents of the southern region of Brazil. The lack of health professionals and the lower investment in health actions and services contributed to this increase in mortality. In addition, the performance of basic procedures, such as punctures and cystoscopy examinations, was lower in regions with higher mortality rates; however, more complex surgeries failed to reduce mortality rates. These results underscore the need to improve public health policies and ensure better access to healthcare for cancer, especially in Brazilian regions with fewer resources. Bladder cancer is one of the most economically costly types of cancer, but few studies have evaluated its mortality considering the factors that impact this outcome. This study aimed to investigate the impact of sociodemographic factors, period, cohort, and health services on bladder cancer mortality. This ecological study analyzed bladder cancer mortality data in Brazil from 2000 to 2022 and evaluated sociodemographic variables (race, region of residence), socioeconomic variables (gross domestic product per capita, Gini index of household income per capita, number of health professionals per inhabitant, expenditure on public health services, and consultations per inhabitant), and bladder cancer diagnosis and treatment procedures. These data were subjected to statistical analysis, which revealed that after the age of 50, there was a progressive increase in the risk of bladder cancer. Indigenous people had the lowest mortality rate, while white people had a significantly greater mortality rate than black and brown people. The North Region and Northeast Region presented the lowest mortality rates, whereas the South Region presented the highest mortality rates. In the South and Southeast Regions, a higher GDP was related to lower mortality. In the South, higher mortality was associated with a lower number of consultations per inhabitant per region. Fewer bladder punctures/aspirations and bladder biopsies were associated with higher mortality rates. In oncology, more procedures, such as total cystectomy, cystoenteroplasty, and total cystectomy with a single shunt, do not reduce the mortality rate. These results can serve as guidelines for adjusting public health policies. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the risk factors associated with diabetes mellitus (DM) among Brazilian adults. Cross-sectional study. Data of 75,860 Brazilian adults (≥18 years) were collected using the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel) (2020–2023). Variables assessed included self-reported medical diagnosis of DM, sociodemographic factors (sex, age, schooling, marital status) and DM risk factors (regular consumption of sweetened beverages (≥5 times/week), infrequent consumption of fruits and vegetables, and beans (<5 times/week), insufficient physical activity, prolonged screen time on cell phones, computers, tablets (CCT), and television (TV), smoking, heavy episodic drinking, excess weight, and obesity). Logistic regression models estimated crude and adjusted odds ratio (aOR) (adjusted for sociodemographic characteristics) for the association between the risk factors and the presence of DM. The overall prevalence of self-reported DM in the population was 9.2%. There was a lower chance of regular consumption of sweetened beverages (aOR 0.79; 95% CI: 0.65–0.97) and heavy episodic drinking (aOR 0.77; 95% CI: 0.65–0.93) and a greater chance of insufficient physical activity (aOR 1.40; 95% CI: 1.25–1.55), prolonged TV screen time (aOR 1.22; 95% CI: 1.09–1.36), excess weight (aOR 1.62; 95% CI: 1.44–1.82) and obesity (aOR 1.87; 95% CI: 1.67–2.10) among individuals with DM. There was a lower chance of regular consumption of sweetened beverages and heavy episodic drinking among individuals with DM and a greater chance of insufficient physical activity, prolonged TV screen time, excess weight, and obesity, among that. [ABSTRACT FROM AUTHOR]

Aim: The occurrence of periodontal diseases is still to be determined in large samples of major Brazilian cities. This study aimed to assess the periodontal status of adults from Curitiba, Paraná, Brazil, using periodontitis definitions by the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP) and the recently published ACES 2018 Classification Framework. Materials and Methods: A multi‐stage probability sampling technique was applied to draw individuals aged 18 or older. A total of 566 individuals underwent a full‐mouth periodontal examination. Periodontitis cases were defined according to the CDC/AAP and the ACES 2018 Classification Framework. Non‐periodontitis cases were classified as healthy or gingivitis. The agreement between the two definitions was calculated. Results: Periodontal health was present in 33.6% and 13.8% of individuals, and gingivitis was found in 11.7% and 7.5%, according to CDC/AAP and ACES, respectively. Mild, moderate and severe periodontitis (CDC/AAP) were present in 2.1%, 33.4% and 19.1% of individuals, respectively. Using ACES, 34.3% had Stages I/II and 43.3% had Stages III/IV. The occurrence of periodontitis was higher when a subgroup of individuals aged 30+ were analysed, ranging from 69.6% (CDC/AAP) to 90.1% (ACES). CDC/AAP and ACES agreement for health, gingivitis and periodontitis accounted for 68.8% of the observations. Conclusions: Periodontal diseases affect more than 66% of the population aged 18+ years. Classic definition by the CDC/AAP and the recently published ACES Framework yielded moderate agreement. [ABSTRACT FROM AUTHOR]

This study aimed to characterize the epidemiological aspects of PrEP use and barriers to accessing this prophylaxis. This cross-sectional study was conducted between January 2021 and April 2022, encompassing 140 PrEP users treated at the Testing and Counseling Center (CTA) in Campo Grande, Mato Grosso do Sul. Data on sociodemographic characteristics and factors associated with PrEP discontinuation were obtained using a standardized questionnaire. Most PrEP users were cisgender men (92.00%), predominantly white (51.00%), over 30 years of age (56.50%), homosexual-oriented (76.50%), and had a minimum of 12 years of education (77.50%). Approximately 60.00% admitted to inconsistent condom use in recent sexual encounters, primarily involving anal intercourse. Approximately 88.00% perceived themselves as at risk of contracting STIs in the upcoming year. Regarding new presentation forms, 54.00% indicated a willingness to use "on-demand PrEP," and 92.00% expressed interest in using "injectable PrEP." After 6 months of follow-up, 43.60% (95.00% CI: 35.50–52.00) discontinued PrEP use, primarily due to changes in sexual behavior (38.30%) and difficulties accessing healthcare services (21.28%). This study underscores the need to involve diverse key populations and highlights the significance of PrEP as an ongoing monitoring strategy for HIV/STI prevention in addition to the importance of incorporating new formulations such as daily oral PrEP into the Brazilian National Health System (SUS). [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study was to analyse the spatial patterns and factors associated with the incidence of tuberculosis-diabetes (TB-DM) in Brazil, from 2001 to 2019. Ecological study. Brazilian municipalities were used as the units of analysis. The local empirical Bayesian rate and the spatial autocorrelation test were calculated. Moran and Getis-Ord Gi∗ were used to identify spatial clusters, and spatially weighted regression was conducted. In total, 75,021 new cases of TB associated with DM were reported in Brazil during the study period. Most Brazilian municipalities had an average TB-DM incidence of 1.0–2.0/100,000 inhabitants. The regression showed that the Gini index (β = 0.85) and family health strategy coverage (β = −0.26) were the two indicators that had the most influence on TB-DM incidence in Brazil. This study identified spatial clusters of TB-DM in Brazil. The results also indicated that social inequalities played a key role in the incidence of TB. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Mortality due to acute respiratory distress syndrome (ARDS) is a major global health problem. Knowledge of epidemiological data on ARDS is crucial to design management, treatment strategies, and optimize resources. There is ample data regarding mortality of ARDS from high-income countries; in this review, we evaluated mortality due to ARDS in Latin America. DATA SOURCES: We searched in PubMed, Cochrane Central Register of Controlled Trials, Web of Science, and Latin American and Caribbean Health Science Literature databases from 1967 to March 2023. STUDY SELECTION: We searched prospective or retrospective observational studies and randomized controlled trials conducted in Latin American countries reporting ARDS mortality. DATA EXTRACTION: Three pairs of independent reviewers checked all studies for eligibility based on their titles and abstracts. We performed meta-analysis of proportions using a random-effects model. We performed sensitivity analyses including studies with low risk of bias and with diagnosis using the Berlin definition. Subgroup analysis comparing different study designs, time of publication (up to 2000 and from 2001 to present), and studies in which the diagnosis of ARDS was made using Pao2/Fio2 less than or equal to 200 and regional variations. Subsequently, we performed meta-regression analyses. Finally, we graded the certainty of the evidence (Grading of Recommendations Assessment, Development, and Evaluation). DATA SYNTHESIS: Of 3315 articles identified, 32 were included (3627 patients). Mortality was 52% in the pooled group (low certainty of evidence). In the sensitivity analysis (according to the Berlin definition), mortality was 46% (moderate certainty of evidence). In the subgroup analysis mortality was 53% (randomized controlled trials), 51% (observational studies), 66% (studies published up to 2000), 50% (studies after 2000), 44% (studies with Pao2/Fio2 ≤ 200), 56% (studies from Argentina/Brazil), and 40% (others countries). No variables were associated with mortality in the meta-regression. CONCLUSIONS: ARDS mortality in Latin America remains high, as in other regions. These results should constitute the basis for action planning to improve the prognosis of patients with ARDS (PROSPERO [CRD42022354035]). [ABSTRACT FROM AUTHOR]

1. Epidemiological surveillance of Salmonella spp. serves as a primary tool for maintaining the health of poultry flocks. Characterising circulating serotypes is crucial for implementing control and prevention measures. This study conducted phenotypic and molecular characterisation of S. enterica Pullorum, S. enterica Heidelberg, and S. enterica Corvalis isolated from broiler chickens during slaughtering. 2. All strains were susceptible to gentamicin, neomycin and norfloxacin. However, resistance rates exceeded 50% for ciprofloxacin and tiamulin, irrespective of the serotype. Approximately 64% of strains were classified as multidrug-resistant, with S. enterica Heidelberg strains exhibiting significantly higher overall resistance. The isolates demonstrated the ability to adhere and produce biofilm at a minimum of three temperatures, with S. enterica Pullorum capable of biofilm production at all temperatures encountered during poultry rearing. 3. Each strain possessed between two and seven different virulence-associated genes. Genetic similarity, as indicated by pulsed field gel electrophoresis, exceeded 90% for all three serotypes and strains were classified in the R5 ribotype by PCR, regardless of serotype. Sequencing revealed high similarity among all strains, with homology ranging from 99.61 to 100% and all were classified to a single cluster. 4. The results suggested a clonal relationship among the strains, indicating the possible circulation of a unique clonal group of S. enterica Pullorum in the southern region of Brazil. [ABSTRACT FROM AUTHOR]

Background: The indigenous population located in the central region of Brazil, is the second largest in terms of population size in the country. The Indigenous Reserve of Dourados has risk factors that increase the vulnerability of the indigenous population to infectious diseases, especially Human alphaherpesvirus (HSV-1), a neglected disease with high prevalence in priority populations in developing countries. The virus can also cause many more severe diseases, including widespread neonatal infections, herpetic keratitis, and herpes encephalitis, which can be fatal if left untreated. We estimated the prevalence of anti-HSV-1 antibodies and correlated it with the demographic and behavioral characteristics of the Indigenous population of the Jaguapirú and Bororó villages (Dourados, Mato Grosso do Sul (MS), Brazil). Methods: Our approach was cross-sectional. From March 2017 to November 2018. Using anti-HSV-1 (Gg1) IgM and anti-HSV-1 (gG1) IgG Euroimmun and the detection and quantification of HSV-1 viral load in plasma samples, through real-time PCR. The maps were constructed using QGIS and the statistical analyses using R Studio software. Results: A total of 1138 individuals (> 18 years old) were enrolled. The prevalence of anti-HSV-1 IgM and IgG were 20% and 97.5%, respectively. The prevalence of anti-HSV-1 antibodies for IgG was higher in both sexes. Anti-HSV-1 IgM antibodies were present in 17.1%, 21.2%, 12.5%, and 22% of the participants with urinary problems, genital wounds, genital warts, and urethral discharge, respectively. Real-time PCR was used for confirmatory testing; HSV-1 DNA was detected in 25.6% (54/211) of anti-HSV1 IgM-positive samples. Viral loads ranged from 5.99E + 02 to 3.36E + 13. Conclusions: The seroprevalence of HSV-1 IgM and detection of HSV-1 DNA in the Indigenous population confirmed high silent prevalence. Furthermore, the seroprevalence of HSV-1 in the Indigenous population was higher than that reported in the general adult Brazilian population. Various socioeconomic factors, drug use, and health and sexual behaviors could contribute to the facilitation of HSV-1 transmission in the Indigenous population. Our results may help develop culturally appropriate intervention programs that eliminate health access barriers and improve the implementation of public health policies aimed at promoting information regarding the prevention, treatment, and control of HSV-1 infection in Brazilian Indigenous populations. [ABSTRACT FROM AUTHOR]

Background: Although approximately 25% of Brazilians have private health coverage (PHC), studies on the surveillance of chronic kidney disease (CKD) in this population are scarce. The objective of this study was to estimate the prevalence of CKD in individuals under two PHC regimes in Brazil, who total 8,335,724 beneficiaries. Methods: Outpatient serum creatinine and proteinuria results of individuals from all five regions of Brazil, ≥ 18 years of age, and performed between 10/01/2021 and 10/31/2022, were analyzed through the own laboratory network database. People with serum creatinine measurements were evaluated for the prevalence and staging of CKD, and those with simultaneous measurements of serum creatinine and proteinuria were evaluated for the risk category of the disease. CKD was classified according to current guidelines and was defined as a glomerular filtration rate (GFR) < 60 ml/min/1.73 m² estimated by the 2021 CKD-EPI equation. Results: The number of adults with serum creatinine results was 1,508,766 (age 44.0 [IQR, 33.9–56.8] years, 62.3% female). The estimated prevalence of CKD was 3.8% (2.6%, 0.8%, 0.2% and 0.2% in CKD stages 3a, 3b, 4 and 5, respectively), and it was higher in males than females (4.0% vs. 3.7%, p < 0.001, respectively) and in older age groups (0.2% among 18-29-year-olds, 0.5% among 30-44-year-olds, 2.0% among 45-59-year-olds, 9.4% among 60-74-year-olds, and 32.4% among ≥ 75-year-olds, p < 0.001) Adults with simultaneous results of creatinine and proteinuria were 64,178 (age 57.0 [IQR, 44.8–67.3] years, 58.1% female). After adjusting for age and gender, 70.1% were in the low-risk category of CKD, 20.0% were in the moderate-risk category, 5.8% were in the high-risk category, and 4.1% were in the very high-risk category. Conclusion: The estimated prevalence of CKD was 3.8%, and approximately 10% of the participants were in the categories of high or very high-risk of the disease. While almost 20% of beneficiaries with PHC had serum creatinine data, fewer than 1% underwent tests for proteinuria. This study was one of the largest ever conducted in Brazil and the first one to use the 2021 CKD-EPI equation to estimate the prevalence of CKD. [ABSTRACT FROM AUTHOR]

The persistence of symptoms for more than three months following infection with severe acute respiratory syndrome coronavirus 2 is referred to as "Long COVID". To gain a deeper understanding of the etiology and long-term progression of symptoms, this study aims to analyze the prevalence of Long COVID and its associated factors in a cohort of Brazilian adults and elders, twelve months after hospital discharge. An observational, prospective, and follow-up study was performed with a cohort of adults and older adults diagnosed with COVID-19 in 2020 in the State of Paraná, Brazil. Twelve months after hospital discharge, patients answered a phone questionnaire about the persistence of symptoms after three levels of exposure to COVID-19's acute phase (ambulatory, medical ward, and intensive care unit). According to the characteristics of participants, the prevalence of Long COVID-19 was calculated, and logistic regression analyses were conducted. We analyzed data from 1822 participants (980 adults [≥18–<60 years] and 842 older people [≥60 years]) across three exposure levels. The overall Long COVID prevalence was 64.2%. Long COVID was observed in 646 adults (55%; of which 326 were women) and 523 older people (45%; of which 284 were women). Females had a higher prevalence of long-term symptoms (52%) compared with men. The most common post-COVID-19 conditions in the 12-month follow-up were neurological (49.8%), followed by musculoskeletal (35.1%) and persistent respiratory symptoms (26.5%). Male individuals were less likely to develop Long COVID (aOR = 0.50). Other determinants were also considered risky, such as the presence of comorbidities (aOR = 1.41). Being an adult and having been hospitalized was associated with the development of Long COVID. The risk of developing Long COVID was twice as high for ward patients (aOR = 2.53) and three times as high for ICU patients (aOR = 3.56) when compared to non-hospitalized patients. Presenting clinical manifestations of digestive (aOR = 1.56), endocrine (aOR = 2.14), cutaneous (aOR = 2.51), musculoskeletal (aOR = 2.76) and psychological systems (aOR = 1.66) made adults more likely to develop Long COVID. Long COVID was present in a large proportion of people affected by the SARS-CoV-2 infection. Presence of Long COVID symptoms displayed a dose–response relationship with the level of disease exposure, with a greater prevalence of symptoms associated with the severe form in the acute period. [ABSTRACT FROM AUTHOR]

Aim: Sarcopenic obesity (SO) is characterized by the coexistence of the loss of muscle mass and function with excess adipose tissue. Its prevalence has increased concomitantly with population aging, becoming one of the most significant challenges for public health, threatening the quality of life and the physical and mental health of the elderly population. Methods: This study estimated the prevalence and factors associated with SO among adults and the elderly in Brazil's macro‐regions, utilizing MEDLINE, Embase, Web of Science, and the Virtual Health Library databases. Primary outcomes included SO prevalence overall and by subgroups, with secondary outcomes identifying associated factors. Results: A systematic review of 33 studies with 10 266 participants up to July 2023 showed a 17% prevalence of SO (95% confidence interval: 13–21%), using a random effects meta‐analysis. The Central‐West region had the highest occurrence (27%). Dual‐energy X‐ray absorptiometry (26%) and bioimpedance (6%) were the top diagnostic methods. Protective factors were chronic kidney disease and healthy lifestyles; risk factors included socioeconomic status, functionality, lifestyle, biochemical parameters, and comorbidities such as osteoarthritis and apnea. Conclusions: The prevalence of SO in Brazil is significant, emerging as a critical public health problem. It is essential to direct attention to changes in prevalence rates in the coming years, given the rising obesity trends and the absolute increase in the elderly population. Geriatr Gerontol Int 2024; 24: 661–674. [ABSTRACT FROM AUTHOR]

Background: There is no consensus on which molar incisor hypomineralization (MIH) indices are more suitable for epidemiological surveys. Aim: To compare the operational aspects and diagnostic ability of the MIH index (simplified/MIH_s and extended/MIH_e) with the MIH‐Severity Scoring System (MIH‐SSS) in classifying and diagnosing MIH. Design: This cross‐sectional study assessed the indices in a homogeneous group of 680 6‐ to 10‐year‐old schoolchildren in Bauru, Brazil, who had at least one first permanent molar, ensuring consistent conditions. Followed by toothbrushing, the children seated on school chairs were examined by the two calibrated researchers under artificial lighting, using mouth mirror and WHO probe, and chronometer recording the duration of examinations. Results: The prevalence of MIH was 24.7%. The most common characteristic of MIH was demarcated opacity, with a prevalence of 81.7% and 85.45% according to the MIH_s and the MIH‐SSS, respectively. A positive association was observed among the MIH_s, the MIH_e, and the MIH‐SSS (chi‐squared test; p <.01). The MIH‐SSS demonstrated a shorter average application time than both versions of the MIH index (ANOVA/Tukey; p <.05). Additionally, fluorosis was found to be the most prevalent among other developmental defects of enamel, with a prevalence of 38.38%. Conclusion: All systems effectively diagnosed MIH and its characteristics. [ABSTRACT FROM AUTHOR]

Background Visceral leishmaniasis results from complex interactions among humans, dogs and environment. Brazil accounts for 97% of cases in the Americas. Methods Twenty years (2001–2020) of the endemic disease in the state of Rio de Janeiro were studied. Incidence, lethality, sociodemographic and clinical characteristics were investigated, complemented with spatial methodologies (kernel and clusters). Results Ninety-seven human cases and 625 dogs were reported. Of the 92 cities, 22 were human endemic areas. The state had a low incidence level (0.6 per 100 000). Lethality was higher compared with the Brazilian average. More than 90% of infections occurred in urban areas. Most cases (66%) occurred in men. The predominant age groups were 0–4 y (28.7%) and 20–39 y (32.9%). Fever (89.5%), splenomegaly (83.2%) and hepatomegaly (76.8%) were the main clinical manifestations. Spatial analysis showed a displacement of the human endemic: in the first decade (2001–2010), cases were concentrated in the Metropolitan region, and in the second decade (2011–2020) in the Médio Paraíba region of the state. Most of the endemic area (56.4%) had canine infections without reported human cases. Conclusions Disorderly urbanisation and precarious living conditions favour the transmission of the disease. Changes in the environment and migratory processes contribute to its expansion. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Head and Neck Cancer (HNC) ranks sixth among the most common men's tumours. The prevalence of HNC in children has increased in several countries, and the prevalence varies worldwide. In several regions in Brazil and the world, a lack of epidemiological data records on childhood HNC is observed, demonstrating little knowledge about the demographic profile of these patients. Aim: To determine the prevalence of HNC in paediatric patients over the years at a reference centre in the North region of Brazil. Materials and Methods: A cross-sectional study was conducted with the objective of quantitatively and qualitatively analysing the prevalence of HNC in a reference oncology hospital. The electronic medical records of patients aged 0 to 19 years were reviewed at a referral centre in Northern Brazil from October 2015 to February 2022. Demographic variables, topographic location of tumours, city of origin, patient outcome, and histopathological diagnosis were collected. Results: A total of 4,113 medical records were analysed, and 126 met the criteria for analysis. Males had a higher incidence n=75 (59.52%) of HNC than females n=51 (40.47%). The age group with the highest percentage of HNC was > 4 to 9-year-old n=40 (31.74%). The most common diagnosis were lymphoma 78 (61.90%), sarcoma 22 (17.46%); carcinoma 14 (11.11%), and histiocytosis 10 (7.93%). Conclusion: In Northern Brazil, the most common tumour was Hodgkin's lymphoma, and the most prevalent group affected were males aged > 4-9-year-old. [ABSTRACT FROM AUTHOR]

Phytoregulators have been used as grapevine defoliants in cluster zones to manage and improve grape quality and production. The present study evaluated the effect of the phytoregulator ethephon on the grapevine defoliation of the cluster region, Botrytis bunch rot (BBR) epidemiology, and the viticultural performance of 'Cabernet Sauvignon', during the 2018/2019 and 2019/2020 growing seasons, in the highland region of the Santa Catarina State, Southern Brazil. Ethephon was applied in the bunch region of both sides of the grapevine vegetative canopy, at the phenological stage of beginning of ripening (BBCH-81) in five active ingredient doses (0 mg L-1 (control); 720 mg L-1; 1,440 mg L-1; 2,160 mg L-1; and 2,880 mg L-1), following a randomized block design with four replications and five plants per replication. The following parameters were evaluated: BBR epidemiology, vegetative, productive, and technological and phenolic maturation. The increasing ethephon doses significantly reduced the linear leaf drop and affected the technological and phenolic grape maturation parameters, improving the must pH, total polyphenols, color 420, 520, and 620 m, color intensity (°hue angle), and anthocyanin, and reducing the total solubre solids in the 'Cabernet Sauvignon' grapevine. However, this significant effect on the linear leaf drop and the technological and phenolic maturation parameters did not interfere with other vegetative, productive, and BBR epidemiology parameters evaluated in the edaphoclimatic conditions of the highland region of southern Brazil. [ABSTRACT FROM AUTHOR]

Objective: To analyze the factors associated with low functional mobility in older adults residing in Alcobaça, BA. Methods: This is an epidemiological survey with a cross‐sectional design, conducted in 2015 with 473 older adults (62.4% women; mean age 70.2 ± 8.2 years) from Alcobaça, BA. The interview script addressed sociodemographic characteristics, health, and behavioral aspects. Functional mobility was assessed using the Short Physical Performance Battery (≤6 points). Inferential analyses were conducted using the Mann–Whitney U test and Poisson regression (with robust variance and estimation of prevalence ratios and their respective 95.0% confidence intervals). Results: The prevalence of low functional mobility was 9.6%, with associated factors including the use of alcoholic beverages (PR = 1.7, 95% CI: 1.01–1.13) and the number of repetitions in elbow flexion (PR = 1.01, 95% CI: 1.01–1.05). Additionally, older adults with low mobility had lower height, thigh circumference, and lower performance in handgrip strength tests, elbow flexion, and flexibility. They also spent more time in sedentary behavior and less time in physical activity compared to older adults with preserved mobility (p < 0.05). Conclusion: Older adults with low mobility exhibit poorer values in anthropometric parameters, lower performance in motor tests, spend less time engaged in physical activities, and more time in sedentary behavior. [ABSTRACT FROM AUTHOR]

The north region of Brazil is characterized by significant vulnerabilities, notably surpassing national poverty indicators. These disparities exacerbated the impact of respiratory illnesses on the healthcare system during the COVID-19 pandemic, particularly in areas with limited healthcare resources, inadequate infrastructure, and barriers to healthcare access. The crisis was further influenced by multiple lineages that emerged as significant virus variants associated with increased transmissibility. Within this context, our ecological study focused on analyzing the epidemiological evolution of COVID-19 in the state of Acre. We constructed time-series trends in incidence, lethality, and mortality from March 2020 to December 2022 using the Prais–Winsten regression model. Our findings revealed that in 2020, there was an increasing trend in incidence, while mortality and lethality continued to decrease (p < 0.05). In the following year, both incidence and mortality decreased, while lethality increased at a rate of 1.02% per day. By the end of 2022, trends remained stationary across all rates. These results underscore the importance of ongoing surveillance and adaptive public health measures to bolster the resilience of healthcare systems in remote and vulnerable regions. Indeed, continuous monitoring of the most predominant SARS-CoV-2 lineages and their dynamics is imperative. Such proactive actions are essential for addressing emerging challenges and ensuring effective responses to adverse situations. [ABSTRACT FROM AUTHOR]

Background: Health information systems (HIS) are a pivotal element in epidemiological surveillance. In Brazil, malaria persists as a public health challenge, with 99% of its occurrences concentrated in the Amazon region, where cases are reported through the HIS Sivep-Malaria. Recent technological advancements indicate that case notifications can be expedited through more efficient systems with broader coverage. The objective of this study is to analyse opportunities for notification within Sivep-Malaria and explore the implementation of mobile electronic devices and applications to enhance the performance of malaria case notifications and use. Methods: This descriptive study analyses data on malaria-positive cases in the Brazilian Amazon from 2004 to 2022. Malaria Epidemiological Surveillance System (Sivep-Malaria) data were used. The Brazilian Amazon region area is approximately 5 million km2 across nine different states in Brazil. Data entry opportunities were assessed by considering the time difference between the 'date of data entry' and the 'date of notification.' Descriptive statistics, including analyses of means and medians, were conducted across the entire Amazon region, and for indigenous population villages and gold mining areas. Results: Between 2004 and 2022, 6,176,878 new malaria cases were recorded in Brazil. The average data entry opportunity throughout the period was 17.9 days, with a median of 8 days. The most frequently occurring value was 1 day, and 99% of all notifications were entered within 138 days, with 75.0% entered within 20 days after notification. The states with the poorest data entry opportunities were Roraima and Tocantins, with averages of 31.3 and 31.0 days, respectively. For indigenous population villages and gold mining areas, the median data entry opportunities were 23 and 15 days, respectively. Conclusions: In malaria elimination, where surveillance is a primary strategy for evaluating each reported case, reducing notification time, enhancing data quality and being able to follow-up cases through computerized reports offer significant benefits for cases investigation. Technological improvements in Sivep-Malaria could yield substantial benefits for malaria control in Brazil, aiding the country in achieving disease elimination and fulfilling the Sustainable Development Goals. [ABSTRACT FROM AUTHOR]

Schistosoma mansoni worms cause a waterborne parasitic disease called schistosomiasis. It commonly affects individuals in lack of sanitation structure. In Brazil, Pará state has Belém as one of the worst sanitation-ranking places in 2023, where schistosomiasis transmission was already documented. This study reports the occurrence of schistosomiasis in residents of Ilha das Onças, an island next to Belém. Stool samples were obtained from participants over 2 years old, all residents from Furo do Rio Grande, one of the rivers on the island. The Kato-Katz technique was performed for parasite investigation in the stool samples. Each participant responded to a sociodemographic and clinical questionnaire. The residences were georeferenced for map designing. Three out of 263 participants were S. mansoni positive, all men, ages ranging from 19 to 41 years old, with low parasitic load. Malacological surveys were carried out, but no Biomphalaria snails were found. Risk factors for schistosomiasis establishment are present on the island, and the lack of sanitation makes it a potential risk area. Malacological surveys are highly encouraged as preventive measures, as well as health surveillance for riverside populations, generating data that will help health authorities in the management and planning of preventive control actions. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyse secular trend in handgrip strength (HGS) in adolescents using an allometric approach and identify the factors associated. The sample comprised 657 and 1004 adolescents (14 to 19 years) in 2007 and 2017/2018, respectively, of public schools in Florianópolis, Brazil. The dependent variable was HGS normalised to body mass and height. Covariance analysis was used to examine secular trends in HGS, and multiple linear regression was used to identify associated factors. The independent variables were sociodemographic, biological, and behavioural factors. Comparison of HGS between surveys indicated a negative secular trend in both sexes (p < 0.001). In boys, there was a positive association of HGS with age and FFM in both surveys. In 2017/18, there was a positive association with sexual maturation and a negative association with sitting time and fat percentage. In girls, FFM was positively associated with HGS in both surveys. In 2007, there were positive associations of HGS with age and vigorous physical activity, whereas, in 2017/18, negative associations were observed with economic level and sitting time. The findings of the present study show a decline in adolescent HGS. And behavioural changes appear to be contributing to declines in HGS. [ABSTRACT FROM AUTHOR]

Objectives Regular quality-assured WGS with antimicrobial resistance (AMR) and epidemiological data of patients is imperative to elucidate the shifting gonorrhoea epidemiology, nationally and internationally. We describe the dynamics of the gonococcal population in 11 cities in Brazil between 2017 and 2020 and elucidate emerging and disappearing gonococcal lineages associated with AMR, compare to Brazilian WGS and AMR data from 2015 to 2016, and explain recent changes in gonococcal AMR and gonorrhoea epidemiology. Methods WGS was performed using Illumina NextSeq 550 and genomes of 623 gonococcal isolates were used for downstream analysis. Molecular typing and AMR determinants were obtained and links between genomic lineages and AMR (determined by agar dilution/Etest) examined. Results Azithromycin resistance (15.6%, 97/623) had substantially increased and was mainly explained by clonal expansions of strains with 23S rRNA C2611T (mostly NG-STAR CC124) and mtr mosaics (mostly NG-STAR CC63, MLST ST9363). Resistance to ceftriaxone and cefixime remained at the same levels as in 2015–16, i.e. at 0% and 0.2% (1/623), respectively. Regarding novel gonorrhoea treatments, no known zoliflodacin-resistance gyrB mutations or gepotidacin-resistance gyrA mutations were found. Genomic lineages and sublineages showed a phylogenomic shift from sublineage A5 to sublineages A1–A4, while isolates within lineage B remained diverse in Brazil. Conclusions Azithromycin resistance, mainly caused by 23S rRNA C2611T and mtrD mosaics/semi-mosaics, had substantially increased in Brazil. This mostly low-level azithromycin resistance may threaten the recommended ceftriaxone-azithromycin therapy, but the lack of ceftriaxone resistance is encouraging. Enhanced gonococcal AMR surveillance, including WGS, is imperative in Brazil and other Latin American and Caribbean countries. [ABSTRACT FROM AUTHOR]

There is scant data about the prevalence and correlates of ADHD in middle-income countries. Objective: The aim of this study was to investigate the prevalence and psychiatric correlates of symptomatic ADHD in a large metropolitan area of a middle-income country. Methods: An in-person household survey with randomly selected 2,297 adults aged 19 to 60 from Rio de Janeiro, Brazil, assessed by trained lay interviewers. The Adult Self-Rating Scale Screener (ASRS-6) was used. Chi-square and logistic regression were conducted. Results: ADHD prevalence was 4.59 (95% CI [3.56, 5.44]). Those with ADHD were younger and more often unemployed; they displayed more psychiatric symptoms (depression, anxiety, and alcohol abuse) and a history of bullying and sexual abuse. They also had worse physical health indicators. Findings remained significant when controlling for socioeconomic variables. Conclusion: Adults with symptomatic ADHD from a large metropolitan area in Brazil show a pattern of findings consistent with what has been observed in higher-income countries [ABSTRACT FROM AUTHOR]

BACKGROUND: A high workload has been associated with musculoskeletal pain in public school teachers. However, the hypothesis of the present study was that physical activity (PA) practice is able to attenuate this association. OBJECTIVE: To analyze the associations between high workload with musculoskeletal pain according to PA levels in public school teachers. METHODS: Teachers (n = 239) from 13 public schools were evaluated. Workload was assessed using a Likert scale in which teachers reported their perception of their work routine as: very low, low, regular, high, and very high. Musculoskeletal pain and PA were assessed using questionnaires. Multivariate logistic regression models were used to investigate the association of high workload with PA levels and musculoskeletal pain in different body regions, compared to participants with normal workload, adjusted by sex, age, and socioeconomic status. RESULTS: A high workload was associated with higher chances of reporting pain in the wrists and hands (OR = 3.55; 95% CI = 1.27–9.89), knee (OR = 3.09; 95CI% = 1.09–8.82), and feet and ankles (OR = 3.16; 95% CI = 1.03–9.76) in less active teachers. However, these associations were not observed in teachers considered more active. CONCLUSION: PA practice is able to act as a good protector against musculoskeletal pain in teachers, even in individuals with a high workload. [ABSTRACT FROM AUTHOR]

Copyright of Fisioterapia Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

[Display omitted] • Of 414.5 million livers analyzed; 224,872 cattle were infected with F. hepatica. • Infected livers were registered in 194 Brazilian municipalities in 2002, and 747 in 2020. • There was a reduction in forest areas and an increase in cattle livers infected with F. hepatica. • Fasciola hepatica was introduced to the Cerrado, Pantanal, and Amazon Forest biomes. • Significant territorial dispersion of infected cattle with F. hepatica was observed. Fasciolosis is caused by parasites of the genus Fasciola, affecting animals and humans worldwide. In South America, the disease is a result of infection with Fasciola hepatica and although animal infections are more frequently reported, the full extent of the impact on human health due to underdiagnosis remains uncertain. This study analyzed changes in land use and the distribution of F. hepatica in bovine livers in Brazil over 18 years. Data on land use and land cover were collected from the Mapbiomas Project. Data on 414,481,963 slaughtered cattle and condemned livers due to F. hepatica infection were obtained from 4,433 municipalities. Joinpoint analysis was used to study the time series, and the Susceptible-Infected-Recovered (SIR) model was utilized to explore the behavior of F. hepatica infection. In the North, pasture areas significantly increased (P = 0.000001), while forested areas decreased (P = 0.000001). The midwestern and northern regions concentrated the highest number (>290 million) of cattle slaughtered in Brazil. More than 2 million bovine livers were infected by F. hepatica. The infected cattle originated from 194 municipalities in 2002, increasing to 747 in 2020. We consider that the changes in land use and intense cattle transportation may have caused the expansion of F. hepatica. The SIR model analyzed the spread of the disease looking at all six biomes: Caatinga, Amazon Forest, Cerrado, Pantanal, Atlantic Forest, and Pampa. Moreover, this infection not only threatens the health of animals but is also a major concern to biodiversity and vulnerable human communities in South America. Emblematic biomes such as the Amazon basin already face challenges with logging, desertification, and loss of biodiversity. Therefore, strategies for mitigating infection should include controlling illegal pasture areas, establishing health inspections of animal transport, quarantine of newly arrived animals, and livestock zoning, as well as clear One Health policies. [ABSTRACT FROM AUTHOR]

Background: The pediatric palliative care (PPC) sets up an interdisciplinary approach of chronic complex diseases throughout birth to adolescence. It encompasses countless contrasts in development and diagnosis scopes, which make this area a challenge to nonpediatric practitioners. Objective: We sought to assess the most prevalent diseases in follow-up of the PPC team. Methods: We analyzed the medical records of PPC clinic during the years 2001 and 2021 and the diagnosis of outpatients. We established a parallel with the world scientific literature concerning the epidemiology of PPC. Results: The most prevalent diseases were epidermolysis bullosa (36.9%), followed by neurological Inherited Errors of Metabolism (IEM) diseases (19.0%), IEM diseases (14.3%), dysmorphological and chromosomal disorders (8.5%), skeletal disorders mainly osteogenesis imperfecta (6.9%), and liver transplantation conditions (5.5%) (p < 0.001). The less frequent conditions were external causes, such as neonatal insults or traffic accidents (2.8%), cancer (1.7%), congenital cardiopathies (1.4%), congenital infectious diseases (1.1%), gastrointestinal and hepatic conditions (0.8%), and rheumatological conditions (0.3%). The patients were older at diagnosis (6.9 years) and at PPC referral (13.2 years) than patients with epidermolysis bullosa and skeletal disorders and dysmorphological and chromosomal disorders were younger on referral. Conclusion: There are a lot of complex chronic conditions which could benefit from palliative care in pediatric setting. However, epidemiological and symptomatological assessment of the health service is necessary to provide an appropriate care to the country's reality. [ABSTRACT FROM AUTHOR]

Candidemia is a significant cause of mortality among hospitalized patients, both worldwide and in Brazil. Prompt and appropriate treatment are essential to mitigate mortality, and clinical practice guidelines aim to optimize patient care based on the best scientific evidence. This study aims to examine the management of candidemia, assessing adherence to the guidelines of the Brazilian Society of Infectious Diseases in a single center located at São Paulo, Brazil. All adult patients hospitalized from 2016 to 2018 who presented one positive blood culture for Candida spp. were included. Electronic medical records were retrospectively reviewed to collect information relevant to the treatment for candidemia, in order to assess the adherence to the Brazilian guideline for the management of candidemia in relation to nine defined outcomes, and we correlated those findings with 30-day mortality by using uni- and multivariate analyses. A total of 115 patients were included; 68 patients (59.1%) were male, with a mean age of 55 years. C. albicans, C. tropicalis and C. glabrata were the most prevalent species. In total, 80 patients (69.5%) received antifungal treatment. The adherence to Brazilian guideline recommendations was determined as described in the following: initial treatment with echinocandin in 48 (60%); step-down to fluconazole in 21 (26.2%); collection of first control blood culture in 43 (58.9%); collection of second control blood culture, if the first one had been positive, in 14 (73.6%); treatment for 14 days after the first negative blood culture in 53 (65.4%); central venous catheter (CVC) removal in 66 (82.5%); CVC removal if the first control blood culture had been positive in 17 (89.4%); performance of a transthoracic echocardiogram in 51 (63.7%) and performance of a fundoscopy in 59 (73.7%). Univariate analysis showed that CVC removal and initial echinocandin therapy were more prevalent in the surviving group, but with no statistically significant difference. On the other hand, step-down to fluconazole demonstrated higher survival rate in the multivariate analysis OR 0.15 (95% CI 0.03–0.8); p = 0.02. The analysis of these nine recommendations demonstrates that it is necessary to improve adherence to specific recommendations and also disseminate strategies of the initial use of echinocandin as the drug of choice and addressing length of treatment and follow-up and complementary exams. Our study provides reassurance that the step-down to fluconazole is safe and may be recommended, if the preexisting conditions are present. [ABSTRACT FROM AUTHOR]

Objectives: To examine the extent to which the effect of income inequalities on tooth loss is attributable to differential exposure and susceptibility to heavy drinking in older Brazilian adults. Methods: We conducted a secondary analysis using data from The Brazilian Longitudinal Study of Ageing (ELSI‐Brazil 2015–2016), a nationally representative sample of community‐dwelling people aged 50 years and over. Causal mediation analysis based on the counterfactual outcome framework decomposed the effect of income on tooth loss mediated by heavy drinking into four components (four‐way decomposition): controlled direct effect (neither mediation nor interaction), reference interaction (interaction only), mediated interaction (both mediation and interaction) and pure indirect effect (mediation only). Proportions of effect attributable to each component were calculated to estimate the differential exposure (the sum of the third and fourth components) and differential susceptibility (the sum of the second and third components) to heavy drinking. Results: The analytical sample comprised 8114 participants. After adjusting for covariates, 7.3% (95% CI: 3.8%; 10.9%) and −39.5% (95% CI: −75.8%; −3.3%) of the effects of income on tooth loss were attributable to differential exposure and susceptibility to heavy drinking, respectively, consistent with the alcohol harm paradox. When setting non‐functional dentition as outcome, only the effect of differential susceptibility remained (−81.7% [95% CI: −128.2%; −35.2%]). Conclusion: Our findings suggest that individuals of low‐income groups appear to be more susceptible to the effects of heavy drinking on tooth loss. [ABSTRACT FROM AUTHOR]

Copyright of Diversitas Journal is the property of Diversitas Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)