ODS/09 - Indústria, inovação e infraestrutura
URI Permanente desta comunidade
Objetivo: Construir infraestruturas resilientes, promover a industrialização inclusiva e sustentável e fomentar a inovação.
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Coleções desta Comunidade
- ODS/09 - Indústria, inovação e infraestrutura
- ODS/09 - Indústria, inovação e infraestrutura
- ODS/09 - Indústria, inovação e infraestrutura
Submissões Recentes
Review of strategies to investigate low sample return rates in remote tobacco trials: A call to action for more user-centered design research
(2023) VILARDAGA, R.; THRUL, J.; DEVITO, A.; KENDZOR, D. E.; SABO, P.; KHAFIF, T. C.
Remote collection of biomarkers of tobacco use in clinical trials poses significant challenges. A recent meta-analysis and scoping review of the smoking cessation literature indicated that sample return rates are low and that new methods are needed to investigate the underlying causes of these low rates. In this paper we conducted a narrative review and heuristic analysis of the different human factors approaches reported to evaluate and/or improve sample return rates among 31 smoking cessation studies recently identified in the literature. We created a heuristic metric (with scores from 0 to 4) to evaluate the level of elaboration or complexity of the user-centered design strategy reported by researchers. Our review of the literature identified five types of challenges typically encountered by researchers (in that order): usability and procedural, technical (device related), sample contamination (e.g., polytobacco), psychosocial factors (e.g., digital divide), and motivational factors. Our review of strategies indicated that 35% of the studies employed user-centered design methods with the remaining studies relying on informal methods. Among the studies that employed user-centered design methods, only 6% reached a level of 3 in our user-centered design heuristic metric. None of the studies reached the highest level of complexity (i.e., 4). This review examined these findings in the context of the larger literature, discussed the need to address the role of health equity factors more directly, and concluded with a call to action to increase the application and reporting of user-centered design strategies in biomarkers research.
Caregivers' perceptions on routine childhood vaccination: A qualitative study on vaccine hesitancy in a South Brazil state capital
(2024) MATOS, Camila Carvalho de Souza Amorim; COUTO, Marcia Thereza; ODUWOLE, Elizabeth O.; WIYSONGE, Charles Shey
Immunization programs worldwide have been facing challenges in keeping vaccination coverage high. Even though universally known for its robust National Immunization Program, Brazil has also faced significant challenges regarding vaccination coverage. One of the reasons for this is vaccine hesitancy, a complex, multi-causal, and context-specific phenomenon. This qualitative study aims to understand the factors associated with decision-making and the drivers of vaccine hesitancy in Florianopolis, Santa Catarina state capital, regarding caregivers' perceptions of routine childhood vaccination. In-depth interviews were conducted in the Capital city of Santa Catarina State. Families with children up to 6 years old were included. Data were analyzed based on thematic content analysis. Twenty-nine caregivers in 18 families were interviewed. These caregivers were mainly mothers and fathers. Three themes emerged: 1. Access to information and the decision-making process, where we discuss the role of social circles, healthcare workers, and the internet; 2. Individual-institutions power relationships: Perceptions about the State's role and the Health institutions: 3. Reasons and motivations: The senses and meanings behind non-vaccination, where we discuss the drivers of vaccine hesitancy related to risk perception, caregivers' opinions on the medical-pharmaceutical industry, vaccines' composition and their side effects, families' lifestyles and worldviews, and the childhood routine vaccination schedule. The results of this study reaffirm the complexity of the decision-making process in childhood vaccination and further enable a better contextual understanding of the complex and challenging phenomenon of vaccine hesitancy.
Tackling Urbanicity and Pollution in Mental Health Prevention Strategies
(2022) VENTRIGLIO, A.; CASTALDELLI-MAIA, J. M.; TORALES, J.; BERARDIS, D. De; BHUGRA, D.
Globalization in the last decades has led to an increase of exchanges through the globe and an expansion of global markets as well as an increase of levels of urbanization through the continents. In particular, urbanization includes environmental, social, and economic changes and factors that may affect the mental health of the general population. In fact, emerging evidence reports higher rates of mental disorders in the urban settings than in rural areas, and social disparities and insecurity may impact on the mental health of the weaker groups of society. Also, the lack of contact with nature in the city and higher levels of pollution are associated with a remarkable rate of psychological distress. Pollution, in particular, is tightly related to the level of industrialization and employment of technology. It has been demonstrated that environmental pollutants (e.g., air pollutants, noise, ionizing radiations, etc.) may impact directly or indirectly on mental health: there may be a direct biological consequence of pollution on the human central nervous system as well as a range of psychological stress generated by the lasting exposure to pollutant agents. This chapter reports emerging evidence regarding the impact of urbanicity and pollution on public mental health and suggests further research and action in order to develop strategies of prevention of mental illness due to the burden of global urbanization. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
COVID-19 vaccine hesitancy in Latin America and Africa: a scoping review
(2023) GONCALVES, Bruna Aparecida; MATOS, Camila Carvalho de Souza Amorim; FERREIRA, Jonathan Vicente dos Santos; ITAGYBA, Renata Fortes; MOCO, Vinicius Rocha; COUTO, Marcia Thereza
Vaccination has played an important role in the containment of COVID-19 pandemic advances. However, SARS-CoV-2 vaccine hesitancy has caused a global concern. This scoping review aims to map the scientific literature on COVID-19 vaccine hesitancy in Latin America and Africa from a Global Health perspective, observing the particularities of the Global South and using parameters validated by the World Health Organization (WHO). The review reporting observes the recommendations of the PRISMA for Scoping Reviews (PRISMA-ScR) model. Search was conducted in PubMed, Scopus, Web of Science, and Virtual Health Library (VHL) databases, selecting studies published from January 1, 2020 to January 22, 2022. Selected studies indicate that COVID-19 vaccine hesitancy involves factors such as political scenario, spread of misinformation, regional differences in each territory regarding Internet access, lack of access to information, history of vaccination resistance, lack of information about the disease and the vaccine, concern about adverse events, and vaccine efficacy and safety. Regarding the use of conceptual and methodology references from the WHO for vaccine hesitancy, few studies (6/94) use research instruments based on these references. Then, the replication in Global South of conceptual and methodological parameters developed by experts from the Global North contexts has been criticized from the perspective of Global Health because of it may not consider political and sociocultural particularities, the different nuances of vaccine hesitancy, and issues of access to vaccines.
Antibiotic-loaded lipid-based nanocarrier: A promising strategy to overcome bacterial infection
(2022) HENOSTROZA, M. A. Bazán; TAVARES, G. Diniz; YUKUYAMA, M. Nishitani; SOUZA, A. De; BARBOSA, E. José; AVINO, V. Carlos; SANTOS NETO, E. dos; LOURENçO, F. Rebello; LöBENBERG, R.; BOU-CHACRA, N. Araci
According to the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC), bacterial infections are one of the greatest threats to global health, food production, and life expectancy. In this sense, the development of innovative formulations aiming at greater therapeutic efficacy, safety, and shorter treatment duration compared to conventional products is urgently needed. Lipid-based nanocarriers (LBNs) have demonstrated the potential to enhance the effectiveness of available antibiotics. Among them, liposome, nanoemulsion, solid lipid nanoparticle (SLN), and nanostructured lipid carrier (NLC) are the most promising due to their solid technical background for laboratory and industrial production. This review describes recent advances in developing antibiotic-loaded LBNs against susceptible and resistant bacterial strains and biofilm. LBNs revealed to be a promising alternative to deliver antibiotics due to their superior characteristics compared to conventional preparations, including their modified drug release, improved bioavailability, drug protection against chemical or enzymatic degradation, greater drug loading capacity, and biocompatibility. Antibiotic-loaded LBNs can improve current clinical drug therapy, bring innovative products and rescue discarded antibiotics. Thus, antibiotic-loaded LBNs have potential to open a window of opportunities to continue saving millions of lives and prevent the devastating impact of bacterial infection. © 2022 Elsevier B.V.
Effects of individual and organizational factors on job tenure of primary care physicians: A multilevel analysis from Brazil
(2023) DIAS, Ivan Wilson Hossni; MATIJASEVICH, Alicia; RUSSO, Giuliano; SCHEFFER, Mario Cesar; LOERBROKS, Adrian
BackgroundThe short tenure of primary care physicians undermines the continuity of care, compromising health outcomes in low-, middle and in high-income countries. The purpose of this study was to investigate the contextual and individual factors associated with the tenure of physician in Primary Health Care (PHC) services. We consider individual-level sociodemographic variables such as education and work-related variables, as well as the characteristics of employers and services. MethodsThis study is a retrospective cohort study of 2,335 physicians in 284 Primary Health Care Units across the Sao Paulo, Brazil, public health care system from 2016 to 2020. A multivariate hierarchical model was selected, and an adjusted Cox regression with multilevel analysis was employed. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was used to report the findings from the study. ResultsThe average physician tenure was 14.54 +/- 12.89 months, and the median was 10.94 months. Differences between Primary Health Care Units accounted for 10.83% of the variance observed in the outcome, while the employing organizations were responsible for only 2.30%. The physician characteristics associated with higher tenure in PHC were age at hire, i.e., being between 30 and 60 years old, [HR: 0.84, 95% CI: (0.75-0.95)] and professional experience over five years [HR: 0.76, 95% CI: (0.59-0.96)]. Specialties not related to PHC practices were associated with a short tenure [HR: 1.25, 95% CI: (1.02-1.54)]. ConclusionDifferences between Primary Health Care Units and in the individual characteristics, such as specializations and experience, are related to the low tenure of professionals, but such characteristics can be changed through investments in PHC infrastructure and changes in work conditions, policies, training, and human resource policies. Finding a remedy for the short tenure of physicians is essential for guaranteeing a robust PHC system that can contribute to universal, resilient, and proactive health care.
The increasing role of electronic media in headache
(2023) DO, Thien Phu; ANDREOU, Anna P.; OLIVEIRA, Arao Belitardo de; SHAPIRO, Robert E.; LAMPL, Christian; AMIN, Faisal Mohammad
Most individuals with access to the internet use social media platforms. These platforms represent an excellent opportunity to disseminate knowledge about management and treatment to the benefit of patients. The International Headache Society, The European Headache Federation, and The American Headache Society have electronic media committees to promote and highlight the organizations' expertise and disseminate research findings. A growing mistrust in science has made dealing with infodemics (i.e., sudden access to excessive unvetted information) an increasing part of clinical management. An increasing role of these committees will be to address this challenge. As an example, recent studies have demonstrated that the most popular online content on migraine management is not evidence-based and is disseminated by for-profit organizations. As healthcare professionals and members of professional headache organizations, we are obliged to prioritize knowledge dissemination. A progressive social media strategy is associated not only with increased online visibility and outreach, but also with a higher scientific interest. To identify gaps and barriers, future research should assess the range of available information on headache disorders in electronic media, characterize direct and indirect consequences on clinical management, and recognize best practice and strategies to improve our communication on internet-based communication platforms. In turn, these efforts will reduce the burden of headache disorders by facilitating improved education of both patients and providers.
Life Cycle Assessment Applied to End-of-Life Scenarios of Sargassum spp. for Application in Civil Construction
(2023) BUENO, Cristiane; ROSSIGNOLO, Joao Adriano; GAVIOLI, Leticia Missiatto; SPOSITO, Camila Cassola Assuncao; TONIN, Fernando Gustavo; VERAS, Mariana Matera; MORAES, Maria Julia Bassan de; LYRA, Gabriela Pitolli
Environmental risks and vulnerabilities in coastal regions include the massive deposits of brown algae of the genus Sargassum in regions such as the Caribbean, Gulf of Mexico, and northern Brazil. Efforts have been made to turn this problem into an opportunity by seeking new uses for this biomass in the sectors of food, agriculture, health, biofuels, bioremediation, and civil construction. Thus, this study aimed to produce quantitative data for different end-of-life scenarios of the Sargassum algae, seeking for potential applications of this macroalgae in the civil construction sector. For this purpose, we conducted a life cycle assessment (LCA) study of the Sargassum algae, in its natural destination, and evaluated its potential impact. This evaluation was then compared to the possible impacts of alternatives to their end of life, such as landfill disposal, drying and grinding to use as fibers or particles, burning the biomass to generate energy and fly ash, using a consequential LCA and the indicators of the ReCiPe 2016 method. For each of the proposed scenarios, the functional unit of 1 kg of the three types of unprocessed Sargassum algae that are found in the Brazilian deposits (natans I, natans VIII, and fluitans) was considered separately, and also for a composition that is closer to that found in the Brazilian deposits (50% fluitans, 15% natans I, and 35% natans VIII). The results for both natural decomposition scenarios demonstrated a dominant contribution to the categories of impact for climate change, marine eutrophication, and land use, thus justifying the search for new initiatives for the use of the algae. The burning process showed a significant contribution to most of the indicators, with emphasis on the massive generation of particulate, inherent to the biomass burning process; however, it showed a reduction in the magnitude of climate change emissions from around 47% to less than 2%. Finally, the proposed scenario of processing Sargassum biomass to obtain particles presented prevalence of magnitude for potential impact in most of the proposed indicators, due to the processes with high electricity consumption, but keeping climate change emissions' relative reduction from 47% to 6%. Thus, new studies may further investigate the potential of application of these materials in different products and components of civil construction.
Adherence, barriers, and facilitators for the treatment of systemic arterial hypertension: rapid review of evidence
(2023) SILVA, Leticia Aparecida Lopes Bezerra da; MELO, Roberta Crevelario de; TOMA, Tereza Setsuko; ARAUJO, Bruna Carolina de; JR, Cezar Donizetti Luquine; MILHOMENS, Lais de Moura; BORTOLI, Maritsa Carla de; BARRETO, Jorge Otavio Maia
Objective. To identify strategies to increase adherence to systemic arterial hypertension (SAH) treatment and describe the barriers and facilitators for implementing these strategies in primary health care (PHC).Method. A rapid evidence review was performed. We included systematic reviews with or without meta -analy-ses, published in English, Spanish or Portuguese, covering adults (age 18 to <= 60 years) with SAH followed in the PHC. Searches were performed in nine databases in December 2020 and updated in April 2022. The systematic reviews were assessed for methodological quality using the AMSTAR 2 tool.Results. Fourteen systematic reviews on treatment adherence strategies and three on barriers and facilitators for implementation were included. Regarding methodological quality, one systematic review was classified as moderate, four as low, and the others as critically low. Four strategies were identified as options for health policies: actions performed by pharmacists; actions performed by non-pharmaceutical health professionals; self-monitoring, use of mobile apps, and text messages; and subsidies for the purchase of medicines. Low digital literacy, limited access to the internet, work process and incipient training were barriers for professio-nals. The users' educational and health literacy levels, accessibility to health services and good relationships with professionals were facilitators. Conclusions. Positive effects of strategies related to pharmaceutical care, self-monitoring, and the use of cell phone applications and text messages were identified to increase adherence to the treatment of SAH in the context of PHC. However, for implementation purposes, it is necessary to consider barriers and facilitators, in addition to the methodological limitations of the analyzed systematic reviews.
Clinical management and diagnosis of CLN2 disease: consensus of the Brazilian experts group
(2023) SAMPAIO, Leticia Pereira de Brito; MANREZA, Maria Luiza Giraldes de; PESSOA, Andre; GURGEL-GIANNETTI, Juliana; COAN, Ana Carolina; LINDEN JUNIOR, Helio van der; EMBIRUCU, Emilia Katiane; HENRIQUES-SOUZA, Adelia Maria de Miranda; KOK, Fernando
Neuronal ceroid lipofuscinosis type 2 (CLN2) is a rare neurodegenerative genetic disease that affects children in early life. Its classic form is rapidly progressive, leading to death within the first 10 years. The urge for earlier diagnosis increases with the availability of enzyme replacement therapy. A panel of nine Brazilian child neurologists combined their expertise in CLN2 with evidence from the medical literature to establish a consensus to manage this disease in Brazil. They voted 92 questions including diagnosis, clinical manifestations, and treatment of the disease, considering the access to healthcare in this country. Clinicians should suspect CLN2 disease in any child, from 2 to 4 years old, with language delay and epilepsy. Even though the classic form is the most prevalent, atypical cases with different phenotypes can be found. Electroencephalogram, magnetic resonance imaging, molecular and biochemical testing are the main tools to investigate and confirm the diagnosis. However, we have limited access to molecular testing in Brazil, and rely on the support from the pharmaceutical industry. The management of CLN2 should involve a multidisciplinary team and focus on the quality of life of patients and on family support. Enzyme replacement therapy with Cerliponase a is an innovative treatment approved in Brazil since 2018; it delays functional decline and provides quality of life. Given the difficulties for the diagnosis and treatment of rare diseases in our public health system, the early diagnosis of CLN2 needs improvement as enzyme replacement therapy is available and modifies the prognosis of patients.