Artigos e Materiais de Revistas Científicas - ODS/10
URI Permanente para esta coleção
A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.
Navegar
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.
- Patient Health Questionnaire-9 Item Pairing Predictiveness for Prescreening Depressive Symptomatology: Machine Learning Analysis(2023) GLAVIN, Darragh; GRUA, Eoin Martino; NAKAMURA, Carina Akemi; SCAZUFCA, Marcia; SANTOS, Edinilza Ribeiro dos; WONG, Gloria H. Y.; HOLLINGWORTH, William; PETERS, Tim J.; ARAYA, Ricardo; VEN, Pepijn Van deBackground: Anhedonia and depressed mood are considered the cardinal symptoms of major depressive disorder. These are the first 2 items of the Patient Health Questionnaire (PHQ)-9 and comprise the ultrabrief PHQ-2 used for prescreening depressive symptomatology. The prescreening performance of alternative PHQ-9 item pairings is rarely compared with that of the PHQ-2.Objective: This study aims to use machine learning (ML) with the PHQ-9 items to identify and validate the most predictive 2-item depressive symptomatology ultrabrief questionnaire and to test the generalizability of the best pairings found on the primary data set, with 6 external data sets from different populations to validate their use as prescreening instruments.Methods: All 36 possible PHQ-9 item pairings (each yielding scores of 0-6) were investigated using ML-based methods with logistic regression models. Their performances were evaluated based on the classification of depressive symptomatology, defined as PHQ-9 scores >= 10. This gave each pairing an equal opportunity and avoided any bias in item pairing selection.Results: The ML-based PHQ-9 items 2 and 4 (phq2&4), the depressed mood and low-energy item pairing, and PHQ-9 items 2 and 8 (phq2&8), the depressed mood and psychomotor retardation or agitation item pairing, were found to be the best on the primary data set training split. They generalized well on the primary data set test split with area under the curves (AUCs) of 0.954 and 0.946, respectively, compared with an AUC of 0.942 for the PHQ-2. The phq2&4 had a higher AUC than the PHQ-2 on all 6 external data sets, and the phq2&8 had a higher AUC than the PHQ-2 on 3 data sets. The phq2&4 had the highest Youden index (an unweighted average of sensitivity and specificity) on 2 external data sets, and the phq2&8 had the highest Youden index on another 2. The PHQ-2 >= 2 cutoff also had the highest Youden index on 2 external data sets, joint highest with the phq2&4 on 1, but its performance fluctuated the most. The PHQ-2 >= 3 cutoff had the highest Youden index on 1 external data set. The sensitivity and specificity achieved by the phq2&4 and phq2&8 were more evenly balanced than the PHQ-2 >= 2 and >= 3 cutoffs.Conclusions: The PHQ-2 did not prove to be a more effective prescreening instrument when compared with other PHQ-9 item pairings. Evaluating all item pairings showed that, compared with alternative partner items, the anhedonia item underperformed alongside the depressed mood item. This suggests that the inclusion of anhedonia as a core symptom of depression and its presence in ultrabrief questionnaires may be incompatible with the empirical evidence. The use of the PHQ-2 to prescreen for depressive symptomatology could result in a greater number of misclassifications than alternative item pairings.
- Perspectives""Advance Care Planning in Brazil(2023) TARDELLI, Natalia Rocha; FORTE, Daniel Neves; VIDAL, Edison Iglesias de OliveiraBrazil is a country of continental size marked by extreme social inequalities. Its regulation of Advance Directives (AD) was not enacted by law but within the scope of the norms that govern the relationships between patients and physicians, as a resolution of the Federal Medical Council without any specific requirement for notarization. Despite this innovative starting point, most of the debate regarding Advance Care Planning (ACP) in Brazil has been dominated by a legal transactional approach focused on making decisions in advance and the creation of AD. Yet, other novel ACP models have recently emerged in the country with a focus on the creation of a specific quality of relationship between patients, families, and physicians aiming at the facilitating future decision-making. Most of the education on ACP in Brazil happens in the context of palliative care courses. As such, most ACP conversations are performed within palliative care services or by healthcare professionals with training in that area. Hence, the scarce access to palliative care services in the country means that ACP is still rare and that those conversations usually happen late in the course of disease. The authors posit that the existing paternalistic healthcare culture is one of the most important barriers to ACP in Brazil and envision with great concern the risk that its combination with extreme health inequalities and the lack of healthcare professionals' education on shared decision-making could lead to the misuse of ACP as a form of coercive practice to reduce healthcare use by vulnerable populations.
- Dimensions of harassment at school: dialogs about gender with young high school students in Sao Paulo/Brazil(2023) SILVA, Cristiane Goncalves da; LEITE, Vanessa Jorge; PONTES, Julia Clara deIn this article, we discuss uses of ""harassment"" as a category employed by young students from public high schools to make sense of violence and gender discrimination experiences that occur in and out of school. The analysis is based on fieldwork records produced within the scope of a multicenter, mixed -methods research carried out in nine schools located in Sao Paulo. Harassment appears as a polysemic category that, by naming violence, helps to face gender and generation hierarchies and inequalities. We infer that the young girls have questioned norms and attitudes that feed gender inequalities in schools; in addition, they have denounced the silence or inadequacy of the institution in facing the problem. This enables to identify convergences with a new sensibility regarding violence against women that globalized feminist discourses have brought to the surface.
- Violence, Discrimination, and High Levels of Symptoms of Depression Among Adolescent Men Who Have Sex With Men and Transgender Women in Brazil(2023) MEDEIROS, Danielle Souto de; MAGNO, Laio; GUIMARAES, Mark Drew Crosland; GRANGEIRO, Alexandre; EUSTORGIO FILHO, Marcos; SOARES, Fabiane; GRECO, Dirceu; WESTIN, Mateus; FERRAZ, Dulce; ZUCCHI, Eliana Miura; DOURADO, InesPurpose: This study aimed at describing the prevalence of symptoms of depression among 15-19 year old adolescent men who have sex with men (aMSM) and transgender women (aTGW), who were recruited in an HIV pre-exposure prophylaxis cohort study in three Brazilian capital cities. The study also examined potential associations, including violence and discrimination, with severe symptoms of depression among aMSM. Methods: This is a cross-sectional study of baseline data among 730 aMSM and 56 aTGWrecruited between February 2019 and February 2021. Sociodemographic and behavioral data were collected. The 20-item Center for Epidemiologic Studies Depression scale was used to screen for symptoms of depression. Scores of >= 22 points indicate the presence of severe symptoms associated with major depression. Logistic regression was used to assess independent associations among aMSM, adjusting for sociodemographic variables. Results: Our findings indicate a high prevalence of symptoms of depression (overall prevalence = 58.5% and 69.6%; 21.2% and 25.0% for mild/moderate, and 37.3% and 44.6% for severe) among these aMSM and aTGW, respectively. Psychological violence (aOR = 1.74; 95% CI = 1.12-2.70), sexual violence (aOR = 1.79; 95% CI = 1.07-2.98), and discrimination due to sexual orientation (aOR = 1.71; 95% CI = 1.23-2.38) were independently associated with severe symptoms of depression in aMSM. Discussion: The high prevalence of severe symptoms of depression and its association with psychological and sexual violence and discrimination creates cycles of vulnerability and carries important public health implications. Thus, our findings indicate public policies should consider assessing depression, psychological and sexual violence, as well as discrimination, especially in populations that will be targeted by interventions, such as the use of pre-exposure prophylaxis. (c) 2023 Society for Adolescent Health and Medicine.
- Civil society and community social support initiatives for vulnerable groups in primary care center catchment areas: the role of the FHS during the pandemic(2023) MENDONCA, Maria Helena Magalhaes de; SOARES, Mariangela Uhlmann; SPADACIO, Cristiane; ALVES, Marcia Guimaraes de Mello; SCHENKMAN, Simone; BOUSQUAT, Aylene Emilia Moraes; GIOVANELLA, LigiaThe pandemic highlighted new and old health risks that require health actions and social support. This study analyzed the knowledge of health professionals working in primary health care centers (PHCCs) regarding civil society and health service separately or along with health promotion and social support initiatives targeting vulnerable groups. The article begins by discussing the concept of social support and then goes on to present an analysis of empirical data from the multidimensional cross-sectional study ""Challenges facing primary health care in the response to COVID-19 in the SUS"", conducted using a nationally representative sample of PHCCs. Scores were calculated for selected and aggregated variables, and we calculated percentages for selected actions together with 95% confidence intervals at national and regional level. The percentage of PHCCs that supported actions and where the local community developed initiatives in the catchment area varied across regions, with rates being significantly higher in the Northeast and in non-urban municipalities with low MHDI, which was associated with actions developed in the catchment area by community health workers. The findings reveal several gaps and challenges, including the need to amplify the magnitude and scope of intra and intersectoral actions, strengthen ties between different actors, reverse the effects of the pandemic on health inequities and promote further research.
- Economic Evaluations and Equity in the Use of Artificial Intelligence in Imaging Exams for Medical Diagnosis in People With Skin, Neurological, and Pulmonary Diseases: Protocol for a Systematic Review(2023) SANTANA, Giulia Osorio; COUTO, Rodrigo de Macedo; LOUREIRO, Rafael Maffei; FURRIEL, Brunna Carolinne Rocha Silva; ROTHER, Edna Terezinha; PAIVA, Joselisa Peres Queiroz de; CORREIA, Lucas ReisBackground: Traditional health care systems face long-standing challenges, including patient diversity, geographical disparities, and financial constraints. The emergence of artificial intelligence (AI) in health care offers solutions to these challenges. AI, a multidisciplinary field, enhances clinical decision-making. However, imbalanced AI models may enhance health disparities. Objective: This systematic review aims to investigate the economic performance and equity impact of AI in diagnostic imaging for skin, neurological, and pulmonary diseases. The research question is ""To what extent does the use of AI in imaging exams for diagnosing skin, neurological, and pulmonary diseases result in improved economic outcomes, and does it promote equity in Methods: The study is a systematic review of economic and equity evaluations following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and CHEERS (Consolidated Health Economic Evaluation Reporting Standards) guidelines. Eligibility criteria include articles reporting on economic evaluations or equity considerations related to AI-based diagnostic imaging for specified diseases. Data will be collected from PubMed, Embase, Scopus, Web of Science, and reference lists. Data quality and transferability will be assessed according to CHEC (Consensus on Health Economic Criteria), EPHPP Results: This systematic review began in March 2023. The literature search identified 9,526 publications and, after full-text screening, 9 publications were included in the study. We plan to submit a manuscript to a peer-reviewed journal once it is finalized, Conclusions: AI in diagnostic imaging offers potential benefits but also raises concerns about equity and economic impact. Bias in algorithms and disparities in access may hinder equitable outcomes. Evaluating the economic viability of AI applications is essential for resource allocation and affordability. Policy makers and health care stakeholders can benefit from this review's insights to make informed decisions. Limitations, including study variability and publication bias, will be considered in the analysis. This systematic review will provide valuable insights into the economic and equity implications of AI in diagnostic imaging. It aims to inform evidence-based decision-making and contribute to more efficient and equitable health care systems. International Registered Report Identifier (IRRID): DERR1-10.2196/48544
- Methodological issues in qualitative research on HIV prevention: an integrative review(2023) SPADACIO, Cristiane; SANTOS, Lorruan Alves dos; SORRENTINO, Isa da Silva; GOMES, Romeu; CASTELLANOS, Marcelo Eduardo Pfeiffer; ZUCCHI, Eliana Miura; GRANGEIRO, Alexandre; COUTO, Marcia TherezaIn view of the growing concern about the use of qualitative approach in health research, this article aims to analyze how the qualitative theoretical -method-ological framework of HIV prevention is presented in empirical research. We conducted an integrative literature review with the following guiding ques-tions: ""How is the qualitative theoretical-methodological framework expressed in empirical research on HIV prevention?""; ""What are the limits and poten-tials of the qualitative methodological designs employed?"". In the qualitative methodological discussion, five dimensions guided the methodological course and the presentation of findings, from the analysis of the characterization of qualitative studies to the contextualization of the studies and the methodologi-cal approaches used, highlighting the use of semi-structured interviews with thematic content analysis. We also examined social categories and analytical references, drawing attention to the plurality of these theoretical-conceptual references and to the authors' polyphony, and identified the limits and po-tentials of qualitative research. This study focuses on a scientific topic that is related to a wide variety of social groups and analyzes how they are af-fected by it, examining issues related to social inequality and other analytical possibilities surrounding HIV prevention, and providing resources for a com-prehensive methodological discussion. Hence, avoiding the risk of conducting qualitative research based on checklists that limit inventiveness and openness to different designs and forms of execution and analysis is as pivotal as ensur-ing that the research is consistent and detailed in publications.
- Vaccines past and future - a Brazilian perspective(2023) KALIL, JorgeIn this opinion article, I provide a brief history of vaccine development, commenting on the classic ways of obtaining vaccines using the infectious agent itself. Then, I address the issue of viral vaccines, their successes , difficulties, discussing the issue of viral serotypes. Bacterial vaccines and their relative success. I present our studies on Rheumatic Heart Disease and the development of an anti-streptococcal vaccine. Then, I discuss vaccine development platforms, especially with the successes achieved with non-replicating viral vector vaccines and, above all, the great success of mRNA vaccines. mRNA vaccines were only possible after the advances obtained with the replacement of nucleotides that reduced the action of innate immunity. Will all vaccines be made from mRNA in the future? Next, I address the issue of vaccine administration routes, whether subcutaneously, intradermally, intramuscularly or nasal instillation. I expose data from my laboratory on the development of an intranasal vaccine that induced a protective mucosal response, preventing infection , consequently the transmission of the SARS-CoV-2 virus. Then, I discuss which future vaccines could be developed beyond acute infectious diseases. Finally, I discuss the advantages of developing safe, effective, multiple-use vaccines and how to make them accessible to the world's population by promoting health equity.
- Critically ill patients with COVID-19-associated acute kidney injury treated with kidney replacement therapy: Comparison between the first and second pandemic waves in São Paulo, Brazil(2023) SAMAAN, Farid; FREITAS, Rafaela Andrade Penalva; VIANA, Renata; GAMBARO, Livia; CUNHA, Karlla; VIEIRA, Tales Dantas; FEITOSA, Valkercyo; CORREA, Eric Aragao; MACIEL, Alexandre Toledo; ARANHA, Sylvia; OSAWA, Eduardo Atsushi; PILLAR, Roberta; FLATO, Elias Marcos da Silva; SILVA, Renata Cristina da; CARNEIRO, Elisa; SOUZA, Fabrizzio Batista Guimaraes de Lima; ROSSI, Paula Regina Gan; ABUD, Munira Bittencourt; KONIGSFELD, Henrique Pinheiro; SILVA, Riberto Garcia da; SOUZA, Ricardo Barbosa Cintra de; COUTINHO, Saurus Mayer; GOES, Miguel angelo; SILVA, Barbara Antunes Bruno da; ZANETTA, Dirce Maria Trevisan; BURDMANN, Emmanuel AlmeidaIntroductionThis study aimed to compare the characteristics and outcomes of critically ill patients with COVID-19-associated acute kidney injury (AKI) who were treated with kidney replacement therapy (KRT) in the first and second waves of the pandemic in the megalopolis of Sao Paulo, Brazil.MethodsA multicenter retrospective study was conducted in 10 intensive care units (ICUs). Patients aged >= 18 years, and treated with KRT due to COVID-19-associated AKI were included. We compared demographic, laboratory and clinical data, KRT parameters and patient outcomes in the first and second COVID-19 waves.ResultsWe assessed 656 patients (327 in the first wave and 329 in the second one). Second-wave patients were admitted later (7.1 +/- 5.0 vs. 5.6 +/- 3.9 days after the onset of symptoms, p<0.001), were younger (61.4 +/- 13.7 vs. 63.8 +/- 13.6 years, p = 0.023), had a lower frequency of diabetes (37.1% vs. 47.1%, p = 0.009) and obesity (29.5% vs. 40.0%, p = 0.007), had a greater need for vasopressors (93.3% vs. 84.6%, p<0.001) and mechanical ventilation (95.7% vs. 87.8%, p<0.001), and had higher lethality (84.8% vs. 72.7%, p<0.001) than first-wave patients. KRT quality markers were independently associated with a reduction in the OR for death in both pandemic waves.ConclusionsIn the Sao Paulo megalopolis, the lethality of critically ill patients with COVID-19-associated AKI treated with KRT was higher in the second wave of the pandemic, despite these patients being younger and having fewer comorbidities. Potential factors related to this poor outcome were difficulties in health care access, lack of intra-hospital resources, delay vaccination and virus variants.
- The World Health Assembly resolution on integrated emergency, critical, and operative care for universal health coverage and protection from health emergencies: a golden opportunity to attenuate the global burden of acute and critical illness(2023) OWOO, Christian; ADHIKARI, Neill K. J.; AKINOLA, Olurotimi C.; ARYAL, Diptesh; AZEVEDO, Luciano; BACHA, Tigist; BAELANI, John Inipavudu; BAKER, Tim; BARTLETT, Emily; BONNEY, Joseph; CONVOCAR, Pauline W.; DIPPENAAR, Enrico; DUNSER, Martin; ESTENSSORO, Elisa; FOWLER, Robert; GORE, Sandeep; GUDDU, Dessalegn Keney G.; HASHMI, Madiha; HOLLONG, Bonaventure M.; KABONGO, Diulu; KIVLEHAN, Sean; KING, Lauren Lai; LOSONCZY, Lia T.; LUNDEG, Ganbold; MCCURDY, Michael; MER, Mervyn; MISANGO, David; MOLL, Vanessa; MURTHY, Srinivas; PATTNAIK, Rajyabardhan; PETROS, Sirak; RIVIELLO, Elisabeth; SCHELL, Carl Otto; SHRESTHA, Gentle Sunder; SULTAN, Menbeu; TEFERA, Muluwork; YIM, Anfernee; TADESSE, Ayalew Zewdie
- Fairness: from the guts to the brain - a critical examination by Atlantic fellows of the Global Brain Health Institute(2023) AVELINO-SILVA, Thiago Junqueira; TRUJILLO, Natalia; UDEH-MOMOH, ChineduIn January 2023, the Global Brain Health Institute (GBHI) at UCSF hosted an online salon to discuss the relationship between fairness and brain health equity. We aimed to address two primary questions: first, how is fairness perceived by the public, and how does it manifest in societal constructs like equity and justice? Second, what are the neurobiological foundations of fairness, and how do they impact brain health? Drawing from interdisciplinary fields such as philosophy, psychology, and neuroscience, the salon served as a platform for participants to share diverse perspectives on fairness. Fairness is a multifaceted concept encompassing equity, justice, empathy, opportunity, non-discrimination, and the Golden Rule, but by delving into its evolutionary origins, we can verify its deep-rooted presence in both human and animal behaviors. Real-world experiments, such as Frans de Waal's capuchin monkey study, have proven enlightening, elucidating many mechanisms that have shaped our neurobiological responses to fairness. Contemporary cognitive neuroscience research further emphasizes the role of neuroanatomical areas and neurotransmitters in encoding fairness-related processes. We also discussed the critical interconnection between fairness and healthcare equity, particularly its implications for brain health. These values are instrumental in promoting social justice and improving health outcomes. In our polarized social landscape, there are rising concerns about a potential decrease in fairness and prosocial behaviors due to isolated social bubbles. We stress the urgency for interventions that enhance perspective-taking, reasoning, and empathy. Overall, fairness is vital to fostering an equitable society and its subsequent influence on brain health outcomes.
- Survival inequalities in head and neck cancers: A hospital-based cohort study(2023) MENEZES, Fabricio dos Santos; PERES, Stela Verzinhasse; CASTRO, Gilberto de; ANTUNES, Jose Leopoldo Ferreira; LATORRE, Maria do Rosario Dias de Oliveira; TOPORCOV, Tatiana NatashaBackgroundWe investigated whether the socioeconomic status (SES) influenced survival rates in oropharynx cancers (OPC), oral cavity cancers (OCC), and larynx cancers (LC) in Brazilian patients. MethodsThis hospital-based cohort study assessed the age-standardized 5-year relative survival (RS) using the Pohar Perme estimator. ResultsOverall, we identified 37 191 cases, and 5-year RS were 24.4%, 34.1%, and 44.9% in OPC, OCC, and LC, respectively. In multiple Cox regression, the highest risk of death occurred in the most vulnerable social strata for all subsites-that is, illiterates or patients relying on publicly funded healthcare services. Disparities increased over time by 34.9% in OPC due to the rising of survival rates in the highest SES, whereas they reduced by 10.2% and 29.6% in OCC and LC. ConclusionsThe potential inequities were more significant for OPC than for OCC and LC. It is urgent to tackle social disparities to improve prognoses in highly unequal countries.
- Editorial: Ultra-processed foods and human and planetary health(2023) CEDIEL, Gustavo; MENDONCA, Raquel de Deus; MEIRELES, Adriana Lucia; LEITE, Maria Alvim; GOMBI-VACA, Maria F.; RAUBER, Fernanda
- The (in)visible Brazilians: A perspective review on the need for brain health and dementia research with Brazilian immigrants in the United States(2023) SIMON, Sharon Sanz; BRUCKI, Sonia Maria Dozzi; FONSECA, Luciana Mascarenhas; BECKER, Jacqueline; CAPPI, Carolina; MARQUES, Andrea Horvath; HEYN, Patricia C.; GONCALVES, Priscila Dib; MARTINS, Silvia S.; BUSATTO, Geraldo; SUEMOTO, Claudia Kimie; NITRINI, Ricardo; CARAMELLI, Paulo; YASSUDA, Monica Sanches; MIOTTO, Eliane Correa; GRINBERG, Lea Tenenholz; RENTERIA, Miguel Arce; ALEGRIA, Margarita; STERN, Yaakov; RIVERA-MINDT, Monica; BERTOLA, LaissIntroduction: The Brazilian population in the United States (U.S.), a Latinx subgroup, is rapidly growing and aging but remains underrepresented in U.S. health research. In addition to group-specific genetic and environmental risks, Brazilian immigrants and their offspring in the U.S. likely have cumulative risks for health inequities. It is estimated that 71% of Brazilian immigrants in the U.S. are undocumented, which may limit healthcare access/utilization. Furthermore, mental health is reported as a health priority by Brazilian immigrants in the U.S., and there is a lack of research on Alzheimer's disease and related dementia (AD/ADRD) in this population.Methods: We reviewed the scientific literature using traditional (e.g., PubMed) sources and databases generated by U.S. and Brazilian governments, as well as international organizations, and press articles.Results: This perspective review lists recommendations for researchers, health providers, and policymakers to promote greater inclusion of U.S. Brazilian populations in health research and care. The review identifies research areas in need of attention to address health inequities and promote mental/brain health in Brazilian immigrants and their offspring living in the U.S. These research areas are: 1) epidemiological studies to map the prevalence and incidence of mental/brain health conditions; 2) research on aging and AD/ADRD risk factors among Brazilian populations in the U.S.; and 3) the need for greater representation of U.S-residing Brazilian population in other relevant research areas involving genetics, neuropathology, and clinical trials.Conclusions: The recommendation and research efforts proposed should help to pave the way for the development of community-engagement research and to promote mental/brain health education, improvement of mental/brain health and AD/ADRD services, and the development of culturally-informed intervention to the U.S.-residing Brazilian communities.
- The (in)visible Brazilians: A perspective review on the need for brain health and dementia research with Brazilian immigrants in the United States ( vol 9, e12425, 2023)(2023) SIMON, Sharon Sanz; BRUCKI, Sonia Maria Dozzi; FONSECA, Luciana Mascarenhas; BECKER, Jacqueline; CAPPI, Carolina; MARQUES, Andrea Horvath; HEYN, Patricia C.; GONCALVES, Priscila Dib; MARTINS, Silvia S.; BUSATTO, Geraldo; BERTOLA, Laiss; SUEMOTO, Claudia Kimie; NITRINI, Ricardo; CARAMELLI, Paulo; YASSUDA, Monica Sanches; MIOTTO, Eliane Correa; GRINBERG, Lea Tenenholz; RENTERIA, Miguel Arce; ALEGRIA, Margarita; STERN, Yaakov; RIVERA-MINDT, Monica
- Analysis of education level in access and use of health care services, ISA-Capital, São Paulo, Brazil, 2003 and 2015(2023) SANTOS, Edige Felipe de Sousa; LOUVISON, Marilia Cristina Prado; OLIVEIRA, Elaine Cristina Torres; MONTEIRO, Camila Nascimento; BARROS, Marilisa Berti de Azevedo; GOLDBAUM, Moises; CESAR, Chester Luiz GalvaoThe great socioeconomic inequality that prevails in Brazil and the existence of a national health system with universal coverage places the need to monitor the evolution and social inequities regarding access to these services. This study aims to analyze the changes in the prevalence of health care use and the extent of social inequality in the demand, use and, access, resolution of health problems, satisfaction, and health care use of Brazilian Unified National Health System (SUS) according to education levels in the population living in the urban area of the Municipality of Sao Paulo, in 2003 and 2015. We analyzed data from two population-based household health surveys (Health Survey in Sao Paulo City - ISA-Capital) from 2003 and 2015. Dependent variables related to health care use in the two weeks preceding the survey and due to diseases included demand, access, satisfaction, problem resolution, and the public or private nature of the service. Prevalence was estimated using level of education and prevalence ratios (PR) by the Poisson regression. In the period, the demand for health care, access, resolution, and use of public health care increased from 2003 to 2015. Inequities in public health care use changed from 2003 to 2015 according to level of education. We found no social inequities in health care use in the municipality of Sao Paulo regarding demand, access, satisfaction, and resolution according to levels of education. Results show progress in the use and resolution of health care services, as well as the strong concentration of the use of SUS by the population with lower education. Results indicate the progress that SUS has made, but also show persistent challenges in the use and access to services.
- Child maltreatment, migration and risk of first-episode psychosis: results from the multinational EU-GEI study(2023) D'ANDREA, Giuseppe; LAL, Jatin; TOSATO, Sarah; GAYER-ANDERSON, Charlotte; JONGSMA, Hannah E.; STILO, Simona A.; VEN, Els van der; QUATTRONE, Diego; VELTHORST, Eva; BERARDI, Domenico; MENEZES, Paulo Rossi; ARANGO, Celso; PARELLADA, Mara; LASALVIA, Antonio; CASCIA, Caterina La; FERRARO, Laura; BARBERA, Daniele La; SIDELI, Lucia; BOBES, Julio; BERNARDO, Miguel; SANJUAN, Julio; SANTOS, Jose Luis; ARROJO, Manuel; DEL-BEN, Cristina Marta; TRIPOLI, Giada; LLORCA, Pierre-Michel; HAAN, Lieuwe de; SELTEN, Jean-Paul; TORTELLI, Andrea; SZOKE, Andrei; MURATORI, Roberto; RUTTEN, Bart P.; OS, Jim van; JONES, Peter B.; KIRKBRIDE, James B.; MURRAY, Robin M.; FORTI, Marta di; TARRICONE, Ilaria; MORGAN, CraigBackground Child maltreatment (CM) and migrant status are independently associated with psychosis. We examined prevalence of CM by migrant status and tested whether migrant status moderated the association between CM and first-episode psychosis (FEP). We further explored whether differences in CM exposure contributed to variations in the incidence rates of FEP by migrant status. Methods We included FEP patients aged 18-64 years in 14 European sites and recruited controls representative of the local populations. Migrant status was operationalized according to generation (first/further) and region of origin (Western/non-Western countries). The reference population was composed by individuals of host country's ethnicity. CM was assessed with Childhood Trauma Questionnaire. Prevalence ratios of CM were estimated using Poisson regression. We examined the moderation effect of migrant status on the odds of FEP by CM fitting adjusted logistic regressions with interaction terms. Finally, we calculated the population attributable fractions (PAFs) for CM by migrant status. Results We examined 849 FEP cases and 1142 controls. CM prevalence was higher among migrants, their descendants and migrants of non-Western heritage. Migrant status, classified by generation (likelihood test ratio:chi(2) = 11.3, p = 0.004) or by region of origin (likelihood test ratio:chi(2) = 11.4, p = 0.003), attenuated the association between CM and FEP. PAFs for CM were higher among all migrant groups compared with the reference populations. Conclusions The higher exposure to CM, despite a smaller effect on the odds of FEP, accounted for a greater proportion of incident FEP cases among migrants. Policies aimed at reducing CM should consider the increased vulnerability of specific subpopulations.
- Country-level gender inequality is associated with structural differences in the brains of women and men(2023) ZUGMAN, Andre; ALLIENDE, Luz Maria; MEDEL, Vicente; BETHLEHEM, Richard A. I.; SEIDLITZ, Jakob; RINGLEIN, Grace; ARANGO, Celso; ARNATKEVICIUTE, Aurina; ASMAL, Laila; BELLGROVE, Mark; BENEGAL, Vivek; BERNARDO, Miquel; BILLEKE, Pablo; BOSCH-BAYARD, Jorge; BRESSAN, Rodrigo; BUSATTO, Geraldo F.; CASTRO, Mariana N.; CHAIM-AVANCINI, Tiffany; COMPTE, Albert; COSTANZI, Monise; CZEPIELEWSKI, Leticia; DAZZAN, Paola; FUENTE-SANDOVAL, Camilo de la; FORTI, Marta Di; DIAZ-CANEJA, Covadonga M.; DIAZ-ZULUAGA, Ana Maria; PLESSIS, Stefan Du; DURAN, Fabio L. S.; FITTIPALDI, Sol; FORNITO, Alex; FREIMER, Nelson B.; GADELHA, Ary; GAMA, Clarissa S.; GARANI, Ranjini; GARCIA-RIZO, Clemente; CAMPO, Cecilia Gonzalez; GONZALEZ-VALDERRAMA, Alfonso; GUINJOAN, Salvador; HOLLA, Bharath; IBANEZ, Agustin; IVANOVIC, Daniza; JACKOWSKI, Andrea; LEON-ORTIZ, Pablo; LOCHNER, Christine; LOPEZ-JARAMILLO, Carlos; LUCKHOFF, Hilmar; MASSUDA, Raffael; MCGUIRE, Philip; MIYATAAAA, Jun; MIZRAHI, Romina; MURRAY, Robin; OZERDEM, Aysegul; PAN, Pedro M.; PARELLADA, Mara; PHAHLADIRA, Lebogan; RAMIREZ-MAHALU, Juan P.; RECKZIEGEL, Ramiro; MARQUES, Tiago Reis; REYES-MADRIGAL, Francisco; ROOS, Annerine; ROSA, Pedro; SALUM, Giovanni; SCHEFFLER, Freda; SCHUMANN, Gunter; SERPA, Mauricio; STEIN, Dan J.; TEPPER, Angeles; TIEGO, Jeggan; UENO, Tsukasa; UNDURRAGA, Juan; UNDURRAG, Eduardo A.; VALDES-SOSAOOO, Pedro; VALLIY, Isabel; VILLARREALU, Mirta; WINTON-BROWNRRR, Toby T.; YALIN, Nefize; ZAMORANO, Francisco; ZANETTI, Marcus V.; WINKLER, Anderson M.; PINE, Daniel S.; EVANS-LACKO, Sara; CROSSLEY, Nicolas A.Gender inequality across the world has been associated with a higher risk to mental health problems and lower academic achievement in women compared to men. We also know that the brain is shaped by nurturing and adverse socio-environmental experiences. Therefore, unequal exposure to harsher conditions for women compared to men in gender-unequal countries might be reflected in differences in their brain structure, and this could be the neural mechanism partly explaining women's worse outcomes in gender-unequal countries. We examined this through a random-effects meta-analysis on cortical thickness and surface area differences between adult healthy men and women, including a meta-regression in which country-level gender inequality acted as an explanatory variable for the observed differences. A total of 139 samples from 29 different countries, totaling 7,876 MRI scans, were included. Thickness of the right hemisphere, and particularly the right caudal anterior cingulate, right medial orbitofrontal, and left lateral occipital cortex, presented no differences or even thicker regional cortices in women compared to men in gender-equal countries, reversing to thinner cortices in countries with greater gender inequality. These results point to the potentially hazardous effect of gender inequality on women's brains and provide initial evidence for neuroscience-informed policies for gender equality.
- Association between Community Violence, Disorder and School Environment with Bullying among School Adolescents in Sao Paulo - Brazil(2023) AZEREDO, Catarina Machado; MARQUES, Emanuele Souza; OKADA, Leticia Martins; PERES, Maria Fernanda TourinhoThe role of contextual-level factors in bullying is still not clear, and evidence is mostly from high-income countries. Our objective was to investigate the association between community violence, disorder, school environment and bullying among school adolescents. We used data from a representative sample of 9th grade Brazilian adolescents (n = 2108) from the Sao Paulo Project for the social development of children and adolescents (SP - PROSO). Multilevel logistic regression models stratified by sex were used to assess the association between variables at student and school/neighbourhood level and bullying victimization or perpetration. For both sexes, we found that adolescents who perceived high violence between students and high school disorder were more likely to be bullies and victims. Boys who perceived high community violence and disorder in their neighbourhood were more likely to be bullies (OR3tertile = 2.73 CI95%: 1.57-4.74). Girls attending schools where the principal reported high community violence and disorder in the neighbourhood (ORhigh = 10.24 CI95%: 2.11-49.59) and inside the school (ORhigh = 6.83 CI95%: 1.48-31.56) were more likely to be bullies. Boys from schools whose principal perceived violence between students were less likely to be victims (ORhigh = 0.35 CI95%: 0.16-0.78) and bullies (ORhigh = 0.21 CI95%: 0.07-0.64). Girls attending schools with signs or posters about tolerance/gender equality and about violence were less (OR = 0.12 CI95%: 0.03-0.50) and more likely (OR = 25.88 CI95%: 4.28-156.63) to report being bullies, respectively. Community violence, disorder and school environment were associated with bullying victimization and perpetration among adolescents. Sex-specific associations should be further investigated. Prevention and management of school violence in adolescence should consider contextual-level characteristics.