Pesquisa | SciELO

Abstract Vaccines are considered one of the most important public health advancements of the modern age and the most cost-effective preventive method of curbing the spread of several diseases with high morbidity and lethality. However, vaccination coverage rates around the world have been threatened by the vaccine hesitancy phenomenon, considered by the World Health Organization (WHO) as one of the ten greatest menaces to public health in the world. Vaccine opposition is a mentality driven by various interests, as old as the vaccine itself, predominantly using the media and social networks, which have an enormous influence on people. They often spread false information about vaccines, frequently with no adequate scientific backing, negatively impacting vaccination rates. To understand the possible correlation between the information spread on social media and childhood vaccination rates, we performed a narrative review on the subject, with a qualitative approach, in original or review articles, indexed in national and international databases and/or journals, in Portuguese and English, published between 2011 and 2021, available in full and free of charge. One hundred and seventy-two articles were extracted from the literature, 49 of which were submitted to analysis. The use of content analysis in a narrative literature review made it possible to interpret the main publications that in the last decade point to the impact of social media as one of the main factors linked to vaccine hesitancy in children. The articles show that communication is presented as a determinant for adherence or vaccine hesitancy, and social media are a useful tool for disseminating information that can influence and mobilize the population, promoting its acceptance or having a negative impact on childhood vaccine coverage rates. Social Media has become fertile ground for the creation and spread of fake news, hence the importance of the health professional's engagement in strengthening the population's confidence in relation to immunization, minimizing vaccine hesitancy.

https://doi.org/10.36367/ntqr.16.2023.e662

Patient safety in undergraduate nursing: Students’ perspective
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Santos, Fernanda Accioly de Lima

; Vasconcelos, Maria Viviane Lisboa de

; Vieira, Maria de Lourdes Fonseca

; Melo, Ana Clara Valente de Lima

; Leitão, Inara Lourenço

New Trends in Qualitative Research

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Set 2023, Volume 16 elocation e661

Resumo: En | Texto: En | PDF: En

Abstract “Patient safety” is an important care factor for all patients and therefore indispensable in the training of all health professionals. Thus, there is a need to assess patient safety in undergraduate nursing in the context of in-person teaching and the curricular stages. Objective: This study proposes to analyze students’ perspective of patient safety at a university in Northeastern Brazil. Methodology: This is an instrumental exploratory single-case study with a qualitative approach. The sample consisted of twelve students selected by convenience. Data collection occurred via an online focus group. The data were processed in NVivo software, version 12.0. Results: The data illustrate the students’ perception of patient safety, divided into three categories: in-person teaching; curricular stages; and attributes for managing future nurses. Although the university does not offer a specific patient safety course, the topic is satisfactorily discussed from the onset of the course. Final considerations: The case study found that health professional training based on patient safety measures is one of the most crucial investments that a university can make, sharpening critical thinking in order to improve care and reduce hospital costs, and above all, preserve life.

https://doi.org/10.36367/ntqr.16.2023.e661

Síndrome congênita do zika e impactos para as famílias: uma revisão integrativa
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Melo, Ana Paula Lopes de

; Lyra, Tereza Maciel

; Barbosa, Jessyka Mary Vasconcelos

; Araújo, Thália Velho Barreto de

Ciência & Saúde Coletiva

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Mai 2023, Volume 28 Nº 5 Páginas 1425 - 1441

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract In 2015, a range of congenital anomalies resulting from mother-to-child transmission of the zika virus emerged. Later called congenital zika syndrome (CZS), the condition includes microcephaly. Since then, around 4,000 children have been affected in 27 countries, with Brazil accounting for the largest proportion of cases. Family caregivers have also been affected. This study analyzes the literature on caregivers of children with CZS and how the disease has affected their everyday lives. We conducted an integrative review using the PubMed, Virtual Health Library, and Embase databases. Thirty-one articles were identified for analysis after screening. The findings were grouped into four categories: a) social impacts - changes in family relationships, life projects, and social life; b) subjective impacts - feelings of resilience, loneliness, grief, overburdening, fear, uncertainty, and spirituality and religion; c) economic and material impacts - loss of income, increased household expenses, change of residence, and unemployment; and d) health impacts - service unpreparedness, selflessness, self-care, changes in nutritional and sleep patterns, and mental health problems, including stress, anxiety and depression.

Resumo Em 2015, um espectro de anomalias congênitas, incluindo microcefalia, acometeu recém-nascidos como resultado da transmissão vertical pelo vírus zika, posteriormente denominada síndrome congênita do zika (SCZ). Desde então, cerca de 4 mil crianças foram afetadas em 27 países, sendo o Brasil o mais atingido. Cuidadores familiares também têm sido impactados. Esse estudo analisa publicações científicas que investigam as maneiras como a doença afetou as dinâmicas de vida de cuidadores familiares de crianças com SCZ. Realizou-se uma revisão integrativa de literatura consultando as bases de dados PubMed, Biblioteca Virtual em Saúde e Embase. Após as etapas de triagem, foram identificados 31 artigos. Os principais resultados foram agrupados em quatro categorias: a) impactos sociais que evidenciaram mudanças nas relações familiares, nos projetos de vida e no convívio social; b) impactos subjetivos - sentimentos de resiliência, solidão, luto, sobrecarga, medo, incerteza e relação com a espiritualidade; c) impactos econômicos e materiais - perda de renda, aumento de despesas, mudança de moradia e desemprego e d) impactos na saúde - despreparo dos serviços, renúncia do cuidado de si, modificações dos padrões nutricionais e de sono, repercussão para a saúde mental e níveis de estresse, ansiedade e depressão.

https://doi.org/10.1590/1413-81232023285.14852022

Síndrome congênita do zika e impactos para as famílias: uma revisão integrativa
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Melo, Ana Paula Lopes de

; Lyra, Tereza Maciel

; Barbosa, Jessyka Mary Vasconcelos

; Araújo, Thália Velho Barreto de

Ciência & Saúde Coletiva

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Mai 2023, Volume 28 Nº 5 Páginas 1425 - 1441

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

https://doi.org/10.1590/1413-81232023285.14852022

Depression Screening in a population-based study: Brazilian National Health Survey 2019
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Melo, Ana Paula Souto

; Bonadiman, Cecília Silva Costa

; Andrade, Fabiana Martins de

; Pinheiro, Pedro Cisalpino

; Malta, Deborah Carvalho

Ciência & Saúde Coletiva

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Abr 2023, Volume 28 Nº 4 Páginas 1163 - 1174

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract This study evaluated the prevalence of positive screening for depression in Brazil and its associated factors. We used data from National Health Survey 2019 (Pesquisa Nacional de Saúde - PNS), a population-based survey with 88,531 adults. The Patient Health Questionnaire (PHQ-9) was used with two scoring methods, the algorithm and the cutoff point≥10. The variables included sociodemographic characteristics. The prevalence ratios and 95% confidence intervals (95%CI) were estimated using Poisson regression. The positive screening for depression was 10.8% (95%CI: 10.4-11.0), at the cutoff point ≥10 and 5.7% (95%CI: 5.4-6.0) for algorithm. Significant differences were found in prevalence in some Brazilian states. Multivariable analyses showed that being female, black, under 70 years of age, having little education, being single, and living in an urban area were independently associated with a depressive symptoms. The highest association was found in the states of Sergipe, Goiás, Piauí, Espírito Santo, São Paulo, Alagoas and lowest in Pará, Mato Grosso and Maranhão. The prevalence of positive screening for depression in Brazil has increased in recent years. More investment in mental health resources is necessary and surveys such as the PNS should be continued.

Resumo Este estudo avaliou a prevalência de triagem positiva para depressão no Brasil e seus fatores associados. Utilizou-se dados da Pesquisa Nacional de Saúde 2019 (PNS), um inquérito de base populacional com 88.531 adultos. Para avaliar os sintomas depressivos utilizou-se o Patient Health Questionnaire (PHQ-9) com dois métodos de pontuação: o algoritmo e o ponto de corte ≥10. As variáveis incluíram características sociodemográficas. Utilizou-se a regressão de Poisson para obter razões de prevalência, com intervalo de confiança de 95% (IC95%). A triagem positiva para depressão foi de 10,8% (IC95%: 10,4-11,0), no ponto de corte ≥10 e 5,7% (IC95%: 5,4-6,0) para o algoritmo. Houve diferenças significativas na prevalência entre alguns estados brasileiros. Análises multivariadas mostraram que ser do sexo feminino, negro, ter menos de 70 anos, ter baixa escolaridade, ser solteiro e residir em área urbana estiveram independentemente associados a sintomas depressivos. A maior associação foi encontrada nos estados de Sergipe, Goiás, Piauí, Espírito Santo, São Paulo, Alagoas e a menor no Pará, Mato Grosso e Maranhão. A prevalência de triagem positiva para depressão no Brasil tem aumentado nos últimos anos. É necessário mais investimento em saúde mental e pesquisas como a PNS devem ser feitas continuamente.

https://doi.org/10.1590/1413-81232023284.14912022

Depression Screening in a population-based study: Brazilian National Health Survey 2019
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Melo, Ana Paula Souto

; Bonadiman, Cecília Silva Costa

; Andrade, Fabiana Martins de

; Pinheiro, Pedro Cisalpino

; Malta, Deborah Carvalho

Ciência & Saúde Coletiva

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2023, Volume 28 Nº 4 Páginas 1163 - 1174

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

https://doi.org/10.1590/1413-81232023284.14912022

Brazilian society of rheumatology methodological guide for the development of evidence-based clinical guidelines in rheumatology evidencebased evidence based
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Melo, Ana Karla Guedes de

; Caparroz, Ana Luíza Mendes Amorim

; Abreu, Mirhelen Mendes de

; Azevedo, Daniela Castelo

; Hoff, Leonardo Santos

; Kowalski, Sérgio Candido

; Torres, Themis Mizerkowski

; Barros, Solange Murta

; Ferreira, Gilda Aparecida

; Montecielo, Odirlei André

; Xavier, Ricardo Machado

; Trevisani, Virgínia Fernandes Moça

Advances in Rheumatology

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2023, Volume 63 elocation 12

Resumo: En | Texto: En | PDF: En

Abstract Clinical practice guidelines (CPG) are developed to align standards of health care around the world, aiming to reduce the incidence of misconducts and enabling more effective use of health resources. Considering the complexity, cost, and time involved in formulating CPG, strategies should be used to facilitate and guide authors through each step of this process. The main objective of this document is to present a methodological guide prepared by the Epidemiology Committee of the Brazilian Society of Rheumatology for the elaboration of CPG in rheumatology. Through an extensive review of the literature, this study compiles the main practical recommendations regarding the following steps of CPG drafting: distribution of working groups, development of the research question, search, identification and selection of relevant studies, evidence synthesis and quality assessment of the body of evidence, the Delphi methodology for consensus achievement, presentation and dissemination ofthe recommendations, CPG quality assessment and updating. This methodological guide serves as an important tool for rheumatologists to develop reliable and high-quality CPG, standardizing clinical practices worldwide. (CPG world resources complexity cost process rheumatology literature drafting groups question search studies achievement updating highquality high worldwide

https://doi.org/10.1186/s42358-023-00293-4

Epidemiologia espacial e a detecção de aglomerados espaciais do dengue na Paraíba: uma comparação entre os métodos Scan flexível e Scan circular
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Melo, Ana Cláudia Oliveira de

; Melo, José Carlos da Silva

; Moraes, Ronei

Cadernos Saúde Coletiva

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Dez 2022, Volume 30 Nº 4 Páginas 561 - 571

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Introdução Estatísticas espaciais são usadas para auxiliar gestores de saúde na tomada de decisão, informando a taxa de ocorrência de agravos na população e destacando quando estas alcançam valores além do esperado. Objetivo Compreender o funcionamento e aplicabilidade das Estatísticas Espaciais Scan flexível e Scan circular, comparando seus resultados na detecção de aglomerados espaciais usando dados epidemiológicos reais do dengue no estado da Paraíba – Brasil. Método Descreveu-se o processo detalhado da aplicação das estatísticas Scan flexível e Scan circular para a detecção de áreas significativas de risco (aglomerados) do dengue na Paraíba, nos anos de 2009 a 20013, por meio dos software FLeXScan e SaTScan. Resultados Ambos os métodos revelaram o oeste do estado como a região com maior frequência de aglomerados detectados com alto risco, em todos os anos analisados, levando-se em consideração os mapas de risco de incidência do dengue na Paraíba, nos anos de 2009 a 2013. Conclusão As estatísticas Scan flexível e Scan circular são praticamente similares quanto à eficiência na detecção de aglomerados do dengue. Entretanto, verificaram-se problemas de superestimação no método Scan circular e subestimação no método Scan flexível na detecção dos aglomerados. Destacou-se ainda o auxílio destas estatísticas espaciais aos gestores de saúde quanto à localização das regiões de agravo da doença, tornando mais efetivo o direcionamento das ações de combate de forma politicamente correta.

Abstract Background Spatial statistics are used to help health managers make decisions, informing the rate of occurrence of diseases in the population and highlighting when they reach values beyond expectations. Objective To understand the functioning and applicability of Spatial Statistics Flexible Scan and Circular Scan by comparing their results in the detection of spatial clusters using real epidemiological data of dengue in the state of Paraíba – Brazil. Method The detailed process for applying the flexible scan and circular scan statistics for detecting significant dengue risk areas (clusters) in Paraíba, between 2009 and 20013, was described using the software FLeXScan and SaTScan. Results Both methods showed the highest frequency of clusters detected at high risk in the western region of the state, in all the years analyzed, considering the risk maps of dengue incidence in Paraíba, between 2009 and 2013. Conclusion The flexible scan and circular scan statistics are practically similar in terms of efficiency in detecting clusters of dengue. However, there were problems of overestimation in the circular Scan method and underestimation in the flexible Scan method in the detection of clusters. It is also worth highlighting that these spatial statistics help health managers locate the regions of disease aggravation, making it more effective to direct combat actions in a politically correct manner.

https://doi.org/10.1590/1414-462x202230040082

Bottom-up modelling of electricity end-use consumption of the residential sector in Brazil
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Teixeira, Cristiano André

; Melo, Ana Paula

; Fossati, Michele

; Lamberts, Roberto

Ambiente Construído

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Set 2022, Volume 22 Nº 3 Páginas 113 - 131

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo O consumo de energia no setor residencial brasileiro tem aumentado significativamente, apesar dos esforços para promover a eficiência energética dos eletrodomésticos. Um dos principais objetivos para a melhoria da eficiência energética nas residências é entender seus usos finais de energia. Neste contexto, este artigo apresenta o desenvolvimento de um modelo bottom-up para analisar os usos finais de energia regionais e nacionais no setor residencial brasileiro com base na Pesquisa de Posse e Hábitos de Uso de Equipamentos Elétricos na Classe Residencial. Foram estimados os percentuais do consumo total de energia elétrica associados a nove eletrodomésticos (lâmpadas, geladeiras, freezers, televisores, chuveiros, microondas, máquinas de lavar, ventiladores e condicionadores de ar). Os valores foram obtidos por meio do software EnergyPlus para condicionadores de ar e com equações de consumo de energia elétrica para os outros oito aparelhos. Os resultados mostram que o modelo proposto fornece estimativas razoáveis de consumo de energia elétrica, próximas aos valores esperados para a maioria dos eletrodomésticos. Observou-se que a posse e utilização dos eletrodomésticos, influenciados pelo clima (chuveiros elétricos, ventiladores e condicionadores de ar), obtiveram a maior variação no percentual de consumo de energia elétrica.

Abstract Electricity consumption in the residential sector in Brazil has been increasing annually despite efforts to promote the energy efficiency of household appliances. One of the main goals for achieving more energy efficiency in dwellings is understanding its energy end uses. In this context, this paper presents a bottom-up model developed to analyse regional and national electricity end uses in the residential sector in Brazil based on a recent survey on Ownership of Appliances and Consumption Habits. The percentages of total electricity consumption associated with nine appliances (light bulbs, refrigerators, freezers, televisions, showers, microwaves, washing machines, fans, and air conditioners) were estimated. The values were obtained using the software EnergyPlus for air conditioners and electricity consumption equations for the other eight appliances. Results show that the proposed model gives reasonable estimates of electricity consumption, which were close to the values expected for most appliances. Regionally, the appliances for which ownership and pattern of use are influenced by the climate (electric showers, fans, and air conditioners) obtained the most significant variation in the percentage of electricity consumption.

https://doi.org/10.1590/s1678-86212022000300611

10.

The burden of suicide in Brazil: findings from the Global Burden of Disease Study 2019
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Bonadiman, Cecília Silva Costa

; Naghavi, Mohsen

; Melo, Ana Paula Souto

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 Supl. 1 elocation e0299-2021

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION: Suicide deaths varies according to location, sex, and age. This study analyzed the Global Burden of Disease Study 2019 (GBD 2019) concerning suicide in Brazil. METHODS: This study described the mortality and years of life lost (YLL) due to premature death caused by suicide in Brazil in 1990 and 2019. The numbers, crude and age-standardized mortality rate (ASMR), and YLL were compared among Brazilian states, age groups, and sexes. RESULTS: There were 13,502 suicides in Brazil in 2019, 46.00% more than in 1990. The crude mortality rate increased 0.32%, while the ASMR declined -21.68% during the period. Crude and age-standardized YLL rates declined by -7.24% and -18.38%, respectively. In 2019, the biggest ASMRs were found in the South, whereas from 1990 to 2019, the ASMR declined in the South, Southeast, and Midwest, and increased in the Northeast. The number of suicides was higher among individuals aged 15-49 years, and suicide rates were higher among those aged over 70 years. From 1990 to 2019, an increase in the rate was found only of 10-14 years of age. Suicide was highest in men, except in the 10-14-year age group, ranking third in mortality among men of 15-34 years of age and fourth among women of 15-24 years of age. CONCLUSIONS: The ASMR and YLL for suicide declined since 1990, but suicide remains an important factor of mortality in the country. The South Region, men, elderly, and youth should be priorities in the implementation of suicide prevention strategies in Brazil.

https://doi.org/10.1590/0037-8682-0299-2021

11.

Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force
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Tavares, Anna Carolina Faria Moreira Gomes

; Melo, Ana Karla Guedes de

; Cruz, Vítor Alves

; Souza, Viviane Angelina de

; Carvalho, Joana Starling de

; Machado, Ketty Lysie Libardi Lira

; Valadares, Lilian David de Azevedo

; Reis Neto, Edgard Torres dos

; Rezende, Rodrigo Poubel Vieira de

; Guimarães, Maria Fernanda Brandão de Resende

; Ferreira, Gilda Aparecida

; Braz, Alessandra de Sousa

; Vieira, Rejane Maria Rodrigues de Abreu

; Pinheiro, Marcelo de Medeiros

; Ribeiro, Sandra Lúcia Euzébio

; Bica, Blanca Elena Gomes Rios

; Baptista, Kátia Lino

; Costa, Izaias Pereira da

; Marques, Claudia Diniz Lopes

; Lopes, Maria Lúcia Lemos

; Martinez, José Eduardo

; Giorgi, Rina Dalva Neubarth

; Mota, Lícia Maria Henrique da

; Loures, Marcos Antônio Araújo da Rocha

; Paiva, Eduardo dos Santos

; Monticielo, Odirlei André

; Xavier, Ricardo Machado

; Kakehasi, Adriana Maria

; Pileggi, Gecilmara Cristina Salviato

Advances in Rheumatology

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2022, Volume 62 elocation 3

Resumo: En | Texto: En | PDF: En

Abstract Objective: To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making decision (SMD) process. Methods: A task force was constituted by 24 rheumatologists (panel members), with clinical and research expertise in immunizations and infectious diseases in immunocompromised patients, endorsed by the Brazilian Society of Rheumatology (BSR), to develop guidelines for COVID-19 vaccination in patients with IMRD. A consensus was built through the Delphi method and involved four rounds of anonymous voting, where five options were used to determine the level of agreement (LOA), based on the Likert Scale: (1) strongly disagree; (2) disagree, (3) neither agree nor disagree (neutral); (4) agree; and (5) strongly agree. Nineteen questions were addressed and discussed via teleconference to formulate the answers. In order to identify the relevant data on COVID-19 vaccines, a search with standardized descriptors and synonyms was performed on September 10th, 2021, of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and LILACS to identify studies of interest. We used the Newcastle–Ottawa Scale to assess the quality of nonrandomized studies. Results: All the nineteen questions-answers (Q&A) were approved by the BSR Task Force with more than 80% of panelists voting options 4—agree—and 5—strongly agree—, and a consensus was reached. These Guidelines were focused in SMD on the most appropriate timing for IMRD patients to get vaccinated to reach the adequate covid-19 vaccination response. Conclusion: These guidelines were developed by a BSR Task Force with a high LOA among panelists, based on the literature review of published studies and expert opinion for COVID-19 vaccination in IMRD patients. Noteworthy, in the pandemic period, up to the time of the review and the consensus process for this document, high-quality evidence was scarce. Thus, it is not a substitute for clinical judgment.

https://doi.org/10.1186/s42358-022-00234-7

12.

Suicide mortality among older adults in Brazil between 2000 and 2019 - estimates from the Global Burden of Disease Study 2019
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Pires, Ademar Moreira

; Reis, Júlia Gondim Maia

; Garcia, Flávia Megda

; Veloso, Guilherme Augusto

; Melo, Ana Paula Souto

; Naghavi, Mohsen

; Passos, Valéria Maria de Azeredo

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 Supl. 1 elocation e0322-2021

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION: Older adults present a higher risk of suicide, and Brazil is experiencing a fast population aging. To understand the impact of demographic transition, we compared Brazilian suicide mortality rates (MR) among adults (50+ years) with global rates, those from one high-income country, and those from one middle-income country. Looking for regional disparities, the MR was analyzed among older adults (60+ years) by Brazilian states. METHODS: This was an ecological study based on estimates from the Global Burden of Disease Study, from 2000 to 2019. Age-standardized MR and age-specific MR per 100,000 inhabitants were described, with 95% uncertainty intervals (UI). RESULTS: During the period, the annual estimates and the declining trend in mortality were higher in the world than in the studied countries. In 2019, global age-standardized MR was 9.39 (95% UI 8.48-10.29), compared to 5.68 (95% UI 5.40-6.19), 6.01 (95% UI 5.10-7.04), and 6.63 (95% UI 6.43-6.95) in Brazil, Mexico, and England, respectively. In Brazil, despite a significant decline in national rates, stability was observed in 15 states. An increase in aging was only found for men, who presented 3-4 times higher MR than women. The states’ rates presented large differences: in 2019, the rates among men aged 60-64 years varied from 7.24 (95% UI 5.31; 9.85) to 26.32 (95% UI 20.21; 34.50). CONCLUSIONS: The smaller decline in suicide mortality among older Brazilian adults, the increasing risk with aging, and the higher mortality among men indicate the need for specific prevention policies. The variation within states suggests differences in the data quality or in socio-cultural and historical aspects, which requires further investigation.

https://doi.org/10.1590/0037-8682-0322-2021

13.

The increasing burden of pancreatic cancer in Brazil from 2000 to 2019: estimates from the Global Burden of Disease Study 2019.
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Chaves, Diogo Oliveira

; Bastos, Aline Cândida

; Almeida, Alessandra Maciel

; Guerra, Maximiliano Ribeiro

; Teixeira, Maria Teresa Bustamante

; Melo, Ana Paula Souto

; Passos, Valéria Maria de Azeredo

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 Supl. 1 elocation e0271-2021

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION: Pancreatic cancer is increasing worldwide. The burden of pancreatic cancer in Brazil and its states was analyzed and compared with that from the USA and China. METHODS: This is a descriptive study of the incidence and mortality estimates from the Global Burden of Disease 2019 study, from 2000 to 2019. The Brazilian states presenting the highest and lowest socio-demographic index (SDI) were selected from each of the five regions. The SDI consists of the per capita income, education, and fertility rate of each population. RESULTS: A significant increase was found in age-standardized incidence and mortality of pancreatic cancer in all three countries, with differences in magnitude and annual increases. In Brazil, this incidence rose from 5.33 [95% Uncertainty Interval (UI): 5.06- 5.51] to 6.16 (95% UI: 5.68- 6.53) per 100,000 inhabitants. China and the Brazilian states with the lowest SDI, such as Pará and Maranhão, showed lower incidence and mortality rates, although presenting the highest annual increases. No difference was found between the sexes. A higher mortality rate was observed for those individuals of 70+ years, which was three to four times higher than those aged 50 to 69 years. CONCLUSIONS: The increasing burden of pancreatic cancer in the studied countries, and the higher estimates for the elderly in a fast-aging country such as Brazil, indicates that more resources and health policies will be necessary. The greatest increase in the states with lower SDI reflects inequalities in the access to diagnosis and registries of this cancer.

https://doi.org/10.1590/0037-8682-0271-2021

14.

The burden of mental disorders attributable by cocaine use: Global Burden of Diseases Study in Brazil, 1990 and 2019
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Crepalde, Rayce dos Santos

; Bonadiman, Cecília Silva Costa

; Malta, Deborah Carvalho

; Naghavi, Mohsen

; Melo, Ana Paula Souto

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 Supl. 1 elocation e0320-2021

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION: Brazil is an important consumer market for cocaine. However, the consequences of this consumption and the pattern of distribution of the estimates are still poorly studied in the Brazilian states. The Global Burden of Disease study - 2019 (GBD-2019) has enabled us to describe and analyze indicators of mental disorders (MD) attributable by cocaine use in Brazil and its states, in 1990 and 2019. METHODS: A descriptive study of the burden of cocaine use disorders, using prevalence, age-standardized mortality rate (ASMR), years of life lost (YLL) due to premature death, years lived with disabilities (YLD), and disability adjusted life years (DALY), which accounts for YLL+YLD. RESULTS: Brazil ranks 8th as DALYs due to cocaine use disorder in the world (42.83/100.000; 95% uncertainty intervals [95% UI]: 35.28 to 61.43). Significant increases have occurred in the age-standardized rate prevalence (ASRP), ASMR, DALY, YLD, and YLL, in Brazil and its states, between 1990 and 2019. The ASRP in 2019 was 2.7-fold higher for men (278.60/100.000; 95% UI: 208.20 to 374.39) in comparison to women (104.01/100.000; 95% UI: 76.70 to 143.02). There is a predominance of YLD in the composition of DALYs; however, the YLL had the biggest increases between 1990 and 2019. CONCLUSIONS: The high rate of DALYs and the increase in mortality rates show the need to scale up effective interventions to prevent and reduce the burden of disease attributable to cocaine use disorder, which is a preventable cause of death and disability.

https://doi.org/10.1590/0037-8682-0320-2021

15.

Sobre gestar e parir uma criança com a Síndrome Congênita do Zika Vírus: um estudo de caso
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Alves, Maria José Cremilda Ferreira

; Melo, Ana Paula Lopes de

; Valongueiro, Sandra

; Santos, Mariana Olívia Santana dos

Saúde e Sociedade

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2022, Volume 31 Nº 3 elocation e210828pt

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Este artigo busca analisar o contexto de gestação, pré-natal e parto de uma criança com Síndrome Congênita do Zika (SCZ). É um estudo exploratório qualitativo, tipo estudo de caso único, delineado a partir de entrevista em profundidade realizada com uma mãe de criança diagnosticada com SCZ em Pernambuco. A análise dos dados ocorreu mediante a categorização do conteúdo da entrevista em quatro núcleos temáticos: contexto da descoberta da gestação; condições da assistência ao pré-natal e ao parto; condições de diagnóstico e assistência à criança; e sentimentos envolvidos na descoberta da gestação e do diagnóstico da síndrome. Esse caso sinaliza falhas no planejamento reprodutivo e na assistência ao pré-natal e parto; despreparo dos profissionais de saúde; e mudanças significativas na rotina da família, que implicam escolhas difíceis num contexto de deficitária assistência pública à saúde. A epidemia da SCZ revelou problemas que vão além do controle vetorial do mosquito. O panorama atual escancara vulnerabilidades dessas famílias, intensificadas com o surgimento e as consequências da covid-19, o que tem exposto ainda mais as fragilidades da atenção integral à saúde da mulher e a necessidade de manter uma rede articulada e resolutiva na assistência e vigilância em saúde.

Abstract This study analyzes the context of pregnancy, prenatal care and birth of children with Congenital Zika Syndrome (CZS). A single case exploratory study was conducted with a mother of a child diagnosed with CZS in Pernambuco, Brazil. Data were collected by an in-depth interview and content was categorized into four themes: discovery of pregnancy; conditions of prenatal and childbirth care; conditions of diagnosis and childcare; and feelings involved in the pregnancy discovery and syndrome diagnosis. This case study highlights failures in reproductive planning and in prenatal and childbirth care; unpreparedness of health professionals; and significant changes in the family’s routine, which imply difficult choices under a deficient public health care. CZS epidemic uncovered problems that go beyond mosquito vector control. The current scenario highlights the vulnerabilities of these families, intensified by the emergence and consequences of COVID-19, which has further exposed the weaknesses of women’s comprehensive health care and the need to maintain an articulated and resolute network in health care and surveillance.

https://doi.org/10.1590/s0104-12902022210828pt

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