Prevalência de uso de dispositivos eletrônicos para fumar e de uso de narguilé no Brasil: Para onde estamos caminhando?

Objective: To describe the prevalence of use of electronic nicotine delivery systems (ENDS) and waterpipe in Brazil, by population subgroups, and to evaluate the trend between 2013 and 2019. Methods: We used data from the 2019 National Health Survey (PNS) to estimate the prevalence of ever and current use of ENDS and current use of waterpipes by socio-behavioral characteristics. Differences in prevalence over time were calculated using data from the BHSU-III-2015 (III Brazilian Household Survey on Substance Use) and the PNS-2013. Results: For 2019, the prevalence of current use of ENDS was estimated at 0.64% (~ 1 million people), of which ~70% were 15-24 years old. The highest prevalence was observed in the Midwest region, but the Southeast concentrates half of these users. Almost 90% are non-smokers, and higher prevalence were found among those who also use waterpipe and abusive alcohol. There was an increase in ENDS use between 2015 and 2019, particularly among younger people. The prevalence of current waterpipe use in 2019 was estimated at 0.47% (~ 800,000 individuals), of which ~80% were 15-24 years old. There was an increase in the prevalence of current waterpipe use between 2013 and 2019, and among young people the increase was ~300%. Conclusions: In Brazil, ENDS have been used mostly by young people, and by never smokers of manufactured cigarettes. The use of DEF and waterpipe has been increasing, even with the country's regulatory restrictions, which may compromise the successful history of the tobacco control policy.Objetivo: Descrever as prevalências de uso de dispositivos eletrônicos para fumar (DEF) e de narguilé no Brasil, por subgrupos populacionais, e avaliar tendência entre 2013 e 2019. Métodos: Os dados principais analisados são da Pesquisa Nacional de Saúde (PNS) de 2019. Estimou-se prevalências de uso na vida e atual de DEF e de uso atual de narguilé segundo características sócio-comportamentais. Os dados da PNS-2019 sobre DEF foram comparados aos do III-LNUD-2015 (III Levantamento Nacional sobre Uso de Drogas pela População Brasileira) e os dados sobre narguilé comparados à PNS-2013. Resultados: Para 2019, estimou-se a prevalência de uso atual de DEF em 0,64% (~1 milhão de pessoas), dos quais ~70% tinham 15-24 anos. Maior prevalência está na região Centro-Oeste, mas o Sudeste concentra metade absoluta desses usuários. Quase 90% são não fumantes, e maiores prevalências foram encontradas entre quem usa também narguilé e álcool abusivo. Observou-se aumento nas estimativas de uso de DEF entre 2015 e 2019, especialmente entre os mais jovens. A prevalência de uso atual de narguilé em 2019 foi estimada em 0,47% (~800 mil indivíduos), dos quais ~80% tinham 15-24 anos. Houve aumento na prevalência de uso atual de narguilé entre 2013 e 2019, e entre jovens o aumento foi de ~300%. Conclusões: No Brasil os DEF têm sido utilizados majoritariamente por jovens, e por nunca fumantes de cigarros industrializados. O uso de DEF e de narguilé vêm aumentando, mesmo com as restrições regulatórias do país, podendo comprometer o exitoso histórico da política de controle do tabagismo

EDUCAÇÃO EM SAÚDE EM UMA COMUNIDADE DA REGIÃO NORTE DE PALMAS-TO: um relato de experiência

O presente artigo trata-se de um relato de experiência, sobre ação social desenvolvida por docentes e discentes de enfermagem e nutrição da Universidade Federal do Tocantins em parceria com a igreja Santuário Nossa Senhora de Fátima. A ação foi realizada no dia 1 de outubro de 2017 na escola Municipal Luiz Gonzaga. Foram realizadas atividades de educação em saúde, tais como aferição de pressão arterial, teste de glicemia capilar, cálculo do índice de massa corpórea (IMC), além de atendimentos e orientações nutricionais.   PALAVRAS-CHAVE: Educação em saúde; Ação social; Avaliação nutricional; Doenças crônicas não-transmissíveis; Educação Nutricional.       ABSTRACT This article is an experience report on a social action developed by professors and students of nursing and nutrition at the Federal University of Tocantins, in partnership with the Church Santuário Nossa Senhora de Fátima. The action was carried out on October 1, 2017 at Luiz Gonzaga School. Health education activities were carried out, such as blood pressure measurement, capillary glycemia test, body mass index (BMI), as well as attendance and nutritional guidelines.   KEYWORDS: Health education; Social action; Nutritional assessment; Chronic non-communicable diseases; Nutrition Education.       RESUMEN Este artículo es un informe de experiencia, sobre la acción social desarrollada por profesores y estudiantes de enfermería y nutrición en la Universidad Federal de Tocantins en colaboración con la iglesia Santuário Nossa Senhora de Fátima. La acción tuvo lugar el 1 de octubre de 2017 en la Escuela Municipal Luiz Gonzaga. Se llevaron a cabo actividades de educación sanitaria, como la medición de la presión arterial, la prueba de glucemia capilar, el cálculo del índice de masa corporal (IMC), además de consultas y pautas nutricionales.     PALABRAS CLAVE: Educación en salud; Acción Social; Evaluación nutricional; Enfermedades crónicas no transmisibles; Educación Nutricional.   &nbsp

Mundos mesclados, espaços segregados: cultura material, mestiçagem e segmentação no sítio Aldeia em Santarém (PA)

This article discusses the processes of cultural exchange between Portuguese, Portuguese-Brazilian, Amerindians, and mestizos based on the analysis of the material culture from households of Santarém (PA), occupied during the eighteenth and nineteenth centuries,. Although these social groups manipulated material culture aiming to express different values, related to hierarchy, social segmentation, and affirmation of identities, ambiguity also characterizes these assemblages. This material ambiguity informs about the mixtures of both practices and cultural references that brought about the building of a mestizo society.Com base na análise da cultura material proveniente de unidades domésticas do núcleo urbano de Santarém (PA), ocupadas nos séculos XVIII e XIX, o presente artigo discute os processos de trocas culturais entre portugueses, luso-brasileiros, indígenas e mestiços. Embora esses grupos sociais tenham manipulado a cultura material visando expressar diferentes valores, relacionados à hierarquia, segmentação social e afirmação de identidades, a ambigüidade é uma característica das amostras analisadas, informando sobre as misturas de práticas e de referenciais culturais que levaram à construção de uma sociedade mestiça

Trajetórias da Educomunicação nas Políticas Públicas e a Formação de seus Profissionais

Esta obra é composta com os trabalhos apresentados no primeiro subtema, TRAJETÓRIA – Educação para a Comunicação como Política pública, nas perspectivas da Educomunicação e da Mídia-Educação, do II Congresso Internacional de Comunicação e Educação. Os artigos pretendem propiciar trocas de informações e produzir reflexões com os leitores sobre os caminhos percorridos, e ainda a percorrer, tendo como meta a expansão e a legitimação das práticas educomunicativas e/ou mídia-educativas como política pública para o atendimento à formação de crianças, adolescentes, jovens e adultos, no Brasil e no mundo

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Population-based evidence of a strong decline in the prevalence of smokers in Brazil (1989–2003)

OBJECTIVE: To evaluate the evolution in smoking indicators in the adult Brazilian population between 1989 and 2003. METHODS: We compared age-adjusted prevalence ratios and means for smoking indicators, stratified by age, sex and sociodemographic variables, obtained from two comparable household surveys that used probabilistic sampling of the Brazilian population aged > 18 years (n = 34 808 in 1989 and n = 5000 in 2003). FINDINGS: Between 1989 and 2003, there was a substantial decrease in the prevalence of smoking (from 34.8% to 22.4%; age-adjusted prevalence ratio, 0.65; 95% confidence interval, CI, 0.60-0.70) and a modest reduction in the mean number of cigarettes smoked per day (from 13.3 to 11.6; age-adjusted difference, -1.8; 95% CI, -2.6 - -1.0). Reductions in the prevalence and intensity of smoking were greater among males, younger age groups and higher socioeconomic strata. CONCLUSION: The prevalence of smoking in the adult Brazilian population declined by 35% between 1989 and 2003, or an average of 2.5% per year. This exceptional reduction surpasses those seen in other countries that implemented wide-ranging and rigorous policies for controlling smoking during the same period. The more intense decline in smoking in younger age groups was consistent with the concentration of efforts of the Brazilian tobacco control programme to prevent the onset of smoking among youths and the total prohibition of cigarette advertising. We recommend the intensification of programme initiatives targeting women and less economically favoured population strata