Measles-containing vaccines in Brazil: Coverage, homogeneity of coverage and associations with contextual factors at municipal level

We aimed to (i) describe both the coverage and the homogeneity of coverage of the first and second doses of measles-containing vaccines (MCV) in Brazil in 2017, and (ii) to investigate the potential influence of contextual factors at municipal level. All 5570 Brazilian municipalities were included. The North and Center-West regions presented the lowest coverages of the first and second doses of MCV, respectively. We found significant associations of both first and second doses of MCV with population size, coverage of Family Health Strategy (FHS) and other indicators of living conditions and inequalities. Monitoring the homogeneity of MCV coverage at national, regional and state levels is essential, as it allows identifying areas at higher risk of measles spread that should be targeted for vaccination. Targeting large cities i.e. 100,000 or more inhabitants, especially poor neighborhoods and areas with low FHS coverage, could lead to improvements in coverage homogeneity

The course of specialization in public health in Rio de Janeiro, Brazil, from 1926 to 2006: lessons and challenges

<p>Abstract</p> <p>Background</p> <p>Public health, as a field of knowledge, depends on its professionals. Their education and training, therefore, is considered to be an important factor for the quality of health services. In Brazil, the Course of Specialization in Public Health of the National School of Public Health is one of the oldest in the country. The course has existed for over 80 years, during which it has had an eventful history, with modifications in its organization, interruptions in its delivery, threats to its survival and changes in the institutions hosting it, reflecting the wider transformation in Brazilian society and public life over that period.</p> <p>Methods</p> <p>In this article we analyse this course via its history, disciplines, organization and characteristics of the student body.</p> <p>Results</p> <p>Insights were gained into the advancement of public health in Brazil and the progress of education for professionals in this field was highlighted. The course has formed nearly 2000 specialists in public health.</p> <p>Conclusions</p> <p>An analysis of the course's history provides valuable lessons for other schools of public health trying to train professionals in developing countries.</p

Does caffeine ingestion before a short-term sprint interval training promote body fat loss?

We investigated the effect of caffeine ingestion combined with a 2-wk sprint interval training (SIT) on training-induced reductions in body adiposity. Twenty physically-active men ingested either 5 mg/kg of cellulose as a placebo (PLA, n=10) or 5 mg/kg of caffeine (CAF, n=10) 60 min before each SIT session (13×30 s sprint/15 s of rest). Body mass and skinfold thickness were measured pre- and post-training. Energy expenditure was measured at rest, during exercise, and 45 min after exercise in the first SIT session. Body fat was similar between PLA and CAF groups at pre-training (P\u3e0.05). However, there was a significant decrease in body fat after training in the CAF group (−5.9±4.2%, P\u3c0.05) but not in PLA (1.5±8.0%, P\u3e0.05). There was no difference in energy expenditure at rest and during exercise between PLA and CAF groups (P\u3e0.05), but the post-exercise energy expenditure was 18.3±21.4% greater in the CAF than in the PLA group (P\u3c0.05). In conclusion, caffeine ingestion before SIT sessions induced a body fat loss that may be associated with higher post-exercise energy expenditure

Social representations of AIDS and their quotidian interfaces for people living with HIV

This qualitative descriptive study, guided by the Social Representations Theory, aimed to describe the content of the social representations regarding the Acquired Immunodeficiency Syndrome (AIDS) for seropositive individuals in outpatient monitoring of the public health network and to analyze the interface of the social representations of AIDS with the quotidian of the individuals living with human immunodeficiency virus (HIV), especially in the adherence to treatment process Interviews were conducted with 30 seropositive individuals and the manual content analysis technique was used. From the analysis, six categories emerged that re-translated the quotidian of seropositive people permeated by the stigma, prejudice, struggle for life and the need for the continuous use of antiretrovirals. AIDS was assimilated to chronic diseases such as diabetes, showing a trend of transformation of the social representation of AIDS, substituting the idea of death, with life. It is concluded that people living with HIV are more optimistic due to effective treatments for the control of the disease.Se trata de un estudio cualitativo descriptivo orientado por la Teoría de las Representaciones Sociales, que objetivó describir el contenido de las representaciones sociales acerca de la Síndrome de Inmunodeficiencia Adquirida (SIDA) para los usuarios seropositivos en acompañamiento de ambulatorio en la red pública de salud y analizar la interconexión de las representaciones sociales del Sida con lo cotidiano de los individuos que viven con el virus de la inmunodeficiencia humana (HIV), especialmente al proceso de adhesión al tratamiento. Se realizaron entrevistas con 30 individuos seropositivos. Se utilizó la técnica de análisis de contenido manual. Del análisis, emergieron seis categorías que tradujeron lo cotidiano de seropositivos impregnados por el estigma, prejuicio, lucha por la vida y la necesidad del uso continuo de antirretrovirales. El Sida fue comparado a enfermedades crónicas como la diabetes, evidenciando una tendencia de transformación de la representación social del Sida, substituyendo la idea de muerte, por la de vida. Se concluye que las personas que conviven con HIV están más optimistas debido a los tratamientos eficaces en el control de la enfermedad.Trata-se de estudo qualitativo descritivo, norteado pela teoria das representações sociais. Objetivou-se descrever o conteúdo das representações sociais acerca da síndrome de imunodeficiência adquirida (AIDS) para os usuários soropositivos, em acompanhamento ambulatorial da rede pública de saúde, e analisar a interface das representações sociais da AIDS com o cotidiano dos indivíduos que vivem com o vírus da imunodeficiência humana (HIV), especialmente no processo de adesão ao tratamento. Realizaram-se entrevistas com 30 indivíduos soropositivos. Utilizou-se a técnica de análise de conteúdo manual. Da análise, emergiram seis categorias que retraduziram o cotidiano de soropositivos, permeados pelo estigma, preconceito, luta pela vida e a necessidade do uso contínuo de antirretrovirais. A AIDS foi assimilada a doenças crônicas como diabetes, evidenciando tendência para transformação da representação social da AIDS, substituindo a ideia de morte, por vida. Conclui-se que as pessoas que convivem com HIV estão mais otimistas devido aos tratamentos eficazes no controle da doença

Polyfunctional T cell responses in children in early stages of chronic Trypanosoma cruzi infection contrast with monofunctional responses of long-term infected adults

Background: Adults with chronic Trypanosoma cruzi exhibit a poorly functional T cell compartment, characterized by monofunctional (IFN-γ-only secreting) parasite-specific T cells and increased levels of terminally differentiated T cells. It is possible that persistent infection and/or sustained exposure to parasites antigens may lead to a progressive loss of function of the immune T cells. Methodology/Principal Findings: To test this hypothesis, the quality and magnitude of T. cruzi-specific T cell responses were evaluated in T. cruzi-infected children and compared with long-term T. cruzi-infected adults with no evidence of heart failure. The phenotype of CD4+ T cells was also assessed in T. cruzi-infected children and uninfected controls. Simultaneous secretion of IFN-γ and IL-2 measured by ELISPOT assays in response to T. cruzi antigens was prevalent among T. cruzi-infected children. Flow cytometric analysis of co-expression profiles of CD4+ T cells with the ability to produce IFN-γ, TNF-α, or to express the co-stimulatory molecule CD154 in response to T. cruzi showed polyfunctional T cell responses in most T. cruzi-infected children. Monofunctional T cell responses and an absence of CD4+TNF-α+-secreting T cells were observed in T. cruzi-infected adults. A relatively high degree of activation and differentiation of CD4+ T cells was evident in T. cruzi-infected children. Conclusions/Significance: Our observations are compatible with our initial hypothesis that persistent T. cruzi infection promotes eventual exhaustion of immune system, which might contribute to disease progression in long-term infected subjects.Fil: Albareda, María Cecilia. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: de Rissio, Ana María. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; ArgentinaFil: Tomas, Gonzalo. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; ArgentinaFil: Serjan, Alicia. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Juan A. Fernández"; ArgentinaFil: Alvarez, María Gabriela. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: Viotti, Rodolfo Jorge. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: Fichera, Laura Edith. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Esteva, Mónica Inés. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; ArgentinaFil: Potente, Daniel Fernando. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: Armenti, Alejandro. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: Tarleton, Rick L.. University of Georgia; Estados UnidosFil: Laucella, Susana Adriana. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

A novel case of human visceral leishmaniasis from the urban area of the city of Rio de Janeiro: autochthonous or imported from Spain ?

Universidade Federal do Estado do Rio de Janeiro. Centro de Ciências Biológicas e da Saúde. Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria. Rio de Janeiro, RJ, Brasil.Universidade Federal do Estado do Rio de Janeiro. Centro de Ciências Biológicas e da Saúde. Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria. Rio de Janeiro, RJ, Brasil.Universidade Federal do Estado do Rio de Janeiro. Centro de Ciências Biológicas e da Saúde. Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria. Rio de Janeiro, RJ, Brasil.Universidade Federal do Estado do Rio de Janeiro. Centro de Ciências Biológicas e da Saúde. Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria. Rio de Janeiro, RJ, Brasil.Universidade Federal do Estado do Rio de Janeiro. Centro de Ciências Biológicas e da Saúde. Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria. Rio de Janeiro, RJ, Brasil.Universidade Federal do Estado do Rio de Janeiro. Centro de Ciências Biológicas e da Saúde. Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria. Rio de Janeiro, RJ, Brasil.Universidade Federal do Estado do Rio de Janeiro. Centro de Ciências Biológicas e da Saúde. Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria. Rio de Janeiro, RJ, Brasil.Universidade Federal do Estado do Rio de Janeiro. Centro de Ciências Biológicas e da Saúde. Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria. Rio de Janeiro, RJ, Brasil.Universidade Federal do Estado do Rio de Janeiro. Centro de Ciências Biológicas e da Saúde. Hospital Universitário Gaffrée e Guinle, 10ª Enfermaria. Rio de Janeiro, RJ, Brasil.Universidade Federal do Estado do Rio de Janeiro. Centro de Ciências Biológicas e da Saúde. Hospital Universitário Gaffrée e Guinle. Serviço de Anatomia Patológica. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil

Evolução na utilização e nos gastos de uma operadora de saúde

Brazil’s aging population and the rising number of people reliant upon the country’s supplementary healthcare system have elicited the concern of public and private managers regarding the increase in healthcare costs. In this paper, the costs per gender, per type of medical expenses and per age group of a major Brazilian self-managed healthcare provider between 2007 and 2013 were analyzed. This healthcare provider is of interest because, besides portraying a single condition of revenue growth restricted to the existing contributors, it also replicates the demographic profile expected for Brazil in 2050, when approximately one-third of its population will be over 60 years of age. The analyses confirm the current literature as they show an increase in healthcare plan usage by the elderly and the difference between admission rates by gender. They also reveal an increase in average length of stay in hospital and the increase in medical costs far above inflation, especially for materials and medicines. It is hoped that this study will help scholars and others interested in comparisons of medical expense trends, especially by age and sex, and that it encourages further collaboration on the sustainability of health insurance providers in Brazil

Interrelationship between arterial hypertension, health service costs, therapeutic treatment and physical activity

Availability of data and materials: The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.Copyright © The Author(s) 2023. Background: Arterial hypertension is a high prevalence disease that increase healthcare costs and affects physical activity level. This study aimed to analyse the interrelationship between arterial hypertension, health service costs, therapeutic treatment, and physical activity in patients with cardiovascular diseases. Method: Cross-sectional study that evaluated 306 patients from a hospital in Presidente Prudente-Brazil. Based on their medical diagnosis, they were classified into multiple groups to access primary care and hospital-related costs variations. Then, using data from medical records and face to face interviews, they were examined on their treatment adherence and physical activity practice. Healthcare costs were accessed using medical records. Finally, the generalised linear model was used to analyse the interrelationship between treatment adherence, physical activity, health care costs and arterial hypertension. The data were analysed with Stata/MP4 16, and a p-value of less than 5% was used to determine statistical significance. Results: The group that adhered to the arterial hypertension treatments but were physically inactive presented higher costs with consultation (US$=24.1, 95$=56.60, 95%CI = 1.65; 111.5) and total primary health care costs (US$=71.60, 95%CI = 19.2; 123.9) even after adjusting for confounding variables, meanwhile those participants that adhered to the treatments and were physical active did not present difference in healthcare cost when compared to normotensive and physical active participants. Conclusion: To be adherent to hypertension treatment were related to higher health care costs meanwhile been physical activity were related to lower health care costs and the combination of both showed that be adherent and physical activity represent the same cost with health than those normotensive and active emphasizing the importance of adherence and physical activity in the hypertensive treatment.The Sao Paulo Research Foundation, FAPESP. Process 2018/07281-9 and 2019/11339-5

SentiBench - a benchmark comparison of state-of-the-practice sentiment analysis methods

In the last few years thousands of scientific papers have investigated sentiment analysis, several startups that measure opinions on real data have emerged and a number of innovative products related to this theme have been developed. There are multiple methods for measuring sentiments, including lexical-based and supervised machine learning methods. Despite the vast interest on the theme and wide popularity of some methods, it is unclear which one is better for identifying the polarity (i.e., positive or negative) of a message. Accordingly, there is a strong need to conduct a thorough apple-to-apple comparison of sentiment analysis methods, \textit{as they are used in practice}, across multiple datasets originated from different data sources. Such a comparison is key for understanding the potential limitations, advantages, and disadvantages of popular methods. This article aims at filling this gap by presenting a benchmark comparison of twenty-four popular sentiment analysis methods (which we call the state-of-the-practice methods). Our evaluation is based on a benchmark of eighteen labeled datasets, covering messages posted on social networks, movie and product reviews, as well as opinions and comments in news articles. Our results highlight the extent to which the prediction performance of these methods varies considerably across datasets. Aiming at boosting the development of this research area, we open the methods' codes and datasets used in this article, deploying them in a benchmark system, which provides an open API for accessing and comparing sentence-level sentiment analysis methods