Profile of the Brazilian projects for technical cooperation on Aids in the world : a look into potential study hypotheses

Há algumas décadas o Brasil inseriu-se nas discussões técnicas sobre a resposta mundial à epidemia de aids e destacou-se como importante ator de cooperação e como formador de opinião pública global sobre o tema. Apesar desse movimento, o perfil predominante desses projetos permanece desconhecido e inexplorado, dificultando análises sobre esse potencial correlação. Pretende-se começar a suprir essa lacuna a partir de um levantamento de projetos de cooperação técnica internacional brasileira em aids, no período de 2002 a 2009, utilizando a base de dados da Assessoria de Cooperação Internacional do Departamento DST, Aids e Hepatites Virais do Ministério da Saúde do Brasil. Para a análise desses dados recorreu-se à técnica de análise de conteúdo para identificar o perfil predominante dessa cooperação e propor hipóteses norteadoras de futuras pesquisas. O levantamento apresentou a distribuição dos projetos de cooperação do Brasil em aids no mundo e a análise de conteúdo possibilitou formular duas hipóteses: que no período em questão a cooperação do Brasil buscou fortalecer as respostas dos países à epidemia de HIV/aids e conferir maior visibilidade às políticas brasileiras de combate à doença no cenário global. Essas observações, por sua vez, indicam a necessidade e pertinência de novas pesquisas amparadas pela hipótese de um forte alinhamento do perfil técnico desses projetos com a política externa nacional, a diplomacia da saúde brasileira e o fortalecimento da governança global em aids. _________________________________________________________________________________ ABSTRACTA few decades ago Brazil became involved in technical discussions about the global response to the Aids epidemics, and assumed an important role for its cooperation and as global public opinion maker on the subject. Despite this characteristic, the predominant profile of these projects remains unknown and unexplored, making it difficult to analyze this potential correlation. This gap will be bridged by means of a study on Brazil’s international technical cooperation projects on Aids between 2002 and 2009, using the database of the International Cooperation Advisory of the Department of STD, Aids and Viral Hepatitis of the Brazilian Ministry of Health. The technique used to analyze these data was content analysis, in order to identify the predominant profile of the cooperation, and to propose hypotheses that will provide guidelines for future research. The study presented the distribution of Brazil’s cooperation projects on Aids in the world, and the content analysis made it possible to devise two hypotheses: within the given period, Brazil’s cooperation attempted to strengthen the responses of other countries to the HIV/Aids epidemic, and to project Brazilian policies for fighting the disease at a global level. These observations, on the other hand, point toward the need for and pertinence of new studies supported by the hypothesis of a strong alignment between the technical characteristic of these projects and the national external policy, the diplomacy of the Brazilian health, and the strengthening of global governance on Aids

Analyzing a national health surveillance strategy to reduce mother-to-child transmission of syphilis: the case of Brazilian investigation committees

Objectives: This study aimed to analyze the relevance of investigation committees in eliminating mother-to-child transmission of syphilis in Brazil. Methods: Questionnaires and interviews were conducted with health managers of 25 Brazilian Federative Units and Brazil’s Federal District. Data were analyzed using Bardin’s content analysis technique and subsequently compared with the global prescriptions for syphilis response of the Pan American Health Organization, World Health Organization, and recent research publications examining the course of syphilis in Brazil, in Brazilian regions, and globally. Results: While the investigation committees drew on the successful experience of those in reducing maternal mortality, which helped the country achieve the Millennium Development Goals, they are not demonstrated to be sufficient for preventing mother-to-child transmission of syphilis. The committees’ systematic and bureaucratic agenda has not been efficient in managing avoidable factors for syphilis, nor do they operate in the scope of the integration of surveillance and care actions, as recommended by the health policy. Conclusion: The committees’ model needs to be reviewed in the context of Brazil’s National Health System. The research process should be rescaled in order to remain a cornerstone for the induction of health policy that integrates surveillance and healthcare across Brazilian Federative Units. The advancement toward an automated case management model becomes relevant for the country to meet global commitments to eliminate congenital syphilis transmission and achieve the goals outlined in the 2030 Agenda.info:eu-repo/semantics/publishedVersio

A melhora da qualidade de vida e os benefícios da atividade física em idosos: uma revisão sistemática / The improvement of quality of life and the benefits of physical activity in the elderly: a systematic review

Introdução: A prática de atividade física regular numa perspectiva do envelhecimento saudável e ativo durante a vida se constitui como uma condição favorável na manutenção da saúde e melhoria na qualidade de vida. Objetivo: Realizar uma revisão de literatura a respeito dos benefícios trazidos pela prática de atividade física, por idosos entre 60 a 80 anos. Métodos: revisão sistemática, realizada por meio das bases de dados Lilacs, Bireme Scielo, Pubmed, Bvsalud e Google Acadêmico, buscados artigos em português, entre os anos de 2009 a 2019. Utilizando os descritores: idosos, qualidade de vida, saúde, atividades físicas, benefícios. Resultados: Foram utilizados e comparados 10 estudos sobre a qualidade de vida do idoso em relação a prática de exercícios físicos, com resultados positivos. Idosos que se exercitam regularmente apresentaram melhora em vários aspectos físicos, cognitivos/ emocionais e sociais. Conclusão: Um estilo de vida ativo com prática regular de atividade física na velhice garante um melhor índice de qualidade de vida, assim como uma melhora nos aspectos físicos, psicológicos, sociais, capacidade de mobilidade, diminuição de dor e desconforto, relaxamento, maiores condições de cuidado de si e melhor compreensão dessa fase da vida

Síndrome de sjögren-larsson: fatores genéticos, sintomas e tratamento / Sjögren-larsson syndrome: genetic factors, symptoms, and treatment

A Síndrome de Sjögren-Larsson (SSL) foi descrita pela primeira vez em 1957 e até os dias atuais é pouco conhecida. Trata-se de um distúrbio autossômico recessivo caracterizado por uma desordem neurocutânea rara. A principal manifestação consiste-se pela tríade clássica que engloba: ictiose congênita, desenvolvimento de paraplegia ou tetraplegia e retardo mental. Os pacientes com SSL apresentam uma mutação no gene ALDH3A2, que codifica a enzima aldeído graxo desidrogenase (FALDH). A mutação desencadeia na queda da quantidade enzimática de FALDH presente no corpo e leva a um déficit na oxidação da cadeia longa dos ácidos graxos, gerando um depósito de metabólitos lipídicos nos tecidos. Por tratar-se de uma síndrome genética, as manifestações dermatológicas podem ser observadas desde o nascimento. Inicialmente, a pele pode apresentar-se áspera, seca e ter aspecto descamativo por defeito na queratina, manifestando-se com coloração acastanhada. Normalmente as regiões de dobras, periumbilical e pescoço estão afetadas, enquanto a face é sempre poupada. A deficiência da oxidação dos ácidos graxos também gera atraso na mielinização e desmielinização das fibras nervosas, o que pode levar a um acometimento neurológico, como um retardo progressivo no desenvolvimento motor ou uma síndrome piramidal. O paciente também pode relatar fotofobia e diminuição da acuidade visual. Outra manifestação comum apresentada é a maculopatia cristalina, caracterizada por pontos esbranquiçados circunjacentes à fóvea no fundo de olho, observada em 100% dos casos relatados. Anomalias como baixa estatura, hipertelorismo, dentes afastados, hipoplasia do esmalte dentário e cifoescoliose também podem estar presentes

Interventions of Brazil's more doctors program through continuing education for Primary Health Care

IntroductionBrazil's More Doctors Program, in its training axis, aims to improve medical training for Primary Health Care through interventions related to the reality of the territory. The research presented here analyzed the interventions implemented by Brazil's More Doctors Program physicians, members of the Family Health Continuing Education Program, and the relationship with Primary Health Care programmatic actions.MethodologyThe research conducted made use of Text and Data Mining and content analysis. In total, 2,159 reports of interventions from 942 final papers were analyzed. The analysis process was composed of the formation of the corpus; exploration of the materials through text mining; and analysis of the results by inference and interpretation.ResultsIt was observed that 57% of the physicians worked in the Northeast Region, which was also the region with the most interventions (66.8%). From the analysis of the bigrams, trigrams, and quadrigrams, four constructs were formed: “women's health,” “child health,” “chronic non-communicable diseases,” and “mental health.” Terms related to improving access, quality of care, teamwork, and reception were also present among the N-grams.DiscussionThe interventions carried out are under the programmatic actions recommended by the Brazilian Ministry of Health for Primary Health Care, also addressing cross-cutting aspects such as Reception, Teamwork, Access Improvement, and Quality of Care, which suggests that the training experience in the Family Health Continuing Education Program reflects on the way these professionals act

The Text Mining Technique Applied to the Analysis of Health Interventions to Combat Congenital Syphilis in Brazil: The Case of the "Syphilis No!" Project

Congenital syphilis (CS) remains a threat to public health worldwide, especially in developing countries. To mitigate the impacts of the CS epidemic, the Brazilian government has developed a national intervention project called "Syphilis No." Thus, among its range of actions is the production of thousands of writings featuring the experiences of research and intervention supporters (RIS) of the project, called field researchers. In addition, this large volume of base data was subjected to analysis through data mining, which may contribute to better strategies for combating syphilis. Natural language processing is a form of knowledge extraction. First, the database extracted from the "LUES Platform" with 4,874 documents between 2018 and 2020 was employed. This was followed by text preprocessing, selecting texts referring to the field researchers' reports for analysis. Finally, for analyzing the documents, N-grams extraction (N = 2,3,4) was performed. The combination of the TF-IDF metric with the BoW algorithm was applied to assess terms' importance and frequency and text clustering. In total, 1019 field activity reports were mined. Word extraction from the text mining method set out the following guiding axioms from the bigrams: "confronting syphilis in primary health care;" "investigation committee for congenital syphilis in the territory;" "municipal plan for monitoring and investigating syphilis cases through health surveillance;" "women's healthcare networks for syphilis in pregnant;" "diagnosis and treatment with a focus on rapid testing." Text mining may serve public health research subjects when used in parallel with the conventional content analysis method. The computational method extracted intervention activities from field researchers, also providing inferences on how the strategies of the "Syphilis No" Project influenced the decrease in congenital syphilis cases in the territory

AVASUS’ Contributions to Promoting Lifelong Learning in Health: Toward Achieving the SDGs and Strengthening Global Health Security

The Virtual Learning Environment of the Brazilian Health System (AVASUS) was developed by the Laboratory for Technological Innovation in Health (LAIS) and the Secretariat of Distance Education (SEDIS) at the Federal University of Rio Grande do Norte (UFRN) in partnership with Brazil’s Ministry of Health (MoH). AVASUS provides open educational resources in the health field and has emerged as the third largest platform for massive health education globally, with more than one million students. Among the various learning pathways AVASUS offers, some specifically focus on meeting the educational needs to address public health emergencies and overlooked health contexts. The main argument in this study is that technology-mediated lifelong learning in health is an effective strategy for achieving the Sustainable Development Goals (SDGs) of the 2030 Agenda. This chapter analyzes the pathways related to COVID-19, syphilis, and prison health, focusing on the contributions towards achieving SDGs 3, 4, 5, 10, 11, 16, and 17 and fulfilling the Global Health Security Agenda. Our analysis revealed two key findings. Lifelong learning in health (i) prompts decision-making on public health policies and (ii) contributes towards implementing the SDGs. Ultimately, AVASUS should be recognized as a tool to improve health services and support policy-making

Brazilian consortium for the study on renal diseases associated with COVID-19 : a multicentric effort to understand SARS-CoV-2-related nephropathy

Kidney involvement appears to be frequent in coronavirus disease 2019 (COVID-19). Despite this, information concerning renal involvement in COVID-19 is still scarce. Several mechanisms appear to be involved in the complex relationship between the virus and the kidney. Also, different morphological patterns have been described in the kidneys of patients with COVID-19. For some authors, however, this association may be just a coincidence. To investigate this issue, we propose assessing renal morphology associated with COVID-19 at the renal pathology reference center of federal university hospitals in Brazil. Data will come from a consortium involving 17 federal university hospitals belonging to Empresa Brasileira de Serviços Hospitalares (EBSERH) network, as well as some state hospitals and an autopsy center. All biopsies will be sent to the referral center for renal pathology of the EBSERH network. The data will include patients who had coronavirus disease, both alive and deceased, with or without pre-existing kidney disease. Kidney biopsies will be analyzed by light, fluorescence, and electron microscopy. Furthermore, immunohistochemical (IHC) staining for various inflammatory cells (i.e., cells expressing CD3, CD20, CD4, CD8, CD138, CD68, and CD57) as well as angiotensin-converting enzyme 2 (ACE2) will be performed on paraffinized tissue sections. In addition to ultrastructural assays, in situ hybridization (ISH), IHC and reverse transcription-polymerase chain reaction (RT-PCR) will be used to detect Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) in renal tissue. For the patients diagnosed with Collapsing Glomerulopathy, peripheral blood will be collected for apolipoprotein L-1 (APOL1) genotyping. For patients with thrombotic microangiopathy, thrombospondin type 1 motif, member 13 (ADAMTS13), antiphospholipid, and complement panel will be performed. The setting of this study is Brazil, which is second behind the United States in highest confirmed cases and deaths. With this complete approach, we hope to help define the spectrum and impact, whether immediate or long-term, of kidney injury caused by SARS-CoV-2

Brazil's international cooperation on HIV / AIDS: institutionalization and specificities in the national and international context

Made available in DSpace on 2019-01-18T14:22:40Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) thaisa_gois_farias_de_moura_santos.pdf: 3167113 bytes, checksum: 2ce4bf6a74167638b4afab966727d192 (MD5) Previous issue date: 2017Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Esta pesquisa é um estudo de caso sobre a cooperação internacional (CI) do Brasil em HIV/Aids no período de 2002-2014. Retrocedeu-se no tempo (anos 1980-90) para melhor compreender essa dinâmica no contexto da disseminação global da Aids e de construção e consolidação da resposta brasileira de enfrentamento da epidemia. Foram analisadas: a estruturação institucional do sistema de CI brasileiro; o processo de institucionalização da cooperação Sul-Sul (CSS) em HIV/Aids no Brasil; as relações e mecanismos de articulação entre o Ministério da Saúde (MS), organizações multilaterais e agencias financiadoras, que possibilitaram o desenvolvimento da CSS brasileira em HIV/Aids; as relações institucionais entre o MS e a Agência Brasileira de Cooperação (ABC/MRE) e os mecanismos de cooperação em HIV/Aids e sua possível contribuição para a priorização da saúde na PEB. Mapearam-se os projetos/iniciativas de cooperação Sul-Sul nessa área, os principais eixos temáticos e sua abrangência mundial, sem, entretanto, aprofundar esta análise. O marco teórico situa-se no campo da análise de políticas, articulando-se a política nacional de controle do HIV/Aids, a CSS do Brasil e a relação dessas iniciativas com a PEB. Os resultados mostram que a dinâmica de estruturação institucional da resposta brasileira à Aids foi permeada por ações de CI recebidas e prestadas, entrelaçadas de forma particular, delimitando-se três distintas fases nesse processo -anos 1990; primeira década de 2000; e período 2011 a 2014. Em todas elas evidenciam-se pelo menos duas dimensões articuladas: a construção da resposta nacional e uma prática de CI com características próprias, capaz de desbravar o cenário internacional, até então dominado pelos países desenvolvidos e suas agências e pelo Sistema da ONU. O elemento comum é a atuação dos atores nacionais e internacionais que participaram desse processo. Os achados comprovam nossa hipótese inicial: a construção coletiva da política nacional de resposta ao HIV/Aids oferece elementos para a melhor compreender a articulação entre relações internacionais e saúde e a projeção da participação do Brasil no sistema internacional, sobretudo em âmbito setorial e outras áreas correlacionadas. As ações de CI em HIV/Aids tomaram a dianteira na CSS em saúde do país e respaldaram a priorização da saúde na agenda da PEB a partir de 2003, projetando o Brasil como um importante ator e protagonista na arena internacional da saúde. Essa trajetória não foi linear nem isenta de percalços, com momentos de inflexão, ressaltando-se a capacidade de negociação da equipe nacional com os organismos internacionais em diferentes conjunturas, configurando o que denominamos de especificidade brasileira da resposta ao HIV/Aids.This case study of Brazil s international cooperation (IC) in HIV/Aids, from 2002 to 2014, backtracked somewhat in time to the 1980s and 90s in order to understand this dynamic better in the context of the global spread of Aids, construction and growing consistency of the Brazilian response to the epidemic. It examined the institutional structuring of Brazil s IC system, the process of institutionalisation in Brazil of South-South cooperation (SSC) on HIV/Aids; the collaboration among the Ministry of Health (MoH), multilateral organisations and financing agencies, which made it possible to develop Brazil s SSC on HIV/Aids; the institutional relations between the MoH and the Brazilian Cooperation Agency (ABC/MRE) and the mechanisms for cooperation on HIV/Aids and their possible contribution to prioritizing health in Brazilian foreign policy. A mapping was made of South-South cooperation projects and initiatives on HIV/Aids and their world reach, as well as their main thematic directions, without however any in-depth analysis. The theoretical framework lies within the policy analysis field, and interrelates national HIV/Aids control policy, Brazil s SSC and the relationship between these endeavours and Brazilian foreign policy. The results show a dynamics permeated by IC received and provided, interlaced in particular ways. Three distinct phases area delimited in this process the 1990s; the 2000s; and 2011 to 2014. All these phases feature at least two interconnected dimensions: construction and institutionalisation of the national response and development of a cooperation practice with characteristics of its own and the capacity to venture into an international scenario hitherto dominated by the developed countries and their agencies and by the UN System. The elements common to the two dimensions are the national and international stakeholders participating in this process. Our findings confirm the starting hypothesis: the collective construction of Brazil s national policy in response to HIV/Aids offers elements that help understand better the linkages between international relations and health and the scope of Brazil s participation in the international system, particularly in the health sector and related areas. Brazil s SSC in health was led by IC on HIV/Aids, which supported the prioritisation of health on the foreign policy agenda from 2003 onwards, projecting Brazil as an important leading player in the international health arena. That trajectory was neither linear nor without turning points, and was notable for the national team s ability to negotiate with international organisations in various different conjunctures, shaping what is termed here the distinctively Brazilian response to HIV/Aids