The role of occupation in SARS-CoV-2 infection within a Brazilian municipality: A test-negative case-control study.

OBJECTIVE: To investigate the association between occupation and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections within a Brazilian municipality. METHODS: In this test-negative study, cases and controls were randomly selected among individuals aged 18-65 years that were registered in a primary health care program in São Caetano do Sul, Brazil. Those who had collected samples for RT-PCR testing between April 2020 and May 2021 were randomly selected to compose the case (positive for SARS-CoV-2) and control (negative for SARS-CoV-2) groups, frequency-matched by sex, age group, and month of sample collection. Complementary data were collected through phone interviews. We estimated the residual effect of occupation on SARS-CoV-2 infection using multiple conditional logistic regression models incrementally adjusted for confounding variables. RESULTS: 1724 cases and 1741 controls who reported being at work at the time of RT-PCR collection were included. Cases were mainly females (52.9%), Whites/Asians (73.3%), and unvaccinated against COVID-19 (46.6%). Compared to other university-level professionals, the highest odds of having COVID-19 were found for workers in police and protective services (odds ratio [OR] 2.21; 95% confidence interval [CI] 1.27-3.84), healthcare and caregiving (OR 1.90; 95% CI 1.34-2.68), and food retail and production (OR 1.88; 95% CI = 1.14-3.11), after adjustment for age, sex, education, means of transport, household crowding, and COVID-19 vaccination. CONCLUSION: Occupation played an important role in SARS-CoV-2 infection. Food retail and production, health care and caregiving, and police and protective services showed the highest odds of SARS-CoV-2 infection.

Perceived discrimination in health services and associated factors in Manaus Metropolitan Region, Brazil: a cross-sectional population-based study.

Objectives: Discrimination is the differentiated treatment of individuals due to prejudgments. Discriminatory practices in health care result in negative effects on patients' health. In Brazil, skin color represents the main form of racial discrimination, which may have an impact on the accessibility and quality of health care. The Brazilian Amazon lacks investigations on this topic at the population level. This study aims to estimate the prevalence of perceived discrimination in health services and associated factors in the Manaus Metropolitan Region, state of Amazonas, Brazil.Design: A population-based cross-sectional study was conducted with a probabilistic sample of adults interviewed in 2015. The associated factors were investigated by calculating the prevalence ratio (PR) using Poisson regression with robust variance.Results: A total of 4,001 participants were included. The overall prevalence of perceived discrimination was 12.9% (95% confidence interval [CI]: 11.8-13.9%). When compared to the reference categories, women (PR = 1.43; 95%CI: 1.20-1.70), individuals with brown skin color (Brazilian mixed race; PR = 1.33; 95%CI: 1.04-1.71), people who suffer from hypertension (PR = 1.27;95%CI: 1.03-1.57), and people who frequently used health services (p≤0.03) experienced more discrimination from health professionals.Conclusions: The prevalence of perceived discrimination in health services in Manaus Metropolitan Region is frequent and is associated with ethnic, social and health-related factors. Investments in inclusive public health policies and a better quality of health assistance are required to tackle this problem.

Temporal trend of leprosy among the elderly in Brazil, 2001 - 2018.

OBJECTIVE: To describe the temporal trends of leprosy indicators among the elderly in Brazil in 2001 - 2018. METHODS: This was an ecological time-series study of new leprosy cases in the elderly reported to the Notifiable Diseases Information System. Prais-Winsten generalized linear regression was used to estimate temporal variations. RESULTS: There were 687 317 new leprosy cases in Brazil from 2001 - 2018, of which 129 214 (18.8%) were among elderly people. Overall detection rates in the elderly and of new cases with grade-2 disability showed a falling trend, with an annual percent change of -4.6% (95%CI = -5.1 to -4.0) and -3.9% (95%CI = -4.6 to -3.2). New case and new multibacillary case proportions showed an increasing trend, with an annual percent change of 2.9% (95%CI = 2.6 to 3.3) and 1.4% (95%CI = 1.0 to 1.7), respectively. Detection rates for new leprosy cases in elderly people in Brazil are decreasing, but the proportion of new cases and multibacillary cases are trending upwards. CONCLUSIONS: New cases are shifting to older age groups, and demographic transition and immunosenescence are an influence. Inadequate reduction of grade-2 disability indicates a high risk of physical disability persists. Improved contact tracing and more effective action are needed in this age group.

Outcomes of Zika virus infection during pregnancy: contributions to the debate on the efficiency of cohort studies.

BACKGROUND: Zika infection during pregnancy (ZIKVP) is known to be associated with adverse outcomes. Studies on this matter involve both rare outcomes and rare exposures and methodological choices are not straightforward. Cohort studies will surely offer more robust evidences, but their efficiency must be enhanced. We aim to contribute to the debate on sample selection strategies in cohort studies to assess outcomes associated with ZKVP. A study can be statistically more efficient than another if its estimates are more accurate (precise and valid), even if the studies involve the same number of subjects. Sample size and specific design strategies can enhance or impair the statistical efficiency of a study, depending on how the subjects are distributed in subgroups pertinent to the analysis. In most ZIKVP cohort studies to date there is an a priori identification of the source population (pregnant women, regardless of their exposure status) which is then sampled or included in its entirety (census). Subsequently, the group of pregnant women is classified according to exposure (presence or absence of ZIKVP), respecting the exposed:unexposed ratio in the source population. We propose that the sample selection be done from the a priori identification of groups of pregnant women exposed and unexposed to ZIKVP. This method will allow for an oversampling (even 100%) of the pregnant women with ZKVP and a optimized sampling from the general population of pregnant women unexposed to ZIKVP, saving resources in the unexposed group and improving the expected number of incident cases (outcomes) overall. CONCLUSION: We hope that this proposal will broaden the methodological debate on the improvement of statistical power and protocol harmonization of cohort studies that aim to evaluate the association between Zika infection during pregnancy and outcomes for the offspring, as well as those with similar objectives.

Involvement of school students in fights with weapons: prevalence and associated factors in Brazil.

BACKGROUND: Violence, as well as other behaviors, is often intensified during adolescence and early adulthood. The objective of this study is estimate the prevalence of Brazilian school students involvement in fights with weapons and to analyze the associated factors. METHODS: This is a cross-sectional study using data from the National School Student Health Survey conducted in 2012 with 9th grade elementary school students attending 2842 schools in all 27 Brazilian Federative Units. The outcome studied was involvement in fights with firearms and/or cold weapons in the 30 days prior to the interview. Poisson regression was used to estimate the prevalence ratios and 95 % confidence intervals (95 % CI). The analyses were stratified by sex. RESULTS: Fifty seven thousand and eighty nine female students and 52,015 male students were included; the prevalence of their involvement in fights with weapons was 7.2 (95 % CI 6.9-7.5) and 13.8 (95 % CI 13.4-14.3), respectively. In the adjusted analysis the factors associated with male student involvement in fights with weapons were: being older, working, having smoked a cigarette, consumed alcoholic beverages and illicit drugs recently, insomnia, not having any close friends, skipping classes without parental supervision, having suffered aggression from a family member, reporting feeling unsafe on the way to or from school and/or at school. The same associated factors were found among female students in addition to not living with their father and/or mother and having suffered bullying. There was no association with type of school in either sex. CONCLUSION: Involvement in fights with weapons was greater among older male students. Health-risk behaviors, mental health characteristics, parental supervision and context of violence also showed association with the outcomes.

[Alcohol use as a necessary cause of death in Brazil, 2010-2012]. / Uso de álcool como causa necessária de morte no Brasil, 2010 a 2012.

OBJECTIVE: To describe mortality from diseases, conditions, and injuries for which alcohol consumption is a necessary cause during the 2010-2012 triennium in Brazil. METHODS: A descriptive study was conducted with data from the Brazilian Ministry of Health's Mortality Information System (SIM). The analysis included deaths whose primary cause was classified as any of the 78 codes of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) corresponding to the diseases, conditions, and injuries for which the use of alcohol is a necessary cause. RESULTS: Deaths with alcohol consumption as a necessary cause totaled 55 380 (88.5% in men). The crude mortality rate for the triennium was 9.6/100 000 people in the overall population, 17.35/100 000 men in males, and 2.15/100 000 women in females. Higher mortality rates were observed in the 50-59 year (28.45) and 60-69 year (27.23) age groups and among people with black or brown skin color (10.15). The Northeast (11.70) and Midwest (11.04) regions exhibited higher age-adjusted mortality rates. Liver diseases were the leading cause of death (55.3%). CONCLUSIONS: Mortality from causes related to alcohol consumption is high in Brazil, especially among men, people aged 50-69 years, and residents in the Northeast and Midwest regions.

[Corrected estimates of femicides in Brazil, 2009 to 2011]. / Estimativas corrigidas de feminicídios no Brasil, 2009 a 2011.

OBJECTIVE: To estimate the corrected femicide rates and to describe the characteristics of these deaths in Brazil during the 2009-2011 triennium. METHODS: A descriptive study was performed with data from the Brazilian Mortality Information System. Femicides were defined as all female deaths classified in the Assault chapter of ICD-10 (X85-Y09). These data underwent two correction procedures: proportional redistribution of events of undetermined intent (Y10-Y34) and application of correction factors for mortality rates previously described in the literature. RESULTS: During the period analyzed, 13 071 femicides were recorded in the Mortality Information System. After the first correction procedure, 17 167 femicides were estimated, corresponding to a death rate of 5.86 per 100 000 women. Higher femicide rates were recorded in the Northeast, Midwest and North regions of Brazil (6.93, 6.88 and 6.43 deaths per 100 000 women respectively) vs. 5.07 and 5.09 per 100 000 women in the South and Southeast respectively. Of the victims, 29.7% were between 20 and 29 years of age and 60.9% were black. Among women aged 15 years or older, 48% had schooling of not more than 8 years. Fire guns were used in 50.2% of deaths; 27.6% of deaths took place in the household; and 35.1% took place on weekends. CONCLUSIONS: Femicide death rates were high and support the need for correction to reduce underestimation. The victims were women of all age groups, ethnicities, and schooling levels. However, most victims were young, black, with low schooling, living in the Northeast, Midwest, and North of Brazil.

Self-rated health in Brazilian adults and elderly: data from the National Household Sample Survey 2008.

OBJECTIVE: To investigate prevalence of poor self-rated health and its association with individual and household-level characteristics among adults and elderly in Brazil. MATERIALS AND METHODS: Cross-sectional study with Brazilian National Household Sample Survey 2008 (n=257 816). Crude and multilevel-adjusted Poisson regression models were fitted. RESULTS: After adjusted analysis, poor self-rated health was significantly associated with higher household income, living alone, not having piped water nor garbage collection, lower education, not having health insurance, female sex, higher age, being a current or previous smoker, physical inactivity, having chronic diseases, having physical impairment. Subjects living in rural areas also had higher prevalence of poor self-rated health. The factors most strongly associated with the outcome were physical impairment and reporting three or more chronic diseases. CONCLUSIONS: Socioeconomic, health related behaviors, and physical health were associated with poor self-rated health.

Prevalence of Physical Violence Against Brazilian Women: Systematic Review and Meta-Analysis.

Violence against women is a major problem in Brazil, but data on its prevalence are scarce. We aimed to estimate the prevalence of physical violence against women in Brazil. We conducted a systematic review and meta-analysis of the prevalence of physical violence against women. Population-based researches that assessed physical violence in Brazilian women were searched on MEDLINE, Embase, Scopus, and VHL/BIREME. The last search update was carried out in March 2020. Two researchers selected the studies, extracted the data, and assessed the quality of the eligible studies. Summary of prevalence and 95% confidence interval (CI) was calculated using Freeman-Tukey double arccosine transformation, weighted by the official local population size. Heterogeneity was estimated by I 2 and investigated by meta-regression analyses. Of 3,408 reports, 13 studies carried out from 1999 to 2016 (n = 25,781 women) were included. Most studies had limitations on sample size (5/13) and response rate (7/13). The prevalence of physical violence was 22.4% in lifetime (95% CI [21.6, 23.2%]; I 2 = 99.0%), and 11.5% in previous year (95% CI [11.1, 11.9%]; I 2 = 99.5%). Assuring privacy during interview significantly increased the prevalence (p = .028; residual I 2 = 80.0%). Higher prevalence was also observed in studies with adequate sample source, validated questionnaire, and privacy (in both recall periods), potentially due to lower risk of nonresponse bias. Over two in 10 Brazilian women suffered physical violence during their lives, and over one tenth, in the previous year. Measurement of outcome affected the prevalence; privacy should be assured for the interviewee for future reliable estimates in the country.

Prevalence of heavy episodic drinking in the Brazilian adult population: National Health Survey 2013 and 2019. / Prevalência de consumo abusivo de bebidas alcoólicas na população adulta brasileira: Pesquisa Nacional de Saúde 2013 e 2019.

OBJECTIVE: To describe the prevalence of heavy episodic drinking in the Brazilian adult population, according to sociodemographic characteristics, in 2013 and in 2019. METHODS: A cross-sectional study using data on heavy episodic drinking among adults (≥ 18 years) from the National Health Survey, analyzed descriptively. RESULTS: 60,202 participants were included in 2013 and 88,531 in 2019. The prevalence of heavy episodic drinking, in 2019 (17.1%; 95%CI 16.6;17.5), was higher than 2013 (13.1%; 95%CI 13.1;14.2). In the two years, there was a higher prevalence among male sex, adults 18 to 39 years old, individuals with high schooling and Black skin color. In addition, higher prevalence were found among residents in urban areas and in the Midwest and Southeast regions. CONCLUSION: The indication of the growing prevalence of alcohol abuse in Brazil and the differences in prevalence, according to sociodemographic characteristics, show the need to encourage public policies and actions to combat its use.

[Challenges for the sustainability of Brazilian scientific journals and the SciELO Program]. / Desafios para a sustentabilidade dos periódicos científicos brasileiros e do Programa SciELO.

Scientific journals play a fundamental role in the development of science. However, in Brazil, there are major challenges for their sustainability, as well as for the sustainability of the SciELO Program. The article reports a worrying scenario of low public funding and lack of strategic planning for long-term funding for scientific publication, contrary to the development of Brazilian journals and the SciELO Program. This scenario places great pressure on journals, with reports of situations of closure of activities, or implementation of fees charged to authors, while bringing financial insecurity to the SciELO Program. The actions taken by Brazilian scientific societies and the position of the Forum of Editors of Public Health Journals are aligned with that of the Advisory Committee of the SciELO Brazil Collection, namely that the publication of scientific journals edited in Brazil is strategic and, therefore, should be fostered through public policies and supported with public financing from the sponsoring institutions and grants from the research funding institutions.

As revistas científicas têm papel fundamental para o desenvolvimento da ciência. Contudo, no Brasil, existem grandes desafios para sua sustentabilidade, assim como do Programa SciELO. O artigo relata um cenário preocupante de baixo financiamento público e ausência de planejamento estratégico com financiamento de longo prazo para a publicação científica, na contramão do desenvolvimento das revistas brasileiras e do Programa SciELO. Tal cenário impõe grande pressão às revistas, com relatos de situações de encerramento de atividades, ou implementação de cobrança de taxas aos autores, ao mesmo tempo que traz insegurança financeira ao Programa SciELO. São informadas as ações tomadas por sociedades científicas Brasileiras e a posição do Fórum de Editores das Revistas da Saúde Coletiva, alinhada à do Comitê Consultivo da Coleção SciELO Brasil, de que a publicação de periódicos científicos editados no Brasil é estratégica e, portanto, deve ser incentivada por meio de políticas públicas e apoiada com recursos públicos provenientes das instituições mantenedoras e dos editais das agências de fomento.

Occupational health crossing borders part 2: Comparison of 18 occupational health systems across the globe.

BACKGROUND: Occupational health and safety (OHS) is considered one of the most important factors for a sustainable development; however, it is often considered a luxury by decision-makers. This article compares OHS systems of 18 countries at different stages of development. METHODS: In an international summer school, structure of the national OHS system, definition of occupational accidents and diseases, procedures for compensation claims, outcome (expressed as incidence of occupational accidents) and training opportunities were presented. RESULTS: National OHS systems ranged from non-existent to systems implemented almost 200 years ago. Priorities, incidence of occupational accidents and training opportunities varied. Common problems included the lack of OHS service for small enterprises and in rural areas. CONCLUSIONS: International training programs like this summer school might enhance the exchange about OHS opportunities around the globe and contribute to improved workers health.

[The increase in domestic violence during the social isolation: what does it reveals?] / Isolamento social e o aumento da violência doméstica: o que isso nos revela?

The social isolation imposed by the COVID-19 pandemic brings out, in a empowered way, some worrying indicators about domestic violence and family violence against women. Organizations addressing domestic violence have already seen an increase in domestic violence due to forced coexistence, economic stress and fears about the Coronavirus. The article seeks to establish some relations between social isolation during the COVID-19 pandemic and the increase in violence against women, taking into account the context of a patriarchal society. Data, still incipient, published by the press of several countries were analyzed, as well as reports from international organizations and organizations focused on combating domestic violence. In parallel, a brief literature review with authors who discuss the social role of women in society.

O isolamento social imposto pela pandemia da COVID-19 traz à tona, de forma potencializada, alguns indicadores preocupantes sobre a violência doméstica e a violência familiar contra a mulher. As organizações voltadas ao enfrentamento da violência doméstica já observaram aumento da violência doméstica por causa da coexistência forçada, do estresse econômico e de temores sobre o coronavírus. O artigo busca estabelecer algumas relações entre o isolamento social durante a pandemia da COVID-19 e o aumento da violência contra as mulheres, levando em conta o contexto de uma sociedade patriarcal. Foram analisados dados, ainda incipientes, publicados pela imprensa de diversos países, bem como relatórios de organizações internacionais e organizações direcionadas ao enfrentamento da violência doméstica. Paralelamente, fez-se uma breve revisão de literatura com autores que discutem o papel social da mulher na sociedade.

[Epidemiological characteristics of leprosy in elderly Brazilians and comparison with other age groups (2016-2018)]. / Características epidemiológicas da hanseníase nos idosos e comparação com outros grupos etários, Brasil (2016-2018).

The article aimed to describe epidemiological indicators and characteristics of new cases of leprosy in elderly Brazilians in 2016-2018, compared to other age groups. A descriptive cross-sectional cohort study was conducted with data from the Information System on Diseases of Notification (SINAN). New leprosy cases were categorized by age groups: 60 or more, 40-59, 15-39, and 15 years of age. Pearson's chi-square test was used to verify differences between groups. A total of 81,205 new leprosy cases were reported in Brazil. Of these, 24.1% were elderly, 37.7% from 40-59 years, 31.9% from 15-39 years, and 6.3% in individuals under 15 years of age. The elderly showed higher proportions (p < 0.001) of cases in males (60.1%), with multibacillary classification (81.3%), and with physical disability grade 2 (PDG2) (11.4%) when compared to the other groups. However, the proportion of new cases detected in the elderly based on contact testing (4.9%) was the lowest among all the age brackets (p < 0.001). The mean detection rate and rate of new cases with PDG2 at diagnosis were higher among the elderly (25.1/100,000 and 28.6/million inhabitants, respectively) compared to other age groups in Brazil as a whole and in the regions and states. Important differences were seen in the epidemiological and clinical profile of leprosy in the elderly compared to other age brackets, especially higher proportions of multibacillary cases, new cases with PDG2, and low detection by contact testing. The findings highlighted the need for leprosy control in this age group, aimed at contributing to interruption of transmission of the disease.

O objetivo foi descrever indicadores epidemiológicos e características dos casos novos de hanseníase em idosos no Brasil, no triênio 2016-2018, comparando a outros grupos etários. Estudo descritivo de corte transversal com dados do Sistema de Informação de Agravos de Notificação (SINAN). Os casos novos de hanseníase foram categorizados por grupos etários: 60 ou mais, 40-59, 15-39 e menores de 15 anos. Utilizou-se o teste qui-quadrado de Pearson para testar diferenças entre grupos. Foram notificados 81.205 casos novos de hanseníase no Brasil. Desses, 24,1% foram em idosos, 37,7% de 40-59 anos, 31,9% de 15-39 e 6,3% em menores de 15 anos. Nos idosos, foram observadas proporções maiores (p < 0,001) de casos no sexo masculino (60,1%), com classificação operacional multibacilar (81,3%) e com grau 2 de incapacidade física (GIF2) (11,4%) em relação aos outros grupos. Contudo, a proporção de casos novos detectados em idosos, por exame de contatos (4,9%), foi a menor entre todas as faixas etárias (p < 0,001). As taxas médias de detecção e de casos novos com GIF2 no diagnóstico foram maiores entre idosos (25,1/100 mil e 28,6/1 milhão de habitantes, respectivamente) em comparação aos demais grupos etários, para o país, regiões e Unidades da Federação. Foram observadas importantes diferenças nos perfis epidemiológico e clínico da hanseníase nos idosos, em relação às demais faixas etárias, destacando-se maiores proporções de casos multibacilares, de casos novos com GIF2 e baixa detecção por exame de contatos. Evidencia-se a necessidade do controle da hanseníase nessa população, visando a contribuir para a interrupção da transmissão da doença.

El objetivo fue describir indicadores epidemiológicos y características de los nuevos casos de hanseniasis en ancianos en Brasil, durante el trienio 2016-2018, comparándolos con otros grupos etarios. Se realizó un estudio descriptivo de corte transversal con datos del Sistema de Información sobre Enfermedades de Notificación obligatoria (Sinan). Los nuevos casos de hanseniasis fueron categorizados por grupos etarios: 60 o más, 40-59, 15-39 y menores de 15 años. Se utilizó el test chi-cuadrado de Pearson para probar diferencias entre grupos. Se notificaron 81.205 casos nuevos de hanseniasis en Brasil. De estos, un 24,1% fueron en ancianos, 37,7% de 40-59 anos, 31,9% de 15-39 años y 6,3% en menores de 15 años. En los ancianos, se observaron proporciones mayores (p < 0,001) de casos del sexo masculino (60,1%), con clasificación operacional multibacilar (81,3%) y con grado 2 de incapacidad física (GIF2) (11,4%), respecto a otros grupos. No obstante, la proporción de casos nuevos detectados en ancianos, por examen de contactos (4,9%), fue la menor entre todas las franjas de edad (p < 0,001). Las tasas medias de detección y de casos nuevos con GIF2 en el diagnóstico fueron mayores entre ancianos (25,1/100.000 y 28,6/1 millón de habitantes, respectivamente), en comparación con los demás grupos etarios, respecto al país, regiones y Unidades de la Federación. Se observaron importantes diferencias en el perfil epidemiológico y clínico de la hanseniasis en ancianos, en relación con las demás franjas de edad, destacándose mayores proporciones de casos multibacilares, de casos nuevos con GIF2 y baja detección por examen de contactos. Se evidencia la necesidad del control de la hanseniasis en esa población, con el fin de contribuir a la interrupción de la transmisión de la enfermedad.

Identification of micro-regions with under-reported tuberculosis cases in Brazil, 2012-2014. / Identificação de microrregiões com subnotificação de casos de tuberculose no Brasil, 2012 a 2014.

OBJECTIVE: to identify Brazilian micro-regions with under-reported tuberculosis cases, from 2012 to 2014. METHODS: this was an ecological study using data from the Notifiable Health Conditions Information System (SINAN). The indirect estimator of the proportion of notified cases (EIPCN) was calculated as the mean between the proportion of cases that adhered to treatment and the proportion of those who underwent sputum smear microscopy. Negative Binomial Regression was used to investigate evidence of under-reporting in the micro-regions selected through EIPCN. RESULTS: under-reporting was suspected in 89 (17.5%) micro-regions with EIPCN below 83%. The EIPCN rate ratio in the regression model was 0.996 (95%CI 0.988;1.003) considering all the data and equal to 0.987 (95%CI 0.974;0.999) excluding the 89 micro-regions with suspected under-reporting. CONCLUSION: evidence of tuberculosis case under-reporting was found in micro-regions where basic indicators of surveillance system quality had poor performance.

How Brazil can hold back COVID-19. / Como o Brasil pode deter a COVID-19.

This article presents the strategies and actions adopted by the Brazilian Ministry of Health to hold back COVID-19. The response to the disease was immediate and occurred prior to the first case being detected in Brazil. Provision of information and communication to the population and the press was adopted as a fundamental strategy for addressing the epidemic. Guidance provided to the population has been clear, stressing the importance of coronavirus transmission prevention measures. Efforts have been directed towards strengthening health surveillance and health care, as well as boosting research, development and innovation. Actions have targeted human resource training and expanding coverage afforded by the Brazilian National Health System (SUS). Protecting health workers is a priority. All SUS health workers, managers and directors are dedicated to preserving the health and life of each and every Brazilian citizen.

Exposures to blood and body fluids in Brazilian primary health care.

BACKGROUND: Primary health care workers (HCWs) represent a growing occupational group worldwide. They are at risk of infection with blood-borne pathogens because of occupational exposures to blood and body fluids (BBF). AIM: To investigate BBF exposure and its associated factors among primary HCWs. METHODS: Cross-sectional study among workers from municipal primary health care centres in Florianópolis, Southern Brazil. Workers who belonged to occupational categories that involved BBF exposures during the preceding 12 months were interviewed and included in the data analysis. RESULTS: A total of 1077 workers participated. The mean incidence rate of occupational BBF exposures was 11.9 per 100 full-time equivalent worker-years (95% confidence interval: 8.4-15.3). The cumulative prevalence was 7% during the 12 months preceding the interview. University-level education, employment as a nurse assistant, dental assistant or dentist, higher workload score, inadequate working conditions, having sustained a previous occupational accident and current smoking were associated with BBF exposures (P

[Factors associated with aggression perpetrated by unknown assailants among young males treated by the emergency services: a case-control study]. / Fatores associados a agressões por desconhecidos entre jovens do sexo masculino atendidos em serviços de urgência e emergência: estudo de casos e controles.

This study aims to analyze the factors associated with aggression perpetrated by unknown assailants among young males treated by the emergency services. It is a case-control study with data from the Violence and Accident Surveillance System conducted in 2014 by 86 emergency services located in Brazilian State capitals. Young males between 15 and 29 years of age were included. All victims of assault perpetrated by unknown assailants were included as cases. Controls were randomly selected among those who had suffered accidental injuries in the ratio of 2:1. Unconditional logistic regression was used to estimate crude and adjusted odds ratios (OR), and 787 cases and 1,574 controls were included. Risk factors according to the adjusted analysis were: lack of paid work (OR 2.09; 95% CI; 1.66; 2.64), alcohol consumption (OR 3.14; 95% CI; 2.36; 4.17), occurrence at night (OR 3.39; 95% CI; 2.50; 4.61) or early morning (OR 5.31; 95% CI; 3.63; 7.75). Higher age (25-29 years) and schooling (5-8 years of study) were factors of protection. The results revealed the need for more effective and multisectoral actions to prevent violence among young males, which consider the factors associated with such aggression, including alcohol consumption, and investments in qualified education and paid employment.

O objetivo do estudo é analisar os fatores associados a agressões por desconhecidos entre homens jovens atendidos em serviços de urgência e emergência. Trata-se de estudo de casos e controles com dados do Sistema de Vigilância de Violências e Acidentes, conduzido, em 2014, em 86 serviços de urgência e emergência do país. Foram incluídos jovens do sexo masculino, de 15 a 29 anos de idade. Todas as vítimas de agressão por desconhecido foram incluídas como casos. Os controles foram selecionados aleatoriamente entre as vítimas de acidentes, na razão de 2:1. Regressão logística não condicional foi empregada para estimar as razões de chances (RC) brutas e ajustadas. Totalizaram 787 casos e 1.574 controles. Foram fatores de risco na análise ajustada não exercer atividade remunerada (RC 2,09; IC95% 1,66; 2,64), consumo de bebida alcoólica (RC 3,14; IC95% 2,36; 4,17) e ocorrência durante a noite (RC 3,39; IC95% 2,50; 4,61) ou madrugada (RC 5,31; IC95% 3,63; 7,75). Maior idade (25-29 anos) e escolaridade (5-8 anos de estudo) foram fatores de proteção. Evidencia-se a necessidade de ações efetivas para a prevenção da violência entre jovens, que considerem os fatores associados a este agravo, incluindo o enfrentamento ao consumo de álcool, e investimentos em ensino qualificado e emprego remunerado.

50 anos da RBSO, 25 anos do SciELO e 38 anos da ABEC Brasil: contribuições para a ciência aberta / 50 years of RBSO, 25 years of SciELO, and 38 years of ABEC Brasil: contributions to open science

Resumo Para comemorar o cinquentenário da Revista Brasileira de Saúde Ocupacional (RBSO), foi realizado, em fevereiro de 2024, o evento "50 anos da RBSO, 25 anos do SciELO e 38 anos da ABEC Brasil: contribuições para a ciência aberta". Esta nota editorial reporta tal evento, descrevendo brevemente o histórico da revista e das entidades representadas: o projeto Scientific Electronic Library Online (SciELO) e a Associação Brasileira de Editores Científicos (Abec Brasil), assim como seus alcances, seus desafios e suas perspectivas. A ciência aberta foi escolhida como assunto para estimular o debate, por ser um tema relevante e transversal que perpassa as atividades da revista e das entidades. A RBSO segue os princípios do acesso aberto desde sua criação, ainda antes do surgimento do movimento do acesso aberto e do debate em torno da ciência aberta. Mais recentemente, aderiu a outras práticas da ciência aberta, como a aceitação de preprints, o incentivo ao depósito de dados de pesquisa e a adoção de políticas editoriais alinhadas. SciELO e Abec Brasil têm sido importantes catalisadores das iniciativas relacionadas à ciência aberta, visando fortalecer os periódicos e ampliar as colaborações científicas e o compartilhamento do conhecimento científico em benefício da ciência e da sociedade.

Abstract As part of the celebration activities for the fiftieth anniversary of the Brazilian Journal of Occupational Health (RBSO), the event "50 years of RBSO, 25 years of SciELO, and 38 years of ABEC Brasil: contributions to open science" was held in February 2024. This editorial note reports on that event, briefly describing the history of the journal and the entities represented: the Scientific Electronic Library Online (SciELO) project and the Brazilian Association of Scientific Editors (ABEC Brasil), as well as their scopes, challenges, and prospects. Open Science was chosen as the theme to stimulate debate, as it is a relevant and cross-cutting issue that permeates the activities of the journal and the organizations. RBSO has followed the open access principles since its inception, even before the emergence of the open access movement and the debate around open science. More recently, it has adopted other open science practices such as accepting preprints, encouraging research data deposition, and adopting aligned editorial policies. SciELO and ABEC Brasil have been important catalysts for initiatives related to open science, aiming not only to strengthen journals but also to expand scientific collaborations and the sharing of scientific knowledge for the benefit of science and society.

Dental care utilization among children in Brazil: an exploratory study based on data from national household surveys.

Wide availability of access to dental services can be considered a predictor of better oral health outcomes in a population. This article aims to compare data from the Brazilian National Household Sample Surveys (PNAD) on dental services utilization among children aged 4 to 12 years. This cross-sectional study was carried out using data from the 1998, 2003, and 2008 National Household Sample Surveys, involving a total of 61.438, 64.659 and 59.561 children, respectively. Ninety-nine percent confidence intervals were considered for the prevalence of each outcome of interest. In 1998, 60.8% (99%CI: 59.4;62.1) of children had been to a dentist; this prevalence was 65.5% (99%CI: 64.4;66.7) in 2003 and 73.8% (99%CI: 72.1;74.2) in 2008. In 1998, 41.2% (99%CI: 39.1;43.3) of children in the lowest household income quartile had been to a dentist; this value was 61.4% (99%CI: 59.5;63.2) in 2008. Among children from families whose head of household had 4 years of formal education or fewer, 49.5% and 63% had been to a dentist in 1998 and 2008, respectively. The lifetime prevalence of dentist attendance among Brazilian children increased between 1998 and 2008, especially among those from low-income families and those whose head of household had a low educational level.