Blockchain and smart contract architecture for notaries services under civil law: a Brazilian experience.

This paper proposes a blockchain solution for some activities currently performed by notary offices under the Civil Law judiciary that is technically viable. The architecture is also planned to accommodate Brazil's legal, political, and economic requirements. Notaries are responsible for providing various intermediation services for civil transactions, where their primary role is to be the trusted party capable of guaranteeing the authenticity of these transactions. This type of intermediation is common and demanded in Latin American countries, such as Brazil, which is regulated by a Civil Law judiciary. The lack of adequate technology to meet such legal demands leads to an excess of bureaucracy, dependence on manual document and signature checks, and centralized and face-to-face actions in the physical dependence of the notary. To deal with this scenario, this work presents a blockchain-based solution to make some of the activities performed by notaries automatic, guaranteeing non-modification and adherence to civil laws. Thus, the suggested framework was evaluated in accordance with Brazilian legislation and provides an economic evaluation of the proposed solution.

Revisiting predictions of movie economic success: random Forest applied to profits.

Previous studies have employed machine learning tools to classify films according to success to guide a reduction in the degree of uncertainty of film production. We revisited the literature to contribute to three relevant issues in classifying films according to economic success. First, we explored the differences between the results of the shortest or longest samples in terms of time to study possible changes in patterns of consumption mainly due to technological changes and between total and wide-released films. Second, we used profits free of price inflation as measures of economic success instead of the usual box office nominal revenues. Third, we employed a smaller set of features, only the ones available at the time of production, to help producers maneuver contingencies since little or nothing can be done by the time a film is in the theaters. We followed the literature to choose the classifiers - Random Forest, Support Vector Machine, and Neural Network - and designed sub-datasets to model and compare the performance of our results. Our dataset includes all films with budgets disclosed at the Box Office Mojo website, resulting in 3167 movies released at theaters worldwide between 1980 and 2019. The Random Forest results outperform previous similar studies with different sampling in time, including results for a less usual larger sample, with the best data sample about 97% both in accuracy and F1-score. Supplementary Information: The online version contains supplementary material available at 10.1007/s11042-023-15169-4.

Association of Iron Supplementation Programs with Iron-Deficiency Anemia Outcomes among Children in Brazil.

Anemia remains a condition with high prevalence in populations worldwide, and the prevalence of anemia among children under five years old in Brazil is approximately 40%, being higher in communities marked by social inequities. Diverse government programs during recent decades targeted iron-deficiency anemia, considering its impacts throughout the lifetime. The objective of this study was to investigate the effects of two government iron supplementation programs on health outcomes related to iron-deficiency anemia among children up to 4 years old in Brazilian municipalities. A longitudinal panel encompassing data from 5570 municipalities from 1998 to 2019 was investigated using a difference-in-differences framework with multiple interventions and distinct times of adhesion, and fixed-effects models were estimated to control for invariant municipal characteristics throughout the period in order to ensure comparability. The results indicate significant effects of the federal programs in reducing hospitalizations and lengths of stay due to iron-deficiency anemia, especially in non-poor municipalities. There was complementarity in the effects of the programs; however, neither of the programs influenced mortality rates. Thus, it is important to consider possible improvements in the operationalization of the programs, in order to achieve better results in the reduction of severe iron-deficiency anemia among children up to 4 years old.

Association between selected individual and environmental characteristics in relation to health behavior of Brazilian adolescents.

OBJECTIVE: The study investigates the evolution of healthy behaviors (healthy eating and regular physical activity) in Brazilian adolescents during 2012 and 2015, and its associations with self-assessment of body weight and adoption of weight control attitudes, in the context of diverse household features, school environments, and regional characteristics. METHODS: Two cross-sectional surveys of Brazilian adolescents attending the ninth grade in 2012 and 2015 were gathered comprising a national sample. Data from 209,601 completed surveys were analyzed using robust error estimates of ordinary least squares regressions. RESULTS: Results showed that there was a decrease in the frequency of healthy foods consumption and recommended physical activity level between 2012 and 2015. The regression analyses revealed that healthy eating and physical activity were significantly higher for adolescents with normal weight perception (i.e., did not perceive themselves to have either low or excess body weight) and for adolescents who were male, were members of middle socioeconomic stratum families, and had mothers with college degrees. In addition, healthy eating was significantly higher for adolescents who did not wish to lose weight, did not watch TV while eating, went to public schools, and lived with both parents. Ethnic differences varied based on region, with healthy eating being significantly higher among black/mulato/indigenous adolescents in the South and Southeast regions, but significantly higher among white/yellow adolescents in the North region. CONCLUSIONS: Ethnic and gender-related differences were identified in health behaviors and attitudes towards weight control of Brazilian adolescents. Findings indicate the relevance of individual characteristics combined with the influence of social networks for the adoption of healthy behaviors among adolescent students. LEVEL OF EVIDENCE: Level IV, evidence obtained from multiple time series without intervention.

An economic investigation of the dengue incidence as a result of a tailings dam accident in Brazil.

On November 2015, the Fundão Tailings Dam, located at Mariana municipality in Brazil, failed. Besides the deaths and injuries, economic losses, pollution and health problems associated to heavy metals in the water, Brazilian municipalities near the accident experienced an increase in the incidence of dengue. Since dengue fever is an insect-borne disease and the mosquito develops where there is stored water, there must be a relationship between the dam accident and the incidence of the disease. The purpose of this study is to test whether there is a causal relationship between the dam accident in Mariana and the number of dengue cases, number of hospitalizations due to dengue, and dengue outbreak in the municipalities affected by the accident. We find evidence that the accident had a positive and statistically significant impact on dengue indicators (for example, the probability of a dengue outbreak increased in 19%), what makes us call attention to another negative externality of tailings dam accidents.

Trends in child labor and the impact on health in adulthood in Brazil from 1998 to 2008.

There is little evidence in Brazil on the impact of child labor on health status in adulthood. This study aimed to investigate trends in child labor in Brazil and estimate the long-term effects of child labor on the health of Brazilian adults, using nationally representative databases (Brazilian National Household Sample Survey) from three different years (1998, 2003, and 2008). The models were based on a two-stage linear equation and Generalized Method of Moments (GMM). The results suggest that child labor has declined in Brazil, although the data still show patterns of early entry into the country's labor market. Regardless of the type of work, child labor adversely affected health outcomes in adulthood, both directly (impacts on health outcomes) and indirectly (losses in educational attainment). Child labor places a long-term burden on Brazilians, jeopardizing the formation of human capital through negative impacts on health outcomes in adulthood.

Trends in child labor and the impact on health in adulthood in Brazil from 1998 to 2008 / Evolução e impacto do trabalho infantil na saúde de indivíduos adultos no Brasil entre 1998 e 2008 / Evolución e impacto del trabajo infantil en la salud de los individuos adultos en Brasil entre 1998 y 2008

There is little evidence in Brazil on the impact of child labor on health status in adulthood. This study aimed to investigate trends in child labor in Brazil and estimate the long-term effects of child labor on the health of Brazilian adults, using nationally representative databases (Brazilian National Household Sample Survey) from three different years (1998, 2003, and 2008). The models were based on a two-stage linear equation and Generalized Method of Moments (GMM). The results suggest that child labor has declined in Brazil, although the data still show patterns of early entry into the country’s labor market. Regardless of the type of work, child labor adversely affected health outcomes in adulthood, both directly (impacts on health outcomes) and indirectly (losses in educational attainment). Child labor places a long-term burden on Brazilians, jeopardizing the formation of human capital through negative impacts on health outcomes in adulthood.

Há escassez de evidências quanto ao impacto do trabalho infantil na saúde do adulto no Brasil. O objetivo do presente artigo é analisar a evolução do trabalho infantil no Brasil e estimar seus efeitos de longo prazo no estado de saúde dos brasileiros em idade adulta, utilizando bases de dados representativas da população nacional (Pesquisa Nacional por Amostra de Domicílios) em três períodos (1998, 2003 e 2008). Os modelos estimados foram baseados em equações lineares em dois estágios e método dos momentos generalizado (GMM). Os resultados obtidos indicam declínio da prevalência de trabalho infantil no Brasil, embora os dados analisados ainda apresentem padrões de ingresso precoce no mercado de trabalho brasileiro. O trabalho infantil, independentemente da atividade, teve influência negativa em indicadores de saúde de adultos, direta (impacto em saúde) e indiretamente (perda de anos de estudos). Assim, o trabalho infantil impõe um prejuízo em longo prazo à população no Brasil, influenciando adversamente a formação de capital humano via impactos negativos em saúde na fase adulta.

Hay escasez de evidencias en cuanto al impacto del trabajo infantil en la salud del adulto en Brasil. El objetivo del artículo es investigar la evolución del trabajo infantil en Brasil y estimar sus efectos de largo plazo en el estado de salud de los brasileños en edad adulta, utilizando bases de datos representativas de la población nacional (Encuesta Nacional por Muestra de Domicilios) en tres períodos (1998, 2003 y 2008). Los modelos estimados se basaron en ecuaciones lineales en dos etapas y método de los momentos generalizado (GMM). Los resultados obtenidos indican una reducción de la prevalencia del trabajo infantil en Brasil, aunque los datos analizados aún presenten padrones de ingreso prematuro en el mercado de trabajo brasileño. El trabajo infantil, independientemente de la actividad, presentó efecto negativo en la salud adulta, directa (impacto en salud) y indirectamente (pérdida de años de estudio). Así, impone un prejuicio a largo plazo a la población brasileña, influyendo adversamente en la formación de capital humano por los impactos negativos de salud en la edad adulta.

Análise de eficiência técnica em saúde entre 1999 e 2006 / Analysis of technical efficiency in health systems between 1999 and 2006 / Análisis de eficiencia técnica en los sistemas de salud entre 1999 y 2006

O objetivo deste estudo é avaliar a eficiência técnica produtiva dos gastos do governo brasileiro com a saúde, comparando o Brasil aos demais países no período entre 1999 e 2006, a partir de dados de 185 países provenientes do Banco Mundial. Para esta finalidade foi utilizado o método de Fronteira Estocástica (FE) de produção em painel, com e sem controle de ineficiências. Indicadores de saúde foram utilizados como produtos e os gastos públicos com tais bens como insumos, com outras variáveis de controle. Os resultados mostram que o Brasil pode melhorar sua eficiência produtiva em saúde por meio da melhoria da gestão de seus recursos produtivos.

The aim of this study is to evaluate the technical efficiency of Brazil government spending on health for the period between 1999 and 2006, regarding the efficiency of spending by other countries to produce health goods. For this purpose we estimated a stochastic frontier of production in panel, with and without control for the inefficiency, using all countries with information available by the World Bank over the period analyzed. Selected indicators of health and education were used as product and public spending on such goods were used as inputs, along with other relevant inputs. The results show that Brazil needs to improve its production efficiency in health goods through better management of their productive resources.

El objetivo de este estudio es evaluar la eficiencia técnica de producción del gasto del gobierno brasileño en salud en relación a otros países para el período comprendido entre 1999 y 2006, sobre la base de datos de 185 países del Banco Mundial. Para ello se utilizó el método del panel de frontera de producción estocástica, con y sin control de las ineficiencias. Los indicadores de salud fueron utilizados como medida de producto y el gasto público en bienes tales fueron utilizados como insumos, junto con otras variables de control. Los resultados muestran que Brasil puede mejorar su eficiencia de producción en salud a través de una mejor gestión de sus recursos.

A comparative analysis of outpatient costs in HIV treatment programs.

OBJECTIVE: To analyze the costs of human immunodeficiency virus (HIV) outpatient treatment for individuals with different CD4 cell counts in the Brazilian public health system, and to compare to costs in other national health systems. METHODS: A retrospective survey was conducted in five public outpatient clinics of the Brazilian national HIV program in the city of São Paulo. Data on healthcare services provided for a period of one year of HIV outpatient treatment were gathered from randomly selected medical records. Prices of inputs used were obtained through market research and public sector databases. Information on costs of HIV outpatient treatment in other national health systems were gathered from the literature. Annual costs of HIV outpatient treatment from each country were converted into 2010 U.S. dollars. RESULTS: Annual cost of HIV outpatient treatment for the Brazilian national public program was US$ 2,572.92 in 2006 in São Paulo, ranging from US$ 1,726.19 for patients with CD4 cell count > 500 to US$ 3,693.28 for patients with 51 < CD4 cell count < 200. Antiretrovirals (ARVs) represented approximately 62.0% of annual HIV outpatient costs. Comparing among different health systems during the same period, HIV outpatient treatment presented higher costs in countries where HIV treatment is provided by the private sector. CONCLUSION: The main cost drivers of HIV outpatient treatment in different health systems were: ARVs, other medications, health professional services, and diagnostic exams. Nevertheless, the magnitude of cost drivers varied among HIV outpatient treatment programs due to health system efficiency. The data presented may be a valuable tool for public policy evaluation of HIV treatment programs worldwide.

A comparative analysis of outpatient costs in HIV treatment programs / Análise comparativa dos custos ambulatoriais em programas de tratamento de pacientes HIV

OBJECTIVE: To analyze the costs of human immunodeficiency virus (HIV) outpatient treatment for individuals with different CD4 cell counts in the Brazilian public health system, and to compare to costs in other national health systems. METHODS: A retrospective survey was conducted in five public outpatient clinics of the Brazilian national HIV program in the city of São Paulo. Data on healthcare services provided for a period of one year of HIV outpatient treatment were gathered from randomly selected medical records. Prices of inputs used were obtained through market research and public sector databases. Information on costs of HIV outpatient treatment in other national health systems were gathered from the literature. Annual costs of HIV outpatient treatment from each country were converted into 2010 U.S. dollars. RESULTS: Annual cost of HIV outpatient treatment for the Brazilian national public program was US$ 2,572.92 in 2006 in São Paulo, ranging from US$ 1,726.19 for patients with CD4 cell count > 500 to US$ 3,693.28 for patients with 51 < CD4 cell count < 200. Antiretrovirals (ARVs) represented approximately 62.0% of annual HIV outpatient costs. Comparing among different health systems during the same period, HIV outpatient treatment presented higher costs in countries where HIV treatment is provided by the private sector. CONCLUSION: The main cost drivers of HIV outpatient treatment in different health systems were: ARVs, other medications, health professional services, and diagnostic exams. Nevertheless, the magnitude of cost drivers varied among HIV outpatient treatment programs due to health system efficiency. The data presented may be a valuable tool for public policy evaluation of HIV treatment programs worldwide.

OBJETIVO: Analisar custos de tratamento ambulatorial de pacientes portadores do vírus da imunodeficiência humana (HIV) com diferentes níveis de CD4 no sistema público de saúde brasileiro e comparar aos custos de outros sistemas de saúde. MÉTODOS: Foi conduzida pesquisa retrospectiva em cinco ambulatórios especializados do programa DST/AIDS no município de São Paulo. Dados referentes à assistência ambulatorial para tratamento de pacientes HIV durante um ano foram obtidos em prontuários médicos selecionados aleatoriamente. Preços dos recursos utilizados foram obtidos via pesquisa de mercado e bancos de dados do setor público. Informações sobre custos do tratamento ambulatorial de pacientes HIV em outros sistemas de saúde foram obtidos na literatura. Os custos anuais de tratamento ambulatorial de pacientes HIV em cada país foram convertidos em dólares norte-americanos no ano base 2010. RESULTADOS: O custo anual de tratamento ambulatorial para pacientes HIV no programa público nacional foi US$ 2.572,92 em 2006 no município de São Paulo, variando entre US$ 1.726,19 para pacientes com CD4 > 500 e US$ 3.693,28 para pacientes com 51 < CD4 < 200. Medicamentos antirretrovirais (ARVs) representaram aproximadamente 62,0% dos custos de tratamento ambulatorial de pacientes HIV. Comparando-se custos entre diferentes sistemas de saúde no mesmo período, o tratamento ambulatorial de pacientes HIV apresentou custos superiores nos países onde a provisão do tratamento é realizada pelo setor privado. CONCLUSÃO: Os principais determinantes dos custos de tratamento ambulatorial de pacientes HIV são: medicamentos ARVs, outros medicamentos, profissionais de saúde e exames diagnósticos. No entanto, a magnitude de participação dos determinantes de custos nos programas de tratamento ambulatorial de pacientes HIV varia em decorrência da eficiência do sistema de saúde. Os dados apresentados constituem importante instrumento para avaliação de políticas públicas de saúde relacionadas ao tratamento de pacientes HIV mundialmente.

Consumo de serviços médicos e marco regulatório no mercado de seguro de saúde brasileiro / Consumption of medical services and the regulatory framework in the Brazilian market for health insurance

O objetivo deste artigo é investigar se a Lei no 9.656/1998, que estabeleceu um novo marco regulatório do mercado brasileiro de seguro privado de saúde, afetou o comportamento dos portadores de seguros/planos privados de saúde em relação ao consumo de bens de saúde. Em termos mais específicos, investigamos se houve aumento do consumo de bens médicos, o que poderia sugerir intensificação do comportamento de risco moral, uma vez que a lei estabeleceu garantias mínimas aos segurados. A literatura sobre o tema apresenta evidências de sólida conexão entre risco moral e consumo de serviços médicos por segurados de saúde. Sob a hipótese de que a aprovação da nova lei representa um evento exógeno, o uso do estimador de diferenças-em-diferenças (DD) permite investigar se houve mudança de comportamento dos segurados em relação ao consumo de serviços médicos. Para esta finalidade, foram utilizadas as Pesquisas Nacionais por Amostra de Domicílios (PNADs) de 1998 e 2003, que contêm informações suplementares de saúde. Dois resultados principais são evidenciados: por um lado, verifica-se que os segurados consomem uma quantidade maior de bens médicos que os não segurados nos intervalos de tempo investigados, em conformidade com a literatura; por outro, a nova legislação teve efeito nulo sobre o consumo de serviços médicos