Association between bullying victimization and health risk behavior in adolescents / Associação entre vitimização de bullying e comportamentos de risco à saúde em adolescentes

ABSTRACT Objective: The aim of this study was to examine the association between bullying victimization and health risk behaviors in adolescents. Methods: A representative sample of 1020 adolescents participated in the study. The variables such as bullying, health risk behaviors (tobacco, drugs, alcohol, sedentary behavior, smartphone use, level of physical activity, and sleep), and economic status were assessed using self-reported questionnaires. Odds ratios with 95% confidence intervals (95%CI) were obtained using binary logistic regression and ordinal, gross, and adjusted logistic regression (p<0.05). Results: Victims of bullying were more likely to smoke (OR 1.75; 95%CI 1.28-2.40), consume alcohol (OR1.43; 95%CI 1.05-1.94), have worse sleep quality (OR 1.94; 95%CI 1.28-2.91), and more sedentary behavior (OR 1.43; 95%CI 1.08-1.89) than those who were not bullied. However, victims were more likely to have high levels of physical activity than their non-bullied peers (OR 1.66; 95%CI 1.22-2.27). Conclusions: Bullying victimization was associated with an increased predisposition for the adoption of health risk behaviors. Interestingly, victims were also more prone to participate in physical activity.

RESUMO Objetivo: Examinar a associação entre vitimização por bullying e comportamentos de risco à saúde em adolescentes. Métodos: Uma amostra representativa de 1.020 adolescentes participou do estudo. As variáveis bullying, comportamentos de risco à saúde (tabaco, drogas, álcool, comportamento sedentário, uso de smartphone, nível de atividade física, sono) e situação econômica foram avaliadas por meio de questionários autorreportados. Razões de chance com intervalos de confiança de 95% (IC95%) foram obtidas por meio de regressão logística binária e regressão logística ordinal, bruta e ajustada (p<0,05). Resultados: As vítimas de bullying apresentaram maior probabilidade de fumar (OR 1,75; IC95% 1,28-2,40), consumir álcool (OR 1,43; IC95% 1,05-1,94), ter pior qualidade de sono (OR 1,94; IC95% 1,28-2,91) e apresentar mais comportamento sedentário (OR 1,43; IC95% 1,08-1,89) do que aqueles que não sofreram bullying. No entanto, as vítimas eram mais propensas a ter níveis elevados de atividade física do que os seus pares não vítimas de bullying (OR 1,66; IC95% 1,22-2,27). Conclusões: A vitimização por bullying esteve associada ao aumento da predisposição para a adoção de comportamentos de risco à saúde. Curiosamente, as vítimas também eram mais propensas a participar de atividades físicas.

Programa de controle do tabagismo em Mato Grosso do Sul: oferta, adesão e efetividade / Smoking control program in Mato Grosso do Sul: offer, adherence and effectiveness / Programa de control del tabaquismo en Mato Grosso do Sul: oferta, adherencia y efectividad

Objetivo: O estudo teve por objetivo avaliar o Programa Nacional de Controle do Tabagismo (PNCT) em Mato Grosso do Sul, taxas de cobertura, abandono, cessação, uso de medicamentos, rede de serviços de saúde e as razões pelas quais algumas Equipes de Saúde da Família de Campo Grande ainda não aderiram ao programa. Métodos: Trata-se de uma pesquisa descritiva, com abordagem quantitativa, baseada em dados primários e secundários sobre o PNCT em Mato Grosso do Sul. Os dados primários foram obtidos por meio de questionário aplicado aos profissionais das Equipes de Saúde da Família (ESF) de Campo Grande, sem oferta do programa e avaliados quanto à frequência e presença de correlação entre as variáveis analisadas utilizando V de Cramer e teste de χ2. Os dados secundários foram obtidos do consolidado do Instituto Nacional de Câncer José Alencar Gomes da Silva com os registros produzidos pelos serviços. Resultados: As taxas de adesão, efetividade e apoio farmacológico na capital e interior foram: 66,80 e 59,79%; 20,58 e 34,91%; 32,14 e 99,86%, respectivamente. A oferta do programa ocorreu em 49,37% municípios e 43,85% das Unidades Básicas de Saúde (UBS) estimadas. Houve correlações entre ser capacitado e implantar o programa; treinamento de ingresso e oferta na UBS. As dificuldades relatadas pelos profissionais foram a pandemia de COVID-19, a sobrecarga e/ou equipe pequena e/ou falta de tempo e a ausência de capacitação/treinamento. Conclusões: O PNCT em Mato Grosso do Sul apresenta baixa cobertura e oferta restrita na rede de saúde, além do desempenho mediano de assistência aos tabagistas. Evidencia-se a necessidade de investimento em capacitação/treinamento, prioritariamente para as ESF de Campo Grande, dando-lhes condições de responder às necessidades de promoção da saúde, reconhecendo o programa como de maior custo-efetividade.

Objective: The objective of this study was to evaluate the National Tobacco Control Program (PNCT) in Mato Grosso do Sul, coverage rates, dropout, cessation, use of medication, the health services network and the reasons why Family Health Teams in Campo Grande have not yet joined the program. Methods: This was a descriptive study with a quantitative approach, based on primary and secondary data on the PNCT in Mato Grosso do Sul. The primary data were obtained by means of a questionnaire administered to Family Health Teams (ESF) in Campo Grande, which did not offer the program and evaluated the frequency and presence of correlation between the variables analyzed using Cramer's V test and the χ2 test. The secondary data were obtained from the consolidated records of the José Alencar Gomes da Silva National Cancer Institute with the records produced by the services. Results: The rates of adherence, effectiveness and pharmacological support in the capital and interior were: 66.80 and 59.79%; 20.58 and 34.91%; and 32.14 and 99.86%, respectively. The program was offered in 49.37% of the municipalities and 43.85% of the Basic Health Units (UBS) estimated. There were correlations between being trained and implementing the program and entry training and provision in the UBS. The difficulties reported by professionals were the COVID-19 pandemic, overload and/or a small team and/or lack of time and the absence of training. Conclusions: The PNCT in Mato Grosso do Sul has low coverage and restricted supply in the health network, in addition to average performance in assisting smokers. There is a clear need to invest in capacitation/training, primarily for the ESF in Campo Grande, enabling them to respond to the needs of health promotion, recognizing the program as more cost-effective.

Objetivo: El objetivo de este estudio fue evaluar el Programa Nacional de Control del Tabaco (PNCT) en Mato Grosso do Sul, las tasas de cobertura, el abandono, la cesación, el uso de medicamentos, la red de servicios de salud y las razones por las que los Equipos de Salud de la Familia en Campo Grande aún no se han unido al programa. Métodos: Se trata de un estudio descriptivo con abordaje cuantitativo, basado en datos primarios y secundarios sobre el PNCT en Mato Grosso do Sul. Los datos primarios se obtuvieron por medio de un cuestionario aplicado a los Equipos de Salud de la Familia (ESF) de Campo Grande, que no ofrecían el programa y evaluaron la frecuencia y la presencia de correlación entre las variables analizadas utilizando la V de Cramer y la prueba de la χ2. Los datos secundarios se obtuvieron de los registros consolidados del Instituto Nacional del Cáncer José Alencar Gomes da Silva con los registros producidos por los servicios. Resultados: Las tasas de adherencia, eficacia y apoyo farmacológico en la capital y en el interior fueron: 66,80 y 59,79%; 20,58 y 34,91%; 32,14 y 99,86%, respectivamente. El programa fue ofrecido en el 49,37% de los municipios y en el 43,85% de las Unidades Básicas de Salud (UBS) estimadas. Hubo correlación entre estar capacitado e implementar el programa; capacitación de entrada y oferta en las UBS. Las dificultades relatadas por los profesionales fueron la pandemia del COVID-19, la sobrecarga y/o un equipo pequeño y/o la falta de tiempo y la ausencia de capacitación. Conclusiones: El PNCT en Mato Grosso do Sul tiene baja cobertura y oferta restringida en la red de salud, además de un desempeño medio en la asistencia a los fumadores. Hay una clara necesidad de invertir en la creación de capacidad / formación, principalmente para la ESF en Campo Grande, lo que les permite responder a las necesidades de promoción de la salud, reconociendo el programa como más rentable.

Prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros / Smoking prevalence and lung cancer morbimortality in Brazilian states / Prevalencia del tabaquismo y morbimortalidad por cáncer de pulmón en los estados brasileños

Introdução: O câncer de pulmão é uma doença grave, sendo a segunda maior causa de morte em todo o mundo, entretanto, em alguns países desenvolvidos, tornou-se já a primeira causa de morte. Cerca de 90% dos casos de neoplasia pulmonares são causados pela inalação da fumaça do cigarro. Objetivo: Correlacionar a prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros, além de demonstrar a associação destes com sexo e faixa etária. Métodos: Estudo de caráter ecológico acerca da prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros, nos períodos de 2013 e 2019, dividida por sexo e faixa etária. Foram utilizados bancos de coleta de dados como o Tabnet e Pesquisa Nacional de Saúde. Resultados: As maiores taxas de mortalidade e internações hospitalares foram do público masculino, em 2013, com taxa de 2,7 e 10, respectivamente, e em 2019 com 3,3 e 11,9, respectivamente. Ademais, a maior prevalência de tabagismo foi encontrada nos homens; entretanto seu índice tem caído, enquanto a quantidade de mulheres tabagistas tem aumentado. A Região Sul demonstrou maiores números de mortalidade em ambos os períodos estudados, com taxas de 4,9 e 5,8 por 100 mil habitantes, e morbidade hospitalar com 19,9 e 23,5 por 100 mil habitantes. Já a Região Norte se configurou com as menores prevalências: em 2013 apresentou taxa de óbito por câncer de pulmão de 1,0 e morbidade hospitalar de 3,5/100 mil habitantes, em 2019 apresentou taxa de mortalidade de 4,6 e internações de 1,6/100 mil habitantes. Os coeficientes de correlação de morbidade hospitalar e prevalência de tabagismo foram R2=0,0628, r=0,251 e p=0,042, enquanto os de mortalidade e prevalência de tabagismo foram R2=0,0337, r=0,183 e p=0,140. Conclusões: Na presente pesquisa, pode-se inferir que houve associação positiva na comparação entre taxa de morbidade hospitalar e prevalência de tabagismo; em contrapartida, não foi possível observar associação positiva na correlação da taxa de mortalidade por câncer de pulmão e prevalência de tabagismo.

Introduction: Lung cancer is a serious disease, being the second leading cause of death worldwide. Moreover, in some developed countries, it has already become the leading cause of death. About 90% of lung cancer cases are caused by cigarette smoking. Objective: To correlate the prevalence of smoking and lung cancer morbidity and mortality in Brazilian states, and to demonstrate their association with sex and age group as well. Methods: An ecological study on the prevalence of smoking and lung cancer morbidity and mortality in Brazilian states between 2013 and 2019, divided by sex and age group. The data collection databases Tabnet and National Health Survey were used. Results: The highest rates of mortality and hospital admissions were among men, in 2013 with a rate of 2.7 and 10, respectively, and in 2019 with 3.3 and 11.9, respectively. In addition, the highest prevalence of smoking was found in men, but this rate has fallen, while the number of women smokers has increased. The South region showed higher mortality rates in both periods studied, with rates of 4.9 and 5.8 per 100,000 inhabitants, and hospital morbidity with 19.9 and 23.5 per 100,000 inhabitants. The North region had the lowest prevalence, where in 2013, it had a death rate from lung cancer of 1.0 and hospital morbidity of 3.5/100 thousand inhabitants, and where in 2019, it had a mortality rate of 4.6 and hospitalizations of 1.6/100 thousand inhabitants. The correlation coefficients for hospital morbidity and smoking prevalence were R2=0.0628, r=0.251 and p=0.042, while for mortality and smoking prevalence, these were R2=0.0337, r=0.183 and p=0.140. Conclusions: In the present study, it can be inferred that there was a positive association between hospital morbidity rate and prevalence of smoking, while it was not possible to observe a correlation between lung cancer mortality rate and prevalence of smoking.

Introducción: El cáncer de pulmón es una enfermedad grave, siendo la segunda causa de muerte en todo el mundo, sin embargo, en algunos países desarrollados, ya se ha convertido en la primera causa de muerte. Alrededor del 90% de los casos de neoplasias pulmonares están causados por la inhalación del humo del cigarrillo. Objetivo: Correlacionar la prevalencia de tabaquismo y la morbimortalidad por cáncer de pulmón en los estados brasileños, además de demostrar la asociación de estos con el género y el grupo de edad. Métodos: estudio ecológico sobre la prevalencia de tabaquismo y morbimortalidad por cáncer de pulmón en los estados brasileños, dentro de los períodos 2013 y 2019, divididos por sexo y grupo de edad. Se utilizaron bancos de recogida de datos como Tabnet y la Encuesta Nacional de Salud. Resultados: las mayores tasas de mortalidad e ingresos hospitalarios se dieron en el público masculino, en 2013 con una tasa de 2,7 y 10, respectivamente, y en 2019 con 3,3 y 11,9, respectivamente. Además, la mayor prevalencia del tabaquismo se encontró en los hombres, sin embargo, su tasa ha disminuido, mientras que la cantidad de mujeres fumadoras ha aumentado. La región Sur presentó cifras más altas de mortalidad en ambos periodos estudiados, con tasas de 4,9 y 5,8 por 100.000 habitantes, y de morbilidad hospitalaria con 19,9 y 23,5 por 100.000 habitantes. Mientras que la región Norte se configuró con las prevalencias más bajas, en 2013 presentó una tasa de mortalidad por cáncer de pulmón de 1,0 y una morbilidad hospitalaria de 3,5/100.000 habitantes, en 2019 presentó una tasa de mortalidad de 4,6 y hospitalizaciones de 1,6/100.000 habitantes. Los coeficientes de correlación para la morbilidad hospitalaria y la prevalencia del tabaquismo fueron R2=0,0628, r=0,251 y p=0,042, mientras que para la mortalidad y la prevalencia del tabaquismo fueron R2=0,0337, r=0,183 y p=0,140. Conclusiones: En la presente investigación se puede inferir que existe una asociación positiva en la comparación entre la tasa de morbilidad hospitalaria y la prevalencia de tabagismo, en contrapartida, no fue posible observar una asociación positiva en la correlación de la tasa de mortalidad por cáncer de pulmón y la prevalencia de tabagismo.

Representation and practices of Electronic Nicotine Delivery System consumption in the university population of Bogotá(Colombia) / Representación social y prácticas de consumo de sistemas electrónicos de administración de nicotina en población universitaria de bogotá (colombia)

RESUMEN Objetivo: Colombia cuenta con una legislación de control del tabaco desde 2009 sin embargo, no existe una regulación específica sobre los Sistemas Electrónicos de Administración de Nicotina (SEAN), por lo tanto, es vital caracterizar las dimensiones cualitativas de consumo. El objetivo de este estudio fue identificar las prácticas y representaciones de los consumidores de SEAN con el fin de obtener elementos para orientar las acciones necesarias para prevenir su consumo. Materiales y métodos: Este artículo presenta los resultados identificados en el componente cualitativo de una investigación macro sobre la prevalencia del uso de SEAN entre estudiantes universitarios. Se realizaron 14 entrevistas individuales y 1 grupo focal, analizados con el software NVivo10®. Resultados: Se presentan como resultados principales la identificación de las prácticas de consumo, de las cuales se derivó que el núcleo central de la representación social sobre SEAN es no autónomo, lo que posibilita un cambio que desincentive su consumo; el sistema periférico de la representación está conformado por tres elementos: la dimensión social, el consumo de SEAN como estilo de vida y la dimensión corporal y emocional. Conclusiones: Se concluye que las acciones de prevención de consumo de SEAN deben partir de la identificación de características particulares y exclusivas del consumo de SEAN y la incorporación de los elementos del sistema periférico que permitan abordar un consumo que no se basa en la toma de decisiones informadas.

ABSTRACT Objective: Colombia has had a tobacco control legislation since 2009, however there is no specific regulation on Electronic Nicotine Delivery Systems (ENDS). Therefore, it is crucial to characterize the qualitative dimensions of consumption. The study aimed to answer the question: What are the representations and practices of the university population regarding the consumption of SEAN? The objective of the study is to identify the practices and representations of ENDS consumers in order to obtain elements to guide the necessary actions to prevent their consumption. Methods: This paper presents the results identified in the qualitative component of a main study on the prevalence of ENDS use among university students. 14 individual interviews and 1 focus group were conducted and analyzed with the NVivo10® software. The corpus consisted of the transcripts of the 14 interviews and 1 focus group, which constitutes a total of 116 pages of raw data. The techniques used were semi-structured interviews and focus groups, using the Microsoft Teams platform. Taking into account ethical aspects, in each interview and in the focus group the informed consent was read and authorization was requested for the interview to be recorded. The average duration of each interview was one hour and forty-five minutes and the focus group lasted a total of 120 minutes. The capture of practices and representation related to the use/non-use of SEAN was achieved by incorporating two phases of analysis: a)Inductivephase: it was developed with an ordered matrix on the theoretical categories of the project, b)Phase of deductive analysis was carried out based on processes typical of the founded theory that allowed expanding the analytical framework having as its axis the identification of consumption practices and the elements that make up the central core and the peripheral system of representation. Results: The main results are the identification of consumption practices, from which it was derived that the central nucleus of the social representation of SEAN is non-autonomous, which enables a change that discourages its consumption. The reasons and practices for consuming ENDS are closely related to conventional cigarette consumption, which corresponds to the fact that 11 of the 14 interviewees who identify themselves as consumers have consumed conventional cigarettes and only two have been exclusive ENDS consumers. The following practices were identified: a) The consumption motivations were grouped like social, economic and socio-emotional; b) Three types of consumption spaces: prohibited, exclusive and recovered spaces. These last ones are places where you couldn't smoke cigarettes and now they feel empowered to vape; c) There are forms of differential consumption and access to ENDS related to the quality, price, exclusivity and adherence; d) Habits and rituals are not related to moments of daily life, as with cigarettes, but to practices such as searching for and mixing "salts" to obtain flavors, cleaning and maintaining the device, smoking tricks; e) About information channels among the interviewees it was noted that the practice of informed consumption is not frequent and that there are few sources of information that offer low confidence. Finally, the peripheral system of representation is made up of three elements: social dimension, the consumption of SEAN as a lifestyle, bodied and emotional dimension. Conclusion : It is concluded that the actions to prevent the consumption of ENDS should start from the identification of particular and exclusive characteristics of the consumption of ENDS and the incorporation of the elements of the peripheral system that allow addressing a consumption not based on making informed decisions. The main finding is the identification of a non-autonomous representation that stems from the difficulty of establishing notable differentiations between conventional cigarette consumption and e-cigarettes. Therefore, the main vein of research that opens up is to delve into the particular and exclusive characteristics of this consumption. It is essential to incorporate bodily, emotional, and especially social (interpersonal) dimensions as important variables in understanding the practices and representations of e-cigarettes through complex approaches that can break the solid elements on which conventional cigarette consumption is anchored, as it continues to define dynamics of electronic device consumption. It is important at this point to recognize that emotions can be understood as the intermediary between the lived experience in the body and everything that happens in the environment. Thus, it is not possible to think of this representation without recognizing that consumption is an embodied exercise, and the absence of the body in discourses about e-cigarettes can be a revealing element of a disconnection between practices and meanings that are reinforced in the insistence on an action (smoking is smoking) despite the recognition of its negative effects on health (even though it should not be). The understanding of the social representation of e-cigarette consumption in relation to specific practices related to it provides some clues on which to work on processes of information, communication, prevention, and regulation to discourage this consumption that appears relatively new.

(Dis)satisfaction With Body Image, Lifestyles and Life Satisfaction in Higher Education Students / (In)satisfacción con la imagen corporal, estilos de vida y satisfacción con la vida en estudiantes de enseñanza superior

Abstract Objective: Body image is a predictor of physical, psychological, and social health. Therefore, it can be an indicator for detecting health problems, to be used in the context of higher education. The aim of this study was to assess body image satisfaction in higher education students and to determine whether body image dissatisfaction is related to lifestyle behaviours and life satisfaction. Methodology: This study included 166 Portuguese higher education students. Body image was assessed using the Figure Rating Scale. Active choices during everyday life were assessed using the Active Choice Index. The questionnaire also included questions about sleep behaviour and tobacco and alcohol consumption. Satisfaction with Life was assessed using a five-item scale previously adapted for the Portuguese population. Results: There was a predominance of boys dissatisfied with thinness (26.10%), while the majority of girls revealed that they were dissatisfied due to being overweight (55.70%). The results indicate statistically significant differences between boys and girls in terms of body image categories (p<0.001). However, when we analysed the behaviours separately according to gender, there were no differences. Active behaviours, as well as the other health behaviours analysed (hours of sleep per week and alcohol and tobacco consumption) did not differ between the different levels of body image satisfaction (p>0.05). Conclusion: Most of the students are dissatisfied with their body image, with the majority of girls showing dissatisfaction due to being overweight. Lifestyles and life satisfaction do not differ between students who are satisfied and those who are dissatisfied with their body image.

Resumen Objetivo: La imagen corporal es un factor predictivo de la salud psicológica, física y social. Por lo tanto, puede ser un indicador para detectar problemas de salud, para utilizar en el contexto de la educación superior. El objetivo de este estudio fue evaluar la satisfacción con la imagen corporal en estudiantes de enseñanza superior y determinar si la insatisfacción con la imagen corporal está relacionada con los comportamientos de estilo de vida y la satisfacción con la vida. Metodología: En este estudio participaron 166 estudiantes portugueses de enseñanza superior. La imagen corporal se evaluó mediante la escala Figure Rating Scale. Las elecciones activas durante la vida cotidiana se evaluaron mediante el Active Choice Index. El cuestionario también incluía preguntas sobre el comportamiento durante el sueño y el consumo de tabaco y alcohol. La satisfacción con la vida se evaluó mediante una escala de cinco ítems previamente adaptada a la población portuguesa. Resultados: Predominaron los chicos insatisfechos por delgadez (26.10%), mientras que la mayoría de las chicas revelaron estar insatisfechas por sobrepeso (55.70%). Los resultados indican diferencias estadísticamente significativas entre chicos y chicas en cuanto a las categorías de imagen corporal (p<0.001). Sin embargo, al analizar los comportamientos por separado en función del sexo, no se observaron diferencias. Las conductas activas, así como las demás conductas de salud analizadas (horas de sueño semanales y consumo de alcohol y tabaco) no difirieron entre los distintos niveles de satisfacción con la imagen corporal (p>0.05). Conclusiones: La mayoría de los estudiantes están insatisfechos con su imagen corporal, siendo mayoritaria la insatisfacción de las chicas por sobrepeso. Los estilos de vida y la satisfacción vital no difieren entre los alumnos satisfechos y los insatisfechos con su imagen corporal.

Prevention and Control of Noncommunicable Diseases and Mental Health Conditions in Peru: The Case for Investment

Noncommunicable diseases (NCDs) and mental disorders are the leading causes of morbidity and mortality in Peru. NCDs account for seven out of every 10 deaths in the country, and nearly half of all people who die from NCDs in Peru are under the age of 70. In addition to the burden they impose on health, these diseases represent a significant burden on the national economy: treating them is expensive and those who suffer from them are more likely to stop working, be absent from work, or work with reduced capacity. Moreover, this situation generates high social costs, since mental health is fundamental to personal well-being, relationships, and making a positive contribution to society. This investment case was conducted in collaboration with the Ministry of Health of Peru, the World Health Organization/Pan American Health Organization, and UNDP. It is intended to strengthen the country's capacity to generate economic evidence on NCDs and mental disorders and to develop, finance, and implement national prevention and control strategies across sectors. The calculated return on investment for the next 15 years is based on three groups of interventions: 1) policies to control tobacco, alcohol, and salt consumption; 2) measures to control cardiovascular disease and diabetes; and 3) expanded treatment of mental disorders, particularly depression, anxiety, and psychotic conditions. Although NCDs and mental disorders represent a considerable burden on health and the economy, this investment case shows that Peru can greatly reduce the burden if it implements the measures recommended by WHO to tackle these diseases more effectively.

Fermentation of Biomass and Residues from Brazilian Agriculture for 2G Bioethanol Production.

Brazil is one of the world's leading producers of staple foods and bioethanol. Lignocellulosic residual sources have been proposed as a promising feedstock for 2G bioethanol and to reduce competition between food and fuels. This work aims to discuss residual biomass from Brazilian agriculture as lignocellulosic feedstock for 2G bioethanol production as bagasse, stalk, stem, and peels, using biorefining concepts to increase ethanol yields. Herein, we focused on biomass chemical characteristics, pretreatment, microorganisms, and optimization of process parameters that define ethanol yields for bench-scale fermentation. Although several techniques, such as carbon capture, linking enzymes to supports, and a consortium of microorganisms, emerge as future alternatives in bioethanol synthesis, these technologies entail necessary optimization efforts before commercial availability. Overcoming these challenges is essential to linking technological innovation to synthesizing environmentally friendly fuels and searching other biomass wastes for 2G bioethanol to increase the biofuel industry's potential. Thus, this work is the first to discuss underutilized lignocellulosic feedstock from other agrifoods beyond sugar cane or corn, such as babassu, tobacco, cassava, orange, cotton, soybean, potatoes, and rice. Residual biomasses combined with optimized pretreatment and mixed fermentation increase hydrolysis efficiency, fermentation, and purification. Therefore, more than a product with a high added value, bioethanol synthesis from Brazilian residual biomass prevents waste production.

Global landscape of nicotine and tobacco products additives policies.

INTRODUCTION: Product design is a key tobacco industry strategy to recruit consumers and hinder cessation. An important technology in tobacco product design is the use of additives including those that create characterising flavours, that is, flavours that are perceived by taste and or smell by the user. To curb youth use, many countries are implementing policies to limit the use of flavours and other additives in tobacco products. This paper reviews the global landscape of tobacco additives policies including those focusing only on flavouring additives, updating a previous review. METHODS: We gathered additives policy data from available online sources of tobacco control policies including parties' reports to the WHO Framework Convention on Tobacco Control (where WHO refers to World Health Organization), the website Tobacco Control Laws, government websites, searches with the Google search engine and consultations with the WHO to ensure comprehensiveness of the assessment. The policies were classified according to their objective and characteristics: Labelling regulations, sales bans and tobacco product design regulations. We classified and organised the regulations according to their stated intent. RESULTS: We found that 62 countries had tobacco products' additives-related regulations at the regional, national or subnational levels. Most of these regulations focused on flavouring additives especially bans on the selling, importing and manufacturing tobacco products with characterising flavours. CONCLUSIONS: The data demonstrate various global policies addressing additives and/or flavours and a range of definitions of additives and flavours. Establishing common definitions and standards could facilitate cooperation between countries and regions.

Does waterpipe smoke induce genotoxicity (DNA damage) in mammalian cells in vivo? A systematic review.

The waterpipe works by placing tobacco in a bowl with holes at the bottom, which is connected to a tube leading to a water-filled container. Upon heating the tobacco product with hot charcoal placed atop it, the emanating smoke is inhaled by the user via a hose linked to the water receptacle. The aim of this literature review is to evaluate whether the use of waterpipes can indeed induce genotoxicity in mammalian cells in vivo. Additionally, the study aims to assess the quality of the included research articles on this topic to ensure the reliability of the findings. We performed comprehensive searches in PubMed, SCOPUS, and Web of Science to identify relevant articles published until July 2024. The findings confirmed that waterpipe smoke induces genetic damage. This assertion is supported by the fact that 11 studies (out of 15) received a Strong or Moderate assessment categorization, suggesting that the majority of studies adhered to most technical standards, thereby enhancing the reliability of the research findings. Regarding the types of DNA damage reported, DNA strand breaks, chromosome damage and oxidative DNA damage were found in this review. Taken together, this study holds significant importance in assessing the efficacy of genotoxicity assays in detecting DNA damage due to waterpipe smoke and the comet and micronucleus assays are suitable biomarkers for biomonitoring people who use waterpipe.

Visibility and availability of single cigarettes around schools in four Latin American countries.

INTRODUCTION: Single cigarette sales at tobacco-selling points of sale (POS) may promote smoking. We explored visibility and availability of single cigarettes in POS around schools in Argentina, Guatemala, Mexico and Peru, countries where their sale is banned. METHODS: Between April and July 2023, an observational study was conducted at POS around high schools in urban and rural areas in Argentina, Guatemala, Mexico and Peru. A sampling frame of schools was generated from public registries, with schools categorised according to their socioeconomic status and randomly selected within socioeconomic strata. A total of 2081 POS were surveyed based on their proximity to these randomly selected schools. Data were collected on the visibility of single cigarettes (any cigarette sticks or open cigarette packs on display and able to be seen by customers were coded as visible) and their availability (ie, whether singles were sold, whether visible or not). RESULTS: Single cigarettes were visible in 37.2% of POS and available in most (84.9%), with neighbourhood stores the primary source. In most (84.1%) POS with visible single cigarettes, they were displayed near candy or toys. Prices of the cheapest single cigarette sticks ranged from US$0.03 in Argentina to US$0.13 in Guatemala. CONCLUSION: The findings indicate widespread availability of single cigarettes in four Latin American countries where their sale is banned. The low price of single cigarettes, and their proximity to candy/toys, may increase the appeal of smoking to youth. Stricter enforcement of bans on single cigarettes, which may serve as a gateway to experimentation and continued smoking, is needed.

Modelo de simulación de impuestos al tabaco de OMS (TaXSiM) datos necesarios por país

El TaXSiM de la OMS es un modelo Excel independiente que permite a los usuarios evaluar el impacto de diferentes políticas y propuestas fiscales en el mercado del tabaco (precios al por menor, consumo, prevalencia de uso de tabaco e ingresos fiscales). El modelo surgió a partir del compromiso de la OMS con los Estados miembros y se diseñó para funcionar independientemente del nivel de detalle disponible sobre el mercado a nivel nacional. Sin embargo, sigue habiendo un conjunto mínimo de datos -como se indica a continuación- que permitirá que el modelo funcione con la mayor precisión.

Marine macrolitter and cigarette butts hazard multiple-use marine protected area and fishing community at Brazil.

Wide marine litter (ML) contamination impacts human health and economic sectors including fishing, navigation, and tourism. Perequê beach, Brazil, is an authentic fishing community within a touristic multiple-use marine protected area. However, no ML contamination monitoring were so far performed in the region. This study evaluated the spatiotemporal abundance, composition, sources, and associated ML hazards at Perequê beach using a multi-index approach. The 2579 items (0.64 ± 0.72 items.m-2) yielded a high contamination level (CCI = 12.6 ± 14.4) with plastic (44.6-50.9 %) and cigarette butts (20.6-28.4 %) prevalence, while primary sources were smoking (cigarette butts, lighters, others-21.2-30.1 %) and packaging (17.8-22.8 %). Levels of pollutants leaked from cigarette butts (CBPI = 30.5 ± 47.5) and hazardous items (HALI = 3.06 ± 2.64) were among the highest globally. Heightened levels occurred in summer, at dry sand strip, where short-term buoyant items prevailed. Multi-indexing approaches offer valuable insights for local authorities to implement mitigation programs, while contributing to global discussions, promoting awareness, and facilitating replicability.

Sense of coherence and substance use in adults: a systematic review and meta-analysis.

This study systematically reviews the evidence on the association between sense of coherence (SOC) and substance use during adulthood. Two researchers conducted independent literature searches on the PubMed, LILACS, PsycINFO and Web of Science databases. Original articles assessing SOC and substance use in adults (age > 19 years) were included. Two reviewers independently assessed studies in two phases - initially by reading the title/abstract, then the full text. Discrepancies were resolved by a third reviewer. Estimates were pooled using random-effects models. Bibliographic search identified 21 studies on the association between SOC and substance use in adults. Studies (n = 11) that assessed the association with tobacco smoking found a 0.92 (95%CI: 0.82; 1.01, very low degree of certainty) odds of smoking among those with a high SOC; the association was not modified by age. Individuals with a strong SOC had lower odds of using alcohol (pooled effect: OR = 0.70, 95%CI: 0.50; 0.90, very low degree of certainty); adjustment for confounding variables decreased the magnitude of the association (pooled OR = 0.89, 95%CI: 0.80; 0.98). This systematic review and meta-analysis suggests that a strong SOC protects against substance use among adults regardless of age, with practical implications for preventive interventions and tailored strategies aimed at high-risk individuals. Longitudinal studies are needed to understand the impact of SOC on substance use. Examining interactions with socioeconomic factors and including diverse populations would enhance generalizability.

Diet and sleep quality in chilean university students.

OBJECTIVES: To evaluate an association between eating patterns and sleep quality in Chilean university students. METHODS: A cross-sectional analytical study was conducted. Participants included students from 4 Chilean universities. Each student was administered survey Questionnaire on the frequency of healthy and unhealthy eating habits and Pittsburgh Sleep Quality Index and their weight and height were taken to obtain the Body Mass Index (BMI). RESULTS: A total of 1,079 young university students, 80.26 % were women and the average age was 21.7 years. The 73.68 % have inadequate sleep quality. There is a significant differences in frequency between sleep quality and the intake of breakfast (p<0.001), fish (p<0.05) and dinner (p<0.05), that is, university students who reported optimal sleep consume breakfast and dinner on a daily basis and their fish intake is in line with nutritional recommendations. With respect to the association between sleep quality and healthy dietary patterns, it is observed a significant association (p<0.01) between optimal sleep and daily breakfast consumption in model 3 (Odds Ratio (OR): 0.61 (0.46-0.82)). Regarding unhealthy dietary patterns, a significant association (p<0.05) is observed in model 3 between sleep quality and alcohol consumption (OR: 1.42 (1.02-1.96)). Furthermore, a significant association between optimal sleep and salt consumption is observed in both model 2 (OR: 0.73 (0.54-0.99)) and model 3 (OR: 0.72 (0.53-0.97)). Finally, a significant relationship between not tobacco use and optimal sleep is observed (OR: 0.68 (0.48-0.96)). CONCLUSION: A positive relationship between healthy diet and sleep quality was observed in university students, which certain dietary patterns, such as the consumption of breakfast and low salt consumption and alcohol, are crucial to talk about a good sleep quality in this population group.

Salivary biomarkers in non-invasive oral cancer diagnostics: a comprehensive review.

OBJECTIVE: This review aims to provide a comprehensive analysis of the effectiveness of saliva as a non-invasive diagnostic marker for oral cancer. Despite progress in oral cancer diagnosis and prognosis, the 5-year survival rate remains low due to the resistance to treatment and delayed diagnosis, which can be attributed to various factors including tobacco and alcohol consumption, genetic damage, and human papillomavirus (HPV). The potential use of saliva as an easily accessible non-invasive screening and diagnostic method arises from its direct contact with the lesion site. METHODOLOGY: Data for this study were gathered via a comprehensive literature evaluation using search engines such as the PubMed, Web of Science, Google Scholar, and SciFinder. RESULTS: Identifying salivary biomarkers shows potential to transform oral cancer diagnostics by offering a reliable alternative to the traditional invasive methods. Saliva is an abundant reservoir for both cell-bound and cell-free organic and inorganic constituents. Thus, saliva is an appropriate field for research in proteomics, genomics, metagenomics, and metabolomics. CONCLUSION: This review provides a comprehensive elucidation of salivary biomarkers and their function in non-invasive oral cancer diagnosis, demonstrating their potential to enhance patient outcomes and reduce the impact of this devastating disease.

Noncommunicable disease burden in Brazil and its states from 1990 to 2021, with projections for 2030.

OBJECTIVES: The aim of this study was to analyse the burden of disease due to noncommunicable diseases (NCDs) between 1990 and 2021 in Brazil. In addition, this study compared mortality from NCDs with mortality from all causes and COVID-19, analysed NCD mortality trends and projections for 2030, and analysed NCD mortality rates and risk factors attributed to these deaths among the 27 states of Brazil. STUDY DESIGN: Ecological studies. METHODS: This study used the Global Burden of Disease study (GBD) database from 1990 to 2021. Premature deaths from four NCDs (neoplasms, cardiovascular disease, chronic respiratory diseases and diabetes mellitus) were analysed. The following metrics were used to analyse the burden of NCDs in Brazil: absolute number of deaths, proportional mortality, mortality rate, years of life lost due to premature death (YLL), years lived with disabilities (YLD) and disability-adjusted years of life lost due to premature death (DALY). For comparison between the years studied and states, age-standardised rates were used. RESULTS: Finding from this study showed that there was increase in the proportion of premature deaths due to NCDs between 1990 and 2019 (29.4 % in 1990, 30.8 % in 2019), and a reduction in 2021 (24.7 %). The mortality rates, DALY and YLL from NCDs declined between 1990 and 2019 (-37.7 %, -34.5 % and -38.3 %, respectively); however, a stability in mortality rates, DALY, YLD, YLL was observed between 2019 and 2021 (-0.1 %, 0.7 %, -0.1 % and 0.8 %, respectively). Between 1990 and 2021, there was a decline in mortality rates, DALY and YLL for most states and an increase in YLD rates. However, results suggest that the Sustainable Development Goal (SDG) for the reduction in mortality from NCDs by one-third by 2030 will not be achieved. The main risk factors associated with premature death from NCDs in 2021 were high blood pressure, tobacco use, dietary risks, high body mass index (BMI) and high blood glucose levels. The correlation between sociodemographic index and percentage change in mortality rates was significant for the following total NCDs, cardiovascular disease, chronic respiratory disease, diabetes and neoplasms. CONCLUSIONS: The current study highlights the importance of deaths from NCDs in Brazil and the worsening of mortality rates since 2016, as a result of austerity measures and the COVID-19 pandemic, which compromises the achievement of the SDG reduced mortality targets for NCDs. There was a reduction in risk factors for NCDs, mainly behavioural, although metabolic risk factors are of great concern and require new strategies to promote health, prevention and comprehensive care.

Alcohol tax indicators in the Region of the Americas

The harmful use of alcohol is one of the leading risk factors for population health. It is linked with over 200 health conditions, including noncommunicable diseases (NCDs) and mental health conditions, maternal and child health, infectious diseases, and injuries. This psychoactive substance caused 5.5% of all deaths and 6.7% of all disability-adjusted life years in the Region of the Americas in 2016. It also causes a significant social burden and imposes substantial direct treatment costs and indirect economic costs that represent a serious threat to economic and social development. This impact is recognized by target 3.5 of the Sustainable Development Goals aiming to “strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol”. The amount and frequency of alcohol consumed by an individual is determined, in large part, by the affordability of alcoholic beverages. Such affordability depends on the real price of alcoholic beverages, the price of other goods and services, and consumers’ incomes. Thus, there is strong health and economic rationale for the use of fiscal policies targeting alcoholic beverages. The World Health Organization (WHO) recommends reducing the harmful use of alcohol through increased excise taxes on alcoholic beverages as part of the WHO Global strategy to reduce the harmful use of alcohol, and the Pan American Health Organization (PAHO) Plan of Action to Reduce the Harmful Use of Alcohol. It is also part of the WHO recommended most cost-effective, evidence-based policies to prevent and control NCDs, and it is highlighted as one of five high-impact strategies of the SAFER technical package. Although 33 out of the 35 PAHO Member States apply excise taxes on alcoholic beverages, there is great heterogeneity in their design and rates, and most could be further leveraged to improve their impact on alcohol consumption and health. PAHO is committed to providing Member States with accurate, relevant, and internationally comparable information that they can use to guide the development of policy and to evaluate the impact of measures to prevent the harmful use of alcohol. Developing a tax share indicator is necessary to monitor taxes on alcoholic beverages, enable standardized comparisons across countries and over time, establish best practices in tax design, and provide a powerful tool for advocacy. Since 2016, the Department of Noncommunicable Diseases and Mental Health (NMH) at PAHO has been working on developing standardized and comparable indicators of the share of indirect taxes in the price of alcoholic beverages. Building on this experience and the WHO methodology for monitoring tobacco taxes, this brochure presents the results of pioneering tax share and complementary price and tax policy indicators for alcoholic beverages—including beer, wine, and spirits—in 30 PAHO Member States. This brochure is a tool for data dissemination to the different sectors involved in alcohol taxation in the Region of the Americas and, likewise, to help countries in designing, planning, and evaluating alcohol taxes to reduce the harmful use of alcohol.

La lucha contra el tabaquismo en Paraguay: evaluando el progreso hacia un futuro sin tabaco

He leído atentamente el artículo de González-Marrón y Casarini sobre el control del tabaco en Costa Rica y al respecto me gustaría hacer una reflexión sobre la situación del Paraguay, donde el consumo de tabaco continúa siendo un desafío significativo para la salud pública a pesar de los esfuerzos por reducir su prevalencia. La epidemia del tabaquismo sigue cobrando vidas y generando costos sanitarios considerables en el país. Desde la ratificación del Convenio Marco para el Control del Tabaco (CMCT) de la Organización Mundial de la Salud (OMS) por parte de Paraguay en 2006, el país ha dado pasos importantes en la implementación de políticas de control del tabaco, aunque aún enfrenta obstáculos significativos para lograr una reducción sustancial en el consumo.

Boletín OPS Adelante, n. 3, May. - Ago. 2024

Este boletín es elaborado por la Representación de la Organización Panamericana de la Salud, Organización Mundial de la Salud (OPS/OMS) en México. Su objetivo primordial es difundir las actividades de cooperación técnica que la OPS realiza en el país, con la Secretaría de Salud Federal, así como con todas las instituciones que forman parte del sistema de salud.

Pica is associated with lower willingness to change negative habits of diet and exercise, inadequate lifestyle, and less healthful food consumption in dialysis.

Background: In dialysis patients, on the one hand unwillingness to change negative lifestyle patterns is associated with worse nutritional status and unhealthy lifestyle, whereas on the other, pica may be highly prevalent. However, it is not known whether pica is associated with unwillingness to change negative lifestyle behaviors, as well as with consumption of different types of foods. This study aimed to investigate this issue. Methods: This is a cross-sectional study in dialysis patients. Lifestyle was assessed using the self-administered Instrument to Measure Lifestyle Questionnaire (IMEVID). Pica diagnosis was established according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. A food frequency questionnaire was performed and self-reported willingness to change was determined by a trans-theoretical model staging inventory. Results: Compared with patients without pica, those with pica (particularly hard pica) had lower willingness to change unhealthy behavior in the case of diet (22% vs. 46% in precontemplation/contemplation stages, respectively) and exercise (43% vs. 62% in precontemplation/contemplation stages, respectively). Patients with hard pica had significantly (p < 0.05) lower scores in almost all dimensions of the lifestyle questionnaire than those in the no pica group: diet (23.9 vs. 26.8, respectively), physical activity (5.5 vs. 7, respectively), knowledge of disease (5.7 vs. 6.4, respectively), emotion management (6.6 vs. 8, respectively) and adherence to treatment (13.4 vs. 14.7, respectively), but not in the consumption of tobacco and alcohol. Compared to patients with no pica, those with hard pica ate vegetables and fruits less frequently, and dairy products, fried foods and soda more frequently. Conclusions: Pica was more frequently observed in patients with lower willingness to change negative habits of diet and exercise, in those who had more unhealthy behaviors in diet, exercise and emotion management dimensions and adherence to treatment, as well as in those who ate less frequently healthful foods and more frequently unhealthy foods.