Correction: Is social cohesion produced by weak ties or by multiplex ties? Rival hypotheses regarding leader networks in urban community settings.

[This corrects the article DOI: 10.1371/journal.pone.0257527.].

Do baseline participant characteristics impact the effectiveness of a mobile health intervention for depressive symptoms? A post-hoc subgroup analysis of the CONEMO trials.

OBJECTIVE: To ascertain whether sociodemographic and health-related characteristics known from previous research to have a substantive impact on recovery from depression modified the effect of a digital intervention designed to improve depressive symptoms (CONEMO). METHODS: The CONEMO study consisted of two randomized controlled trials, one conducted in Lima, Peru, and one in São Paulo, Brazil. As a secondary trial plan analysis, mixed logistic regression was used to explore interactions between the treatment arm and subgroups of interest defined by characteristics measured before randomization - suicidal ideation, race/color, age, gender, income, type of mobile phone, alcohol misuse, tobacco use, and diabetes/hypertension - in both trials. We estimated interaction effects between the treatment group and these subgroup factors for the secondary outcomes using linear mixed regression models. RESULTS: Increased effects of the CONEMO intervention on the primary outcome (reduction of at least 50% in depressive symptom scores at 3-month follow-up) were observed among older and wealthier participants in the Lima trial (p = 0.030 and p = 0.001, respectively). CONCLUSION: There was no evidence of such differential effects in São Paulo, and no evidence of impact of any other secondary outcomes in either trial. CLINICAL TRIAL REGISTRATION: NCT02846662 (São Paulo, Brazil - SP), NCT03026426 (Lima, Peru - LI).

Populism and health. An evaluation of the effects of right-wing populism on the COVID-19 pandemic in Brazil.

What are the effects of right-wing populism in the struggle against COVID-19? We explore data from Brazil, a country whose populist radical right-wing president was among the prominent denialists regarding the effects of the pandemic. Using cross-sectional and weekly-panel data for 5,570 municipalities during 2020, we present evidence that social distancing was weakened, and the number of cases and deaths were higher in places where the president had received greater electoral support during the 2018 presidential elections. Placebo tests using traditional right-wing vote and data on Severe Acute Respiratory Syndrome (SARS) before the pandemic outbreak indicate that the former does not correlate with health outcomes, and the populist share of the vote does not correlate with the latter. Hence, we find strong indications that right-wing populism relates to a poor response to the disease.

Cultural adaptation and Rasch psychometrics of the Substance Addiction Consequences scale.

This study aims to adapt and evaluate the validity of the Substance Addiction Consequences scale for the Brazilian community-based addiction setting. This is a psychometric study, conducted in two stages: (1) cultural adaptation and (2) validation using the psychometric Rasch model. The Substance Addiction Consequences derived from the Nursing Outcome Classification comprises 16 items and four domains in the original instrument. We applied the original scale with 200 outpatients at two Psychosocial Care Centers for Alcohol and Drugs in São Paulo, Brazil. The four subscales are suitable for the Rasch model. In 13 of the 16 items, infits and outfits are between 0.5 and 1.5, corresponding to the model's optimal parameters. In addition, we removed one item that distorted the measurement. The psychometrics suggested that the SAC scale is valid with its 15 items and four domains. Therefore, it can be considered appropriate to use in the Brazilian community-based addiction setting.

Is social cohesion produced by weak ties or by multiplex ties? Rival hypotheses regarding leader networks in urban community settings.

In his seminal work, Mark Granovetter (1973) challenged sociologists to test sociometric hypotheses regarding collective action in communitarian settings. In this article, we tested the two main hypotheses which consider social cohesion in communitarian urban settings-these being firstly cohesion by weak ties and secondly cohesion by multiplex ties. We studied the elite leaders of two slum communities of Belo Horizonte (Brazil). Three social processes were examined as multiplex interactions: recognized status, exchange of useful information and collaboration. Our findings reveal, on the one hand, that multiplexity is associated with the frequency of ties and, on the other, that reciprocity and shared domains of performance fuel such strong multiplexity. If we assume that elite connections conform to a high order structure, our findings, in contrast to previously well-established hypotheses, reveal a segmented social order in which multiplexity does not mean the overlapping of social circles. On the contrary, multiplexed social exchanges are restricted to specialized domains.

Consequences of psychoactive substance use: a comparative study of two services in Brazil and Portugal.

OBJECTIVE: To compare the consequences of psychoactive substance use among users of mental health services in Brazil and Portugal. METHOD: Cross-sectional, comparative, quantitative study, carried out with 362 users of two specialized treatment services in the cities of São Paulo (n = 200) and Lisbon (n = 162). Data collected in 2019 through the application of the Substance Addiction Consequences scale. A descriptive analysis and ordinary least squares and logistic regressions were performed. RESULTS: All dimensions assessed by the scale were more severe for Brazilian users, with a difference for the physical domain and cognitive skills (p < 0.01). Brazilian participants were more likely to consume cocaine (p < 0.01) and have psychosis (p = 0.02) and Portuguese participants to have hepatitis (p < 0.01), personality disorders (p < 0.01), use benzodiazepines (p < 0.01) and tobacco (p < 0.01), and receive pharmacological support (p < 0.01). CONCLUSION: It was found that Brazilian users have more serious consequences related to substance use, and Portuguese users have more comorbidities and exposure to risky consumption. It emerges that Portuguese responses minimize the consequences severity.

A Mobile Health Intervention for Patients With Depressive Symptoms: Protocol for an Economic Evaluation Alongside Two Randomized Trials in Brazil and Peru.

BACKGROUND: Mobile health interventions provide significant strategies for improving access to health services, offering a potential solution to reduce the mental health treatment gap. Economic evaluation of this intervention is needed to help inform local mental health policy and program development. OBJECTIVE: This paper presents the protocol for an economic evaluation conducted alongside 2 randomized controlled trials (RCTs) to evaluate the cost-effectiveness of a psychological intervention delivered through a technological platform (CONEMO) to treat depressive symptoms in people with diabetes, hypertension, or both. METHODS: The economic evaluation uses a within-trial analysis to evaluate the incremental costs and health outcomes of CONEMO plus enhanced usual care in comparison with enhanced usual care from public health care system and societal perspectives. Participants are patients of the public health care services for hypertension, diabetes, or both conditions in São Paulo, Brazil (n=880) and Lima, Peru (n=432). Clinical effectiveness will be measured by reduction in depressive symptoms and gains in health-related quality of life. We will conduct cost-effectiveness and cost-utility analyses, providing estimates of the cost per at least 50% reduction in 9-item Patient Health Questionnaire scores, and cost per quality-adjusted life year gained. The measurement of clinical effectiveness and resource use will take place over baseline, 3-month follow-up, and 6-month follow-up in the intervention and control groups. We will use a mixed costing methodology (ie, a combination of top-down and bottom-up approaches) considering 4 cost categories: intervention (CONEMO related) costs, health care costs, patient and family costs, and productivity costs. We will collect unit costs from the RCTs and national administrative databases. The multinational economic evaluations will be fully split analyses with a multicountry costing approach. We will calculate incremental cost-effectiveness ratios and present 95% CIs from nonparametric bootstrapping (1000 replicates). We will perform deterministic and probabilistic sensitivity analyses. Finally, we will present cost-effectiveness acceptability curves to compare a range of possible cost-effectiveness thresholds. RESULTS: The economic evaluation project had its project charter in June 2018 and is expected to be completed in September 2021. The final results will be available in the second half of 2021. CONCLUSIONS: We expect to assess whether CONEMO plus enhanced usual care is a cost-effective strategy to improve depressive symptoms in this population compared with enhanced usual care. This study will contribute to the evidence base for health managers and policy makers in allocating additional resources for mental health initiatives. It also will provide a basis for further research on how this emerging technology and enhanced usual care can improve mental health and well-being in low- and middle-income countries. TRIAL REGISTRATION: ClinicalTrials.gov NCT12345678 (Brazil) and NCT03026426 (Peru); https://clinicaltrials.gov/ct2/show/NCT02846662 and https://clinicaltrials.gov/ct2/show/NCT03026426. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/26164.

Rasch Analysis of the Global Appraisal of Individual Needs in the City of São Paulo.

INTRODUCTION: Approximately 5% of the global population used an illicit drug in 2013. Regarding licit drugs, alcohol is responsible for the occurrence of approximately 200 diseases, among them depression. In addition to health impairments, alcohol is also implicated in many acts of violence. This study aimed to measure the properties of the Rasch model of the Portuguese version of the Global Appraisal of Individual Needs-Short Screener based on evidence obtained during care for users of alcohol and other drugs. METHOD: To collect the data, 128 interviews were held at the Psychosocial Care Center for Alcohol and Other Drugs in the state capital, during which the scale was applied. RESULTS: The Rasch model revealed that the subscales of the instrument were appropriate, with all items having mean infit and outfit values from 0.5 to 1.5, considered optimal for measurement. There was no evidence of differential performance for gender. Substance use and crime and violence items presented redundancy for severity measures. CONCLUSION: Given the need for validated instruments for use in Brazil, it is encouraging that the Portuguese version of the scale was valid for the Rasch model. The results are consistent with studies using the other American, Brazilian, and Canadian versions of the instrument.

Do baseline participant characteristics impact the effectiveness of a mobile health intervention for depressive symptoms? A post-hoc subgroup analysis of the CONEMO trials

Objective: To ascertain whether sociodemographic and health-related characteristics known from previous research to have a substantive impact on recovery from depression modified the effect of a digital intervention designed to improve depressive symptoms (CONEMO). Methods: The CONEMO study consisted of two randomized controlled trials, one conducted in Lima, Peru, and one in São Paulo, Brazil. As a secondary trial plan analysis, mixed logistic regression was used to explore interactions between the treatment arm and subgroups of interest defined by characteristics measured before randomization - suicidal ideation, race/color, age, gender, income, type of mobile phone, alcohol misuse, tobacco use, and diabetes/hypertension - in both trials. We estimated interaction effects between the treatment group and these subgroup factors for the secondary outcomes using linear mixed regression models. Results: Increased effects of the CONEMO intervention on the primary outcome (reduction of at least 50% in depressive symptom scores at 3-month follow-up) were observed among older and wealthier participants in the Lima trial (p = 0.030 and p = 0.001, respectively). Conclusion: There was no evidence of such differential effects in São Paulo, and no evidence of impact of any other secondary outcomes in either trial. Clinical trial registration: NCT02846662 (São Paulo, Brazil - SP), NCT03026426 (Lima, Peru - LI). Funded by the U.S. National Institute of Mental Health (grant U19MH098780).

Transparency of subnational governments: the impact of inequality on transparency / Transparencia de los gobiernos subnacionales: el impacto de la desigualdad en la transparencia / Transparência dos governos subnacionais: o impacto da desigualdade na transparência

Abstract What are the effects of extractive informal institutions on the horizontal accountability process in a developing democracy? This paper presents evidence about the harmful effects of extractive informal institutions on horizontal accountability within subnational governments in Brazil. After three decades of free and competitive elections, the institutional design of oversight institutions for state governments has hardly changed. We explore the hypothesis that more extractive informal institutions, measured by the level of income inequality, is associated with decreasing transparency levels. Given its extensive social, political, and economic diversity embedded in an overall centralized formal institutional framework, Brazil provides an appropriate setting to test the hypothesis that extractive informal institutions responsible for increased income inequality can undermine horizontal accountability in new democracies.

Resumen ¿Cuáles son los efectos de las instituciones informales extractivas sobre el proceso de accountability horizontal en una democracia en desarrollo? Este artículo presenta evidencia sobre los efectos dañinos de las instituciones informales extractivas sobre la accountability horizontal dentro de los gobiernos subnacionales en Brasil. Después de tres décadas de elecciones libres y competitivas, el diseño institucional de las instituciones de supervisión de los gobiernos estatales apenas ha cambiado. Exploramos la hipótesis de que las instituciones informales más extractivas, medidas por el nivel de desigualdad de ingresos, están asociadas con niveles decrecientes de transparencia. Dada su amplia diversidad social, política y económica integrada en un marco institucional formal, general y centralizado, Brasil proporciona un entorno apropiado para probar la hipótesis de que las instituciones informales extractivas, responsables de una mayor desigualdad de ingresos, pueden socavar la accountability horizontal en las nuevas democracias.

Resumo Quais são os efeitos das instituições informais extrativas no processo de accountability horizontal numa democracia em desenvolvimento? Este artigo apresenta evidências sobre os efeitos nocivos das instituições informais extrativistas na accountability horizontal dos governos subnacionais no Brasil. Após três décadas de eleições livres e competitivas, o desenho institucional das instituições de fiscalização dos governos estaduais praticamente não mudou. Exploramos a hipótese de que instituições informais mais extrativas, medidas pelo nível de desigualdade de renda, estão associadas a níveis decrescentes de transparência. Dada a sua extensa diversidade social, política e econômica, inserida num quadro institucional formal centralizado, o Brasil oferece um cenário apropriado para testar a hipótese de que as instituições informais extrativas responsáveis pelo aumento da desigualdade de rendimentos podem minar a accountability horizontal nas novas democracias.

Preditores de problemas relacionados ao uso de substâncias psicoativas entre usuários em tratamento psicossocial / Predictors of problems related to the consumption of psychoactive substances among users undergoing psychosocial treatment / Predictores de problemas relacionados con el uso de sustancias psicoactivas entre usuarios en tratamiento psicossocial

Objetivo: analisar os preditores de problemas relacionados ao uso de substâncias psicoativas entre usuários de um Centro de Atenção Psicossocial Álcool e Drogas. Método: estudo transversal de abordagem quantitativa realizado com 200 usuários de um Centro de Atenção Psicossocial Álcool e Drogas do interior paulista. Os dados foram coletados por meio de um questionário sociodemográfico e do instrumento denominado Avaliação Global de Necessidades Individuais - Triagem Curta. Realizou-se análise descritiva e regressão linear múltipla de mínimos quadrados ordinários, em busca de preditores para a variação no escore da escala. Resultados: o perfil dos usuários foi de 84% do sexo masculino, com idade média de 38,97 anos, brancos (85%), vivendo com familiares (43,5%) e com vínculo de trabalho informal (53%). Os preditores de gravidade dos problemas relacionados ao uso de substâncias foram: problemas de internalização e externalização, crime e violência, escolaridade e padrão de uso. Com relação a escala total, os preditores foram: sexo feminino, idade, situação de rua e padrão de uso. Conclusão: os preditores analisados apontam para fatores biopsicossociais que devem ser considerados no processo de cuidado desta população. Tais resultados destacam a necessidade de uma abordagem interdisciplinar, interprofissional e intersetorial, que pode ser norteada pelo projeto terapêutico singular.(AU)

Objective: to analyze the predictors of problems related to the consumption of psychoactive substances among users of a Psychosocial Care Center-Alcohol and Drugs. Method: a cross-sectional study with a quantitative approach conducted with 200 users of a Psychosocial Care Center-Alcohol and Drugs from inland São Paulo. The data were collected by means of a sociodemographic questionnaire and through the instrument called Global Assessment of Individual Needs - Short Screener. A descriptive analysis and multiple regression of ordinary least squares were performed searching predictors for the variation in the scale score. Results: the users' profile showed 84% males with a mean age of 38.97 years old, white-skinned (85%), living with family members (43.5%) and with informal employment contracts (53%). The predictors corresponding to severity of the substance-related problems were internalization and externalization, crime and violence, schooling and use pattern. In relation to the total scale, the predictors were female gender, age, street situation and use pattern. Conclusion: the predictors analyzed pointed to biopsychosocial factors that should be considered in the care process for this population group. The results highlight the need for an interdisciplinary, interprofessional and intersectoral approach that can be guided by the singular therapeutic project.(AU)

Objetivo: analizar los predictores de problemas relacionados al uso de sustancias entre usuarios de un Centro de Atención Psicosocial de Alcohol y Drogas. Método: estudio transversal de abordaje cuantitativo realizado con 200 usuarios de un Centro de Atención Psicosocial de Alcohol y Drogas del interior de São Paulo. Los datos fueron recolectados a través de un cuestionario sociodemográfico y de un instrumento denominado Evaluación Global de las Necesidades Individuales - Análisis Breve. Se realizó análisis descriptivo y regresión lineal múltiple por mínimos quadrados ordinarios en busca de predictores de la variación en la puntuación de la escala. Resultados: el perfil de los usuarios fue 84% masculino, edad media 38,97 años, raza blanca (85%), viviendo con familiares (43,5%) y con relación laboral informal (53%). Los predictores de gravedad de los problemas relacionados con el consumo de sustancias fueron: problemas de internalización y externalización, delincuencia y violencia, educación y patrón de consumo. En cuanto a la escala total, los predictores fueron: sexo femenino, edad, situación de calle y patrón de consumo. Conclusión: los predictores analizados apuntan a factores biopsicosociales que deben ser considerados en el proceso de atención a esta población. Estos resultados destacan la necesidad de un abordaje interdisciplinar, interprofesional e intersectorial, que puede ser norteado por el proyecto terapéutico singular.(AU)

Internal Consistency and Convergent Validity of the Portuguese Versions of the Global Appraisal of Individual Needs-Initial and Short Screener: Validity of the Portuguese GAIN-I and SS.

The goal of this article is to present evidence on the internal consistency and convergent validity of the Brazilian Portuguese versions of the Global Appraisal of Individual Needs-"Initial" and "Short Screener" versions. METHODS: One hundred sixty-eight individuals from an inpatient service and/or a community-based outpatient service located in São Paulo were interviewed using the Brazilian Portuguese versions of the instruments. The internal consistency of the instruments scales was computed, along with evidence for the convergent validity between corresponding subscales of the Initial and Short Screener instruments. RESULTS: Cronbach's alpha values for both instruments' total scale scores were greater than .7. The Short Screener scales showed strong-to-moderate correlations with corresponding subscales of the Initial. The General Individual Severity Scale from the Initial and Total Disorder Screener from the Short Screener have convergent validity with each other (ρ = 0.801). CONCLUSIONS: The Brazilian Portuguese instrument scales showed evidence for internal consistency and convergent validity performing similarly to the American English versions.

Atitudes de profissionais de Centros de Atenção Psicossocial sobre álcool, alcoolismo e alcoolistas / Attitudes of professionals from Psychosocial Care Centers towards alcohol, alcoholism, and alcoholics

RESUMO Objetivo avaliar as atitudes dos profissionais de Centros de Atenção Psicossocial frente ao álcool, alcoolismo e alcoolista. Métodos estudo transversal, avaliativo, com 288 profissionais de 12 serviços de saúde. Coletaram-se dados sociodemográficos, Escala de Satisfação dos Pacientes com os Serviços de Saúde Mental e Escala de Atitude para álcool, alcoolismo e alcoolistas. Resultados os profissionais que demonstraram postura mais crítica em relação ao seu cotidiano de trabalho e os que atuavam nos serviços por mais tempo apresentaram atitudes positivas em relação ao álcool, alcoolismo e alcoolistas. Profissionais da equipe administrativa e técnicos de saúde apresentaram atitudes mais negativas. Conclusão as atitudes dos profissionais ao álcool, alcoolismo e alcoolista, no geral, são positivas e associaram-se ao maior tempo de atuação na área e à expressão de incômodos com o trabalho.

ABSTRACT Objective to assess the attitudes of professionals from Psychosocial Care Centers towards alcohol, alcoholism, and alcoholics. Methods a cross-sectional evaluation study with 288 professionals from 12 healthcare services. Sociodemographic data, Patient Satisfaction Scale with Mental Health Services and Attitude Scale for alcohol, alcoholism, and alcoholics were collected. Results the professionals who showed a more critical attitude towards their work routine and those who worked in the healthcare services for longer had positive attitudes towards alcohol, alcoholism, and alcoholics. Professionals from the administrative team and health technicians had more negative attitudes. Conclusion the attitudes of professionals towards alcohol, alcoholism, and alcoholics, in general, are positive and were associated with longer working time in the field and the manifestation of disapproving situations with work.

Rasch model of the GAIN substance problem scale among inpatient and outpatient clients in the city of São Paulo, Brazil.

INTRODUCTION: This study used the Rasch model to evaluate the psychometric properties of the Portuguese version of the Substance Problem Scale (SPS) of the "Global Appraisal of Individual Needs - Initial" for use in Brazil. The SPS measures alcohol and drug problem severity within a DSM-IV-TR framework. The goal of the Rasch analysis was to assess scale dimensionality, item severity, and differential item functioning (DIF). METHODS: Data was collected from 40 inpatients and 70 outpatients in São Paulo, Brazil. The Rasch model fit and DIF by gender and level of care were examined. RESULTS: The SPS fit the Rasch model, with no items distorting the measure. Only three of the sixteen items performed differently between men and women and three performed differently by level of care. CONCLUSIONS: The results were compatible with those from Rasch analyses of the American English and Canadian English versions of the scale. The Portuguese version of the SPS is, thus, valid for use in Brazil, both with men and women in inpatient and outpatient programs.

•Rasch analysis of the Portuguese version of the Substance Problem Scale performed•This scale has performance similar to Canadian and American versions.•None of the scale items distort the measurement.•Further differential item functioning analysis with larger sample needed.

Drug use, mental health and problems related to crime and violence: cross-sectional study.

OBJECTIVE: To investigate the correlation between disorders related to the use of alcohol and other drugs and symptoms of mental disorders, problems related to crime and violence and to age and gender. METHODS: Cross-sectional descriptive study carried out with 128 users of a Psychosocial Care Center for Alcohol and other Drugs, in the city of São Paulo, interviewed by means of the instrument entitled Global Appraisal of Individual Needs - Short Screener. Univariate and multiple linear regression models were used to verify the correlation between the variables. RESULTS: Using univariate regression models, internalizing and externalizing symptoms and problems related to crime/violence proved significant and were included in the multiple model, in which only the internalizing symptoms and problems related to crime and violence remained significant. CONCLUSIONS: There is a correlation between the severity of problems related to alcohol use and severity of mental health symptoms and crime and violence in the study sample. The results emphasize the need for an interdisciplinary and intersectional character of attention to users of alcohol and other drugs, since they live in a socially vulnerable environment.

Satisfação de negros e não negros assistidos por Centros de Atenção Psicossocial em Álcool e Outras Drogas / Satisfaction of black and non-black individuals assisted at the Alcohol and Drugs Psychosocial Care Center

RESUMO Este artigo objetivou analisar comparativamente a satisfação de indivíduos negros e não negros assistidos por Centros de Atenção Psicossocial em Álcool e Outras Drogas de três estados brasileiros. É um estudo quantitativo, transversal e avaliativo, cujos dados foram coletados por meio de entrevistas seguidas de análise inferencial. Participaram do estudo 707 indivíduos, a maioria homens, autodeclarados negros, com média de idade de 44 anos. Os resultados mostraram que indivíduos negros e não negros estavam igualmente satisfeitos com a assistência ofertada, sobretudo com a competência e compreensão dos profissionais, acolhimento e ajuda recebida, o que contradiz a literatura tradicional que desvela racismo nos serviços de saúde. A avalição é a de que os Centros de Atenção Psicossocial em Álcool e Outras Drogas são locais potentes e diferenciados do sistema de saúde, mais acolhedores e inclusivos, para o cuidado de qualquer tipo de população com necessidades decorrentes do uso de substâncias. Esse resultado é coerente com a história desses dispositivos de saúde em nosso país, sendo serviços centrais da rede substitutiva aos cuidados hegemônicos e asilares.

ABSTRACT The paper aimed to compare the satisfaction of black and non-black individuals assisted by Psychosocial Care Centers for Alcohol and Drugs in three Brazilian states. This is a quantitative, cross-sectional and evaluative study, with inferential analysis of the data we collected through interviews. A total of 707 individuals participated in the study, mostly men, self-declared black, with an average age of 44 years. The results show that black and non-black individuals were equally satisfied with the assistance offered, especially with the competence and understanding of the professionals, embracement and help received. These results contradict the traditional literature that reveals racism in health services. We believe that the Psychosocial Care Centers on Alcohol and Drugs are powerful and differentiated services in the health system, more welcoming and inclusive of their. This result is consistent with the history of these health devices in our country, being central services in the network that is substitutive of hegemonic and asylum-centered psychiatric care.

A importância do crescimento econômico local na escolha do chefe do Executivo no Brasil / La importancia del crecimiento económico local en la elección del jefe del Ejecutivo en Brasil / The importance of local economic growth on the elections of Brazilian chief executives of governments

Resumo A investigação dos fatores que influenciam a escolha do chefe do Executivo no Brasil é uma questão de vital importância. Neste artigo, apresentam-se evidências de que o crescimento econômico local no último ano de governo possui impacto positivo na porcentagem de votos obtidos pelo incumbente em uma amostra da população dos municípios brasileiros, com dados das eleições presidenciais e municipais de 2000 a 2010. Usamos a expansão real do PIB municipal como medida do crescimento econômico local e testamos a hipótese de que os eleitores em um município premiam os incumbentes, ou seus respectivos candidatos, que tiveram bom desempenho econômico no último ano de mandato. A hipótese se baseia na teoria econômica do voto que sugere que os incumbentes têm mais chances de vencer uma reeleição, ou eleger seu sucessor, quando a economia está em um bom momento. Na análise utilizamos as abordagens para dados em painel, além de análise multinível, de modo a melhor explorar a heterogeneidade existente no fenômeno do voto econômico e com isso inferir a existência de efeitos do crescimento econômico na proporção de votos obtidos pelo incumbente e como esses efeitos podem variar em relação a partidos, unidades da federação, circunscrição eleitoral e outras variáveis.

Resumen La investigación de los factores que influyen en la elección del jefe del Ejecutivo en Brasil es un asunto de vital importancia en la literatura. En este artículo, presentamos evidencia de que el crecimiento económico local en el último año del gobierno tiene un impacto positivo en el porcentaje de votos obtenidos por el incumbente en una muestra de los municipios brasileños, con datos relativos a las elecciones presidenciales y municipales de 2000 a 2010. Utilizamos el crecimiento real del PIB municipal como medida de crecimiento económico local para poner a prueba la hipótesis de que los votantes en una ciudad tienden a recompensar el titular y sus candidatos que tuvieron un buen desempeño económico en el último año de mandato. La hipótesis se base en la teoría económica de la votación que sugiere que los titulares tienen más probabilidades de ganar la reelección, o elegir a su sucesor, cuando la economía está en un buen momento. En el análisis se utiliza los métodos de datos de panel y el análisis multinivel con el fin de aprovechar mejor la heterogeneidad existente en el fenómeno del voto económico y con ello inferir la existencia de efectos del crecimiento económico sobre la proporción de votos obtenidos por el incumbente y cómo estos efectos pueden variar en relación a partidos, las unidades de la federación, circunscripción electoral y otras variables.

Abstract The motives for choosing the government's chief executive are of vital importance in a democratic society. In this article, evidence is presented of how local economic growth in the last year of government has a positive impact on the percentage of votes obtained by the incumbent in a population sample of Brazilian municipalities, with data of the presidential and municipal elections of 2000 to 2010. Real GDP growth of the city is used as a measure of local economic growth to test the hypothesis that voters in a municipality tend to reward incumbents and their candidates, if they had good economic performance in the last year of their mandate. The hypothesis is based on the economic theory of voting, suggesting that incumbents are more likely to win re-election, or elect their successor, when the economy is good. Panel and Multilevel models are used to detail the effects and the impact of economic growth in the proportion of votes obtained by the incumbent. The multilevel analysis was used in order to better explore existing heterogeneity in the economic voting phenomenon and thereby infer how economic growth effects may vary among parties, the federation units, constituency and other variables.

Vulnerabilidade para o comportamento sexual de risco em usuários de álcool e outras drogas / Vulnerability to sexual risk behavior in users of alcohol and other drugs / La vulnerabilidad a la conducta sexual de riesgo en las usuarias de alcohol y otras drogas

OBJETIVOS: avaliar a associação entre o uso de álcool e outras drogas, variáveis sóciodemográficas e aspectos psicossociais, com o comportamento sexual de risco dos usuários. MÉTODOS: pesquisa quantitativa transversal, entrevistados 110 usuários de um Centro de Atenção Psicossocial em Álcool e outras Drogas (CAPSad) com o instrumento Avaliação Global das Necessidades Individuais. Utilizou-se a Escala de Risco Sexual, características sociodemográficas, dias de uso de drogas e demais subescalas do instrumento. RESULTADOS: o comportamento sexual de risco foi significativo em usuários que estavam a mais dias em uso de crack, em situação de rua e mais graves em aspectos psicossociais. CONCLUSÃO: fatores do cotidiano dos usuários tem influências importantes sobre o comportamento sexual de risco e doenças sexualmente transmissíveis.

OBJECTIVES: to evaluate the association between alcohol use and other drugs, socio-demographic variables and psychosocial aspects, with the users risky sexual behavior. METHODS: cross-sectional quantitative research, interviewed 110 users of a Center for Psychosocial Care in Alcohol and Other Drugs (CAPSad) with the Global Assessment of Individual Needs instrument. The Sexual Risk Scale, sociodemographic characteristics, days of drug use and other subscales of instrument were used. RESULTS: risky sexual behavior was significant in users who were more days on crack use, in homeless and more severe in psychosocial aspects. CONCLUSION: daily users factors have important influences on sexual risk behavior and sexually transmitted diseases.

OBJETIVOS: evaluar la asociación entre el consumo de alcohol y otras drogas, variables sociodemográficas y aspectos psicosociales, con los usuarios de comportamientos sexuales de riesgo. MÉTODOS: transversal de investigación cuantitativa, entrevistó a 110 usuarios de un Centro de Atención Psicosocial en Alcohol y Otras Drogas (CAPSad) con el instrumento de Evaluación Global de Necesidades Individuales. Se utilizaron la Escala de Riesgo Sexual, las características sociodemográficas, los días de consumo de drogas y otras subescalas del instrumento. RESULTADOS: el comportamiento sexual de riesgo fue significativo en usuarios que estuvieron más días en el uso de crack, en personas sin hogar y más graves en aspectos psicosociales. CONCLUSIÓN: los factores diarios de los usuarios tienen importantes influencias en el comportamiento de riesgo sexual y las enfermedades de transmisión sexual.

Drug use, mental health and problems related to crime and violence: cross-sectional study / Uso de drogas, saúde mental e problemas relacionados ao crime e à violência: estudo transversal / Uso de drogas, salud mental y problemas relacionados con el crimen y la violencia: estudio transversal

Objective: to investigate the correlation between disorders related to the use of alcohol and other drugs and symptoms of mental disorders, problems related to crime and violence and to age and gender. Methods: cross-sectional descriptive study carried out with 128 users of a Psychosocial Care Center for Alcohol and other Drugs, in the city of São Paulo, interviewed by means of the instrument entitled Global Appraisal of Individual Needs - Short Screener. Univariate and multiple linear regression models were used to verify the correlation between the variables. Results: using univariate regression models, internalizing and externalizing symptoms and problems related to crime/violence proved significant and were included in the multiple model, in which only the internalizing symptoms and problems related to crime and violence remained significant. Conclusions: there is a correlation between the severity of problems related to alcohol use and severity of mental health symptoms and crime and violence in the study sample. The results emphasize the need for an interdisciplinary and intersectional character of attention to users of alcohol and other drugs, since they live in a socially vulnerable environment.

Objetivo: verificar a correlação entre os transtornos relacionados ao uso de álcool e outras drogas e sintomas de transtornos mentais, problemas relacionados ao crime e à violência e à idade e ao gênero. Métodos: estudo descritivo transversal, realizado com 128 usuários de um Centro de Atenção Psicossocial em Álcool e outras Drogas, da cidade de São Paulo, entrevistados por meio do instrumento Avaliação Global das Necessidades Individuais - Rastreio Rápido. Realizaram-se modelos de regressão linear univariados e múltiplos para verificar a correlação entre as variáveis. Resultados: nos modelos de regressão univariados, sintomas de internalização, externalização e problemas relacionados a crime/violência mostraram-se significantes e foram incluídos no modelo múltiplo, em que apenas os sintomas de internalização e problemas relacionados ao crime e à violência permaneceram significantes. Conclusões: há correlação entre a gravidade dos problemas relacionados ao uso de álcool e a gravidade de sintomas de saúde mental e crime e violência na amostra estudada. Os resultados enfatizam a necessidade de um caráter interdisciplinar e intersetorial da atenção ao usuário de álcool e outras drogas, uma vez que estão inseridos em ambiente de vulnerabilidade social.

Objetivo: investigar la correlación entre los trastornos relacionados con el uso de alcohol y otras drogas y los síntomas de trastornos mentales, problemas relacionados con el crimen y la violencia y a la edad y al género. Métodos: estudio descriptivo transversal, llevado a cabo con 128 usuarios de un Centro de Atención Psicosocial en Alcohol y otras Drogas, en la ciudad de São Paulo, entrevistados a través del instrumento Evaluación Global de Necesidades Individuales - Detección Corta. Se realizaron modelos de regresión lineal univariantes y múltiples para verificar la correlación entre las variables. Resultados: en los modelos de regresión univariantes, los síntomas de internalización, externalización y problemas relacionados con el crimen/la violencia se mostraron significantes y se incluyeron en el modelo múltiple, en que solamente los síntomas de internalización y problemas relacionados con el crimen y la violencia siguieron siendo significativos. Conclusiones: hay correlación entre la gravedad de los problemas relacionados con el consumo de alcohol y la severidad de los síntomas de salud mental y con el crimen y la violencia en la muestra estudiada. Los resultados enfatizan la necesidad de un carácter interdisciplinario e intersectorial de atención al usuario de alcohol y otras drogas, ya que viven en un ambiente de vulnerabilidad social.