Artigos e Materiais de Revistas Científicas - LIM/39

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A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.

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Data-driven, cross-disciplinary collaboration: lessons learned at the largest academic health center in Latin America during the COVID-19 pandemic
(2024) RITTO, Ana Paula; ARAUJO, Adriana Ladeira de; CARVALHO, Carlos Roberto Ribeiro de; SOUZA, Heraldo Possolo De; FAVARETTO, Patricia Manga e Silva; SABOYA, Vivian Renata Boldrim; GARCIA, Michelle Louvaes; KULIKOWSKI, Leslie Domenici; KALLAS, Esper Georges; PEREIRA, Antonio Jose Rodrigues; COBELLO JUNIOR, Vilson; SILVA, Katia Regina; ABDALLA, Eidi Raquel Franco; SEGURADO, Aluisio Augusto Cotrim; SABINO, Ester Cerdeira; RIBEIRO JUNIOR, Ulysses; FRANCISCO, Rossana Pulcineli Vieira; MIETHKE-MORAIS, Anna; LEVIN, Anna Sara Shafferman; SAWAMURA, Marcio Valente Yamada; FERREIRA, Juliana Carvalho; SILVA, Clovis Artur; MAUAD, Thais; GOUVEIA, Nelson da Cruz; LETAIF, Leila Suemi Harima; BEGO, Marco Antonio; BATTISTELLA, Linamara Rizzo; DUARTE, Alberto Jose da Silva; SEELAENDER, Marilia Cerqueira Leite; MARCHINI, Julio; FORLENZA, Orestes Vicente; ROCHA, Vanderson Geraldo; MENDES-CORREA, Maria Cassia; COSTA, Silvia Figueiredo; CERRI, Giovanni Guido; BONFA, Eloisa Silva Dutra de Oliveira; CHAMMAS, Roger; BARROS FILHO, Tarcisio Eloy Pessoa de; BUSATTO FILHO, Geraldo
Introduction The COVID-19 pandemic has prompted global research efforts to reduce infection impact, highlighting the potential of cross-disciplinary collaboration to enhance research quality and efficiency.Methods At the FMUSP-HC academic health system, we implemented innovative flow management routines for collecting, organizing and analyzing demographic data, COVID-related data and biological materials from over 4,500 patients with confirmed SARS-CoV-2 infection hospitalized from 2020 to 2022. This strategy was mainly planned in three areas: organizing a database with data from the hospitalizations; setting-up a multidisciplinary taskforce to conduct follow-up assessments after discharge; and organizing a biobank. Additionally, a COVID-19 curated collection was created within the institutional digital library of academic papers to map the research output.Results Over the course of the experience, the possible benefits and challenges of this type of research support approach were identified and discussed, leading to a set of recommended strategies to enhance collaboration within the research institution. Demographic and clinical data from COVID-19 hospitalizations were compiled in a database including adults and a minority of children and adolescents with laboratory confirmed COVID-19, covering 2020-2022, with approximately 350 fields per patient. To date, this database has been used in 16 published studies. Additionally, we assessed 700 adults 6 to 11 months after hospitalization through comprehensive, multidisciplinary in-person evaluations; this database, comprising around 2000 fields per subject, was used in 15 publications. Furthermore, thousands of blood samples collected during the acute phase and follow-up assessments remain stored for future investigations. To date, more than 3,700 aliquots have been used in ongoing research investigating various aspects of COVID-19. Lastly, the mapping of the overall research output revealed that between 2020 and 2022 our academic system produced 1,394 scientific articles on COVID-19.Discussion Research is a crucial component of an effective epidemic response, and the preparation process should include a well-defined plan for organizing and sharing resources. The initiatives described in the present paper were successful in our aim to foster large-scale research in our institution. Although a single model may not be appropriate for all contexts, cross-disciplinary collaboration and open data sharing should make health research systems more efficient to generate the best evidence.
Interview: Family agriculture and social control of health: active principles of public herbal medicines in Brazil: Maria José Martins de Souza
(2023) CARLESSI, P. C.; AZEREDO, M. V.
In this interview, Maria José Martins de Souza talks about the process of building the State Policy on Medicinal and Aromatic Plants, and about experiences from the past as a way of imagining other possible futures for public health in the State of São Paulo.
Preface: Current experiences on herbal medicine and living pharmacies in São Paulo State: a multidisciplinary work
(2023) CARMONA, F.; CARLESSI, P. C.; CARNEVALE, R. C.; BARROS, N. F. de; PEREIRA, A. M. S.
Interview: Between the local productive arrangement and the industrial pharmaceutical market: setbacks of the public supply of herbal medicines in Ribeirão Preto
(2023) CARLESSI, P. C.; SILVA, K. C.
In this interview, Lúcia Helena Terenciani Rodrigues Pereira presents the itinerary followed by Ribeirão Preto/SP when implementing the supply of herbal medicines in the municipality.
Interview: Uncrossing paths in a Living Pharmacy implementation at Promissão/SP: Andresa Baja
(2023) ANGELIS, L. P. De; CARLESSI, P. C.
In this interview, Andresa Baja presents the path taken by the city of Promissão/SP in the implementation of the Live Pharmacy program.
Screen use and sleep duration and quality at 15 years old: Cohort study
(2023) ECHEVARRIA, P.; DEL-PONTE, B.; TOVO-RODRIGUES, L.; MATIJASEVICH, A.; HALAL, C. S.; SANTOS, I. S.
Objective/background: The evidence on the association between screen use and sleep of adolescents is mainly based on studies about time watching television, with a few examining time using computers, videogames, and mobile devices. Our aim was to investigate the association between screen time for entertainment (watching TV, using computer, or playing games on tablets, smartphones, or videogame consoles) and sleep duration and self-reported sleep quality, among adolescents aged 15 years. Methods: With data from the 2004 Pelotas Birth Cohort, sleep duration was assessed with questions extracted from the Munich Chronotype Questionnaire and quality was self-reported. Adjusted β coefficients and prevalence ratios (PR) with (95% confidence intervals) were obtained, respectively, by linear and Poisson regressions. Results: 1,949 adolescents had information about screen time and sleep quality, and 1,851 about screen time and sleep duration. The median screen time was 4.5hs/24hs. The mean sleep duration was 7.6hs/24hs and the prevalence of bad sleep was 17.3% (15.7–19.0%). There was an inverse relationship between screen time and sleep duration. When compared with those with less than 2hs/24hs of screen time, adolescents with 6–8.8hs/24hs and ≥9hs experienced, respectively, 23.4 and 32.4 min reduction in sleep duration (β = -0.39; −0.62;-0.16 and β = -0.54; −0.77;-0.30). Adolescents with ≥9hs of screen time were 60% more likely to report bad sleep than those with less than 2hs/24hs (PR: 1.60; 1.10–2.32). Conclusions: The median time spent using screens was longer than recommended. Screen use for ≥6hs/24hs was associated with a shorter sleep duration, and ≥9hs/24hs with poor sleep quality.
Development and Validation of Predictive Model for a Diagnosis of First Episode Psychosis Using the Multinational EU-GEI Case-control Study and Modern Statistical Learning Methods
(2023) AJNAKINA, O.; FADILAH, I.; QUATTRONE, D.; ARANGO, C.; BERARDI, D.; BERNARDO, M.; BOBES, J.; HAAN, L. De; DEL-BEN, C. M.; GAYER-ANDERSON, C.; STILO, S.; JONGSMA, H. E.; LASALVIA, A.; TOSATO, S.; LLORCA, P.-M.; MENEZES, P. R.; RUTTEN, B. P.; SANTOS, J. L.; SANJUáN, J.; SELTEN, J.-P.; SZöKE, A.; TARRICONE, I.; D'ANDREA, G.; TORTELLI, A.; VELTHORST, E.; JONES, P. B.; ROMERO, M. A.; CASCIA, C. La; KIRKBRIDE, J. B.; OS, J. Van; O'DONOVAN, M.; MORGAN, C.; FORTI, M. Di; MURRAY, R. M.; HUBBARD, K.; STAHL, D.
Background and Hypothesis: It is argued that availability of diagnostic models will facilitate a more rapid identification of individuals who are at a higher risk of first episode psychosis (FEP). Therefore, we developed, evaluated, and validated a diagnostic risk estimation model to classify individual with FEP and controls across six countries. Study Design: We used data from a large multi-center study encompassing 2627 phenotypically well-defined participants (aged 18-64 years) recruited from six countries spanning 17 research sites, as part of the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions study. To build the diagnostic model and identify which of important factors for estimating an individual risk of FEP, we applied a binary logistic model with regularization by the least absolute shrinkage and selection operator. The model was validated employing the internal-external cross-validation approach. The model performance was assessed with the area under the receiver operating characteristic curve (AUROC), calibration, sensitivity, and specificity. Study Results: Having included preselected 22 predictor variables, the model was able to discriminate adults with FEP and controls with high accuracy across all six countries (rangesAUROC=0.84-0.86). Specificity (range=73.9-78.0%) and sensitivity (range=75.6-79.3%) were equally good, cumulatively indicating an excellent model accuracy; though, calibration slope for the diagnostic model showed a presence of some overfitting when applied specifically to participants from France, the UK, and The Netherlands. Conclusions: The new FEP model achieved a good discrimination and good calibration across six countries with different ethnic contributions supporting its robustness and good generalizability.
Cyclists' practices and perceptions during the covid-19 pandemic. Results of a survey of cyclists in the city of São Paulo, Brazil
(2023) MASCOLLI, Maria Antonietta
This is a cross-sectional, descriptive study with the objective to investigate how the pandemics changed the habits of those who use bicycles, and how this practice changed. This research interviewed 340 cyclists in the city of Sao Paulo, Brazil, using an online questionnaire and was carried out between February and March of 2021; the cyclists were initially recruited from the 'Pedal Project' and then through snowball methodology. The authors conclude that the bicycle was used tactically, both to avoid crowds and maintain social isolation and to practice physical exercise when other places for sports activities were prohibited. The circulation occurred mostly in the central region of the city, inhabited by the middle and upper class and with better cycling infrastructure. The proportion of those who increased or maintained the use of bicycles is similar to that which decreased, but changing the motivations for commuting. There was a high adherence to the use of masks, mainly by women. Keywords: Cycling; Mobility; Behaviour; Covid-19; Brazil.
Insights into the evolutionary history of the most skilled tool-handling platyrrhini monkey: Sapajus libidinosus from the Serra da Capivara National Park
(2023) LIMA, Thaynara; FAM, Bibiana; TAVARES, Gustavo Medina; FALOTICO, Tiago; CANTELE, Camila; FANTI, Lucca; LANDAU, Luane; VISCARDI, Lucas Henriques; VARGAS-PINILLA, Pedro; BARRIENTOS-DIAZ, Ossman; PISSINATTI, Alcides; SORTICA, Vinicius A.; OTTONI, Eduardo B.; SEGATTO, Ana Lucia A.; TURCHETTO-ZOLET, Andreia Carina; BORTOLINI, Maria Catira
Sapajus libidinosus members of the Pedra Furada group, living in the Serra da Capivara National Park, use stone tools in a wider variety of behaviors than any other living animal, except humans. To rescue the evolutionary history of the Caatinga S. libidinosus and identify factors that may have contributed to the emergence and maintenance of their tool-use culture, we conducted fieldwork seasons to obtain biological samples of these capuchin monkeys. Using CYTB sequences, we show a discrete but constant population growth from the beginning of the Holocene to the present, overlapping the emergence of the Caatinga biome. Our habitat suitability reconstruction reports the presence of plants whose hard fruits, seeds, or roots are processed by capuchins using tools. The S. libidinosus individuals in the Caatinga were capable of dynamically developing and maintaining their autochthonous culture thanks to: a) cognitive capacity to generate and execute innovation under selective pressure; b) tolerance favoring learning and cultural inheritance; c) an unknown genetic repertoire that underpins the adaptive traits; d) a high degree of terrestriality; e) presence and abundance of natural resources, which makes some places ""hot spots"" for innovation, and cultural diversification within a relatively short time.
Oral Pre-Exposure Prophylaxis for HIV Discontinuation in a Large Cohort of Adolescent Men Who Have Sex With Men and Transgender Women in Brazil
(2023) ZEBALLOS, Diana; MAGNO, Laio; SOARES, Fabiane; EUSTORGIO FILHO, Marcos; AMORIM, Leila; PINTO JR., Jony Arrais; GRECO, Dirceu; GRANGEIRO, Alexandre; DOURADO, Ines
Purpose: This study aimed to describe pre-exposure prophylaxis (PrEP) for HIV discontinuation in adolescent men who have sex with men (aMSM) and adolescent transgender women (aTGW) and to identify factors associated with discontinuation. Methods: The PrEP1519 study included a cohort of aMSM and aTGW aged 15-19 years old, and itwas conducted in three large Brazilian capital cities. For this analysis, we included adolescents who initiated PrEP. PrEP discontinuationwas defined as no possession of PrEP pills for >90 days. Kaplan-Meier curves were used to analyze the probabilities of discontinuation, and survival distributions stratified bycovariates were compared using log-rank or Wilcoxon tests. Cox regression models were used to estimate the adjusted hazard ratio (aHR) with a 95% confidence interval (95% CI). Results: We included 908 adolescents, 829 (91.30%) aMSM and 79 (8.70%) aTGW, most of whom were 18-19 years (80.29%). The incidence rate of discontinuation was 75.6 per 100 person-years. The probability of discontinuation was 52.61% in the first year. The multivariate analysis demonstrated that the aTGW (aHR = 1.63; 95% CI: 1.02-1.64) and adolescents with a medium (aHR = 1.29; 95% CI: 1.02-1.64) or low (aHR = 1.65; 95% CI: 1.29-2.12) perceived risk of HIV infection had an increased risk of discontinuation, whereas the adolescents with a partner living with HIV had a lower risk of discontinuation (aHR = 0.57; 95% CI: 0.35-0.91). Discussion: Adolescents with a high risk for discontinuation may need additional support that emphasizes the value of PrEP as a tool for HIV prevention because PrEP discontinuation was associated with a disconnect between HIV risk perception and HIV prevention. (c) 2023 Society for Adolescent Health and Medicine.
Violence, Discrimination, and High Levels of Symptoms of Depression Among Adolescent Men Who Have Sex With Men and Transgender Women in Brazil
(2023) MEDEIROS, Danielle Souto de; MAGNO, Laio; GUIMARAES, Mark Drew Crosland; GRANGEIRO, Alexandre; EUSTORGIO FILHO, Marcos; SOARES, Fabiane; GRECO, Dirceu; WESTIN, Mateus; FERRAZ, Dulce; ZUCCHI, Eliana Miura; DOURADO, Ines
Purpose: This study aimed at describing the prevalence of symptoms of depression among 15-19 year old adolescent men who have sex with men (aMSM) and transgender women (aTGW), who were recruited in an HIV pre-exposure prophylaxis cohort study in three Brazilian capital cities. The study also examined potential associations, including violence and discrimination, with severe symptoms of depression among aMSM. Methods: This is a cross-sectional study of baseline data among 730 aMSM and 56 aTGWrecruited between February 2019 and February 2021. Sociodemographic and behavioral data were collected. The 20-item Center for Epidemiologic Studies Depression scale was used to screen for symptoms of depression. Scores of >= 22 points indicate the presence of severe symptoms associated with major depression. Logistic regression was used to assess independent associations among aMSM, adjusting for sociodemographic variables. Results: Our findings indicate a high prevalence of symptoms of depression (overall prevalence = 58.5% and 69.6%; 21.2% and 25.0% for mild/moderate, and 37.3% and 44.6% for severe) among these aMSM and aTGW, respectively. Psychological violence (aOR = 1.74; 95% CI = 1.12-2.70), sexual violence (aOR = 1.79; 95% CI = 1.07-2.98), and discrimination due to sexual orientation (aOR = 1.71; 95% CI = 1.23-2.38) were independently associated with severe symptoms of depression in aMSM. Discussion: The high prevalence of severe symptoms of depression and its association with psychological and sexual violence and discrimination creates cycles of vulnerability and carries important public health implications. Thus, our findings indicate public policies should consider assessing depression, psychological and sexual violence, as well as discrimination, especially in populations that will be targeted by interventions, such as the use of pre-exposure prophylaxis. (c) 2023 Society for Adolescent Health and Medicine.
When Ethics and the Law Collide: A Multicenter Demonstration Cohort Study of Pre-Exposure Prophylaxis Provision to Adolescent Men Who Have Sex With Men and Transgender Women in Brazil
(2023) ZUCCHI, Eliana Miura; FERGUSON, Laura; MAGNO, Laio; DOURADO, Ines; GRECO, Dirceu; FERRAZ, Dulce; TUPINAMBAS, Unai; GRANGEIRO, Alexandre
Purpose: To explore legal and ethical challenges related to adolescents' participation in human immunodeficiency virus (HIV) research that may affect their best interests. Methods: We analyzed the ethical principles and legal aspects of the participation of 15-17-year-old men who have sex with men and transgender women in the pre-exposure prophylaxis (PrEP) 1519 study, a PrEP demonstration cohort study in three Brazilian cities. The analyses of ethics review committees' (ERCs) evaluations and court decisions followed ethical and human rights principles. An HIV vulnerability score was created, and descriptive statistics and multivariate logistic regression were performed using data from 347 participants. Results: The ERCs evaluated the benefits and risks of research participation, all finding that the benefits outweighed the risks. ERCs deferred responsibility for decisions about waiving parental consent to the judiciary. State courts reached different decisions about waiving parental consent, reflecting variation in recognition of adolescents' evolving capacities and the adolescent as a subject of sexual rights and the primary agent capable of deciding on their health and best interests. The most vulnerable adolescent participants were found in sites where the blanket waiver was in place. Discussion: Judicializing the ethical review process is detrimental to fulfilling the ethical principle of justice and vulnerable adolescents' access to health research. ERCs must be sufficiently independent and autonomous and have the capacity to respect, protect, and help fulfill the rights of participants while ensuring the generation of adequate evidence to inform public health practice. (c) 2023 Society for Adolescent Health and Medicine.
Same-Day Initiation of Oral Pre-Exposure Prophylaxis is High Among Adolescent Men Who Have Sex With Men and Transgender Women in Brazil
(2023) SOARES, Fabiane; MAGNO, Laio; PINTO JR., Jony Arrais; GRANGEIRO, Alexandre; BRUXVOORT, Katia; GRECO, Dirceu; DOURADO, Ines
Purpose: This study analyzed the sociodemographic and behavioral characteristics of adolescent men who have sex with men (aMSM) and transgender women (aTGW) initiating oral pre-exposure prophylaxis (PrEP) in human immunodeficiency virus (HIV) prevention clinics. Methods: PrEP1519 is a prospective, multicenter, open-label PrEP demonstration cohort study of aMSM and aTGWaged 15-19 years living in three large Brazilian capital cities. For this analysis, we included adolescents who enrolled in PrEP1519 from February 2019 to August 2021. Adolescents who visited PrEP clinics were classified into four groups based on PrEP eligibility and on their decision to use PrEP: (1) ineligible for same-day PrEP initiation; (2) eligible for same-day PrEP initiation, initiated PrEP at first visit; (3) eligible for PrEP initiation, initiated PrEP after the first visit; and (4) eligible for same-day PrEP initiation but declined. The groups that were eligible for same-day PrEP initiation were compared using the Chi-square and Fisher's exact tests. Results: Of the 1,254 adolescents enrolled in the PrEP1519 study, 61 (4.9%) were considered ineligible for same-day PrEP initiation. Of the 1,193 eligible for same-day PrEP initiation, 1,113 (93.3%) initiated PrEP [1,054 initiated PrEP in the first visit (88.3%) and 59 in subsequent visits (4.9%)] and 80 (6.7%) did not. Despite 90% of the PrEP decliners reporting a low risk of HIV infection, most reported condomless anal sex in the past six months (70%). Discussion: Same-day PrEP initiation among aMSM and aTGW was high, highlighting that this strategy was important to promote PrEP initiation among adolescents with increased vulnerability to HIV in Brazil. (c) 2023 Society for Adolescent Health and Medicine.
Implementing Differentiated and Integrated PrEP Services for Adolescent Key Populations: What Works and What Is the Way Forward?
(2023) DOURADO, Ines; MULLICK, Saiqa; MAGNO, Laio; GRANGEIRO, Alexandre
Adherence, Safety, and Feasibility of HIV Pre-Exposure Prophylaxis Among Adolescent Men Who Have Sex With Men and Transgender Women in Brazil (PrEP1519 Study)
(2023) DOURADO, Ines; SOARES, Fabiane; MAGNO, Laio; AMORIM, Leila; EUSTORGIO FILHO, Marcos; LEITE, Beo; GRECO, Dirceu; WESTIN, Mateus; TUPINAMBAS, Unai; MASSA, Paula; ZUCCHI, Eliana Miura; GRANGEIRO, Alexandre
Purpose: To evaluate the adherence, safety, and feasibility of pre-exposure prophylaxis (PrEP) in real-world settings among adolescent men who have sex with men (AMSM) and transgender women (ATGW). Methods: PrEP1519 is a single-arm, multicentric demonstration cohort study of daily oral PrEP among AMSM and ATGW aged 15 to 19 years in Brazil. Study visits occurred at baseline, weeks 4, 12, and then quarterly until 96 weeks. Descriptive statistics and a mixed logistic model for longitudinal data evaluated the factors associated with high adherence. Results: One thousand sixteenAMSMand ATGWaccessed the PrEP1519 clinics. Of those, 998 (98.2%) underwent clinical triage. Forty one were diagnosed with human immunodeficiency viruses (HIV) at baseline (4.0%) and 79 (7.9%) were not eligible for PrEP. Of the 878, 795 (90.5%) enrolled in PrEP, 82 (10.3%) were lost to follow-up, and 713 were included. Therewas no significant decrease in creatinine clearance; only two participants had grade-III aspartate aminotransferase elevation. Incident HIV infection occurred in eight participants (incidence rate [IR] = 1.64 per 100 person-years [PY]): two in 15-17 years (IR = 2.24 per 100 PY) and six in 18-20 years (IR = 1.51 per 100 PY). PrEP adherencewas higher among those with more years of schooling, those reporting no difficulties in PrEP use due to side effects, and who had low HIV risk perception in the past three months. Discussion: PrEP for AMSM and ATGW was safe and feasible in real-world settings. However, a higher IR among young adolescents and a higher adherence among less vulnerable people indicate the need for greater care, considering the specificities of this age group. (c) 2023 Society for Adolescent Health and Medicine.
Violence, discrimination, and sexual health practices among adolescent men who have sex with men, transgender women and travestis in three cities in Brazil
(2023) RYNGELBLUM, Marcelo; GRANGEIRO, Alexandre; ZUCCHI, Eliana Miura; COUTO, Marcia Thereza; DOURADO, Ines; MAGNO, Laio; TUPINAMBAS, Unai; PERES, Maria Fernanda Tourinho
The HIV epidemic has a disproportionate impact on adolescent and young men who have sex with men (AMSM) and transgender women and travestis (ATGW), with an increased HIV prevalence over the last 10 years. Violence affects the lives of these populations, undermining their ability to self-care and making them more vulnerable to HIV infection. In this study, we aimed to examine the association between different types of victimization by violence and discrimination and sexual health practices of these adolescent populations in steady and casual relationships. We conducted a cross-sectional study using baseline data from the cohort of PrEP1519 project. We used the mean score of sexual health practices as our outcome and the cumulative score of discrimi-nati on (within family, community, education, religious, online and public spaces) and violence (physical, sexual and intimate partner) as our exposure variable. We performed linear regression analyses to estimate the association between exposure and outcome. We found that 90% of AMSM and 95% of ATGW experienced at least one form of violence in the three months prior to this study and about 45% of ATGW suffered sexual violence during the same period. Experiencing discrimination within healthcare settings (from facilities or providers) was negatively associated with sexual health practices. Discrimi-nation and violence negatively affect sexual health practices. HIV prevention and care of AMSM and ATGW people should involve listening to their experi-ences and addressing discrimination and violence in this population.
Forty years of the Brazilian response to HIV: reflections on the need for a programmatic shift and policy as a common good
(2023) GRANGEIRO, Alexandre; FERRAZ, Dulce; MAGNO, Laio; ZUCCHI, Eliana Miura; COUTO, Marcia Thereza; DOURADO, Ines
Agradecemos a Barreira & Alencar 1 e Paiva & Ayres 2 pelos comentarios apontando caminhos mais efetivos para a resposta ao HIV no Brasil. Neste 2023, que marca 40 anos das primeiras acoes brasileiras contra o HIV, inauguradas em 1983 pelo Grupo Somos, nosso objetivo e marcar a necessidade de retomar uma discussAo com a sociedade brasileira que permita ""acordar"" a politica de HIV e reforNo primeiro artigo deste debate 3, evidenciamos um desafio: se a variedade de metodos de prevencAo existente nos permite almejar a eliminacAo do HIV, a persistencia de barreiras de acesso e as
HIV epidemic, prevention technologies, and the new generations: trends and opportunities for epidemic response
(2023) GRANGEIRO, Alexandre; FERRAZ, Dulce; MAGNO, Laio; ZUCCHI, Eliana Miura; COUTO, Marcia Thereza; DOURADO, Ines
The United Nations has underscored the possibility of ending the HIV epide-mic as a public health problem. However, an increase in the incidence among adolescents and youth has indicated a greater distance between HIV responses and the specificities of the new generations, which can maintain the epidemic for an extended period. Regards this matter, it is debated that the provision of a range of preventive methods, even if highly effective, and a conservatism that has internalized stigma within government policies, hinder the proper and essential dialogue between current preventive policies and the needs of the new generations. These generations are marked by a social representation of AIDS as a mild disease, by new gender and sexuality performances, and by the search for a more critical role in affective and sexual encounters, which inclu-des frequent use of dating apps and substances. The hierarchy of the delivery of prevention methods is presented as a proposal for a new policy, prioritizing pre-exposure prophylaxis (PrEP) and addressing the social determinants of the HIV epidemic, including strategies to mitigate stigma. The importance of the participation of adolescents and youth in constructing the policy and the need for an intersectoral response are also reinforced.
Changes and predictors of adolescent emotion regulation, self-esteem, and locus of control during the COVID-19 pandemic: 2004 Pelotas Birth Cohort
(2023) MARUYAMA, Jessica Mayumi; TOVO-RODRIGUES, Luciana; SANTOS, Ina S.; MURRAY, Joseph; MATIJASEVICH, Alicia
Objectives: There is growing interest in examining the impacts of the coronavirus disease 2019 (COVID-19) pandemic on adolescent socioemotional development. This study aimed to examine changes in adolescent emotion regulation (ER), self-esteem (SE), and locus of control (LoC) from before to during the pandemic in a Brazilian birth cohort, and to investigate the variables associated with changes in those socioemotional competences.Methods: 1,949 adolescents from the 2004 Pelotas Birth Cohort were assessed before (T1, November 2019 to March 2020) and during (T2, August to December 2021) the COVID-19 pandemic (mean ages [SD] = 15.69 [0.19] and 17.41 [0.26], respectively). Adolescents' socioemotional competences were assessed, including ER, SE, and LoC. Sociodemographic, pre-pandemic, and pandemic-related correlates were examined as predictors of change. Multivariate latent change score models were used in the analyses.Results: There were significant mean increases in adolescents' ER and SE (mean ER = 1.918, p < 0.001; mean SE = 1.561, p = 0.001) and a significant mean decrease (towards internalization) in LoC levels (MLoC = -0.497, p < 0.01) during the pandemic. Factors that predicted a lower competency increase included family conflicts, harsh parenting, and maternal depressive symptoms during the pandemic.Conclusion: Despite the stress imposed by the COVID-19 pandemic, the adolescents of this cohort showed positive development in their socioemotional competences. Family-related factors emerged as important predictors of adolescent socioemotional adjustment during the study period.
Ultra-processed food consumption and dental caries in adolescents from the 2004 Pelotas Birth Cohort study
(2023) SILVA, Nathalia Ribeiro Jorge da; CAMARGO, Maria Beatriz Junqueira de; VAZ, Juliana Santos dos; CORREA, Marcos Britto; MATIJASEVICH, Alicia; SANTOS, Ina da Silva dos; CASCAES, Andreia Morales
ObjectiveTo investigate the relationship between ultra-processed food (UPF) consumption and dental caries in adolescents. MethodsData from 996 adolescents aged 12-13 years who participated in an oral health sub-study of the 2004 Pelotas Birth Cohort in southern Brazil were analysed. The main exposure was daily UPF consumption at age 10-11 years, measured by a food frequency questionnaire containing 24 UPF items defined based on the NOVA system. UPF consumption was calculated in frequency, grams and calories, in general and for six types of food (biscuits, savoury snacks and sugar-sweetened cereals; ultra-processed meats and fats; sweets; fast food and instant noodles; soft drinks and artificially flavoured drinks; and sweetened milk and powdered chocolate). The outcome was dental caries, measured according to the decayed, missing and filled indexes (DMFS and dmfs) at age 12-13 years. Poisson regression models were used to analyse the association between UPF consumption and dental caries, adjusting for socioeconomic and demographic variables, dental visits and oral hygiene. ResultsOverall, the daily UPF consumption in frequency, grams and calories was associated with caries. The findings were consistent for UPF consumption for all six food groups. The higher the UPF consumption, the higher the probability of having caries in adolescence. The associations between ultra-processed meats and fats, and fast food and instant noodles intake with dental caries alert to the cariogenic potential of such UPF foods. ConclusionUltra-processed food consumption was associated with greater caries burdens in young adolescents. The findings reinforce the need for interventions and public policies to reduce UPF consumption in adolescence.

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