MARIA FERNANDA TOURINHO PERES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
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- Vaccination coverage rates and predictors of HPV vaccination among eligible and non-eligible female adolescents at the Brazilian HPV vaccination public program(2020) FAISAL-CURY, Alexandre; LEVY, Renata Bertazzi; TOURINHO, Maria Fernanda; GRANGEIRO, Alexandre; ELUF-NETO, JoseBackground Since March 2014, the quadrivalent HPV vaccine has been incorporated into the Brazilian Unified Health Care System and began to be offered, without direct costs, for girls from 9 to 13 years of age. Older female adolescents would have the option to be vaccinated at private health care system being responsible for the payment of HPV vaccine. The present study aimed to evaluate the coverage rates and predictors of HPV vaccination in Brazil among two groups of female adolescents: eligible and non-eligible for the HPV vaccination public program. Methods We used data from the 2015 Brazilian National Adolescent School-Based Health Survey, which involved a probabilistic sample of 5404 female adolescents students at public and private schools. Using a questionnaire, we gathered information on sociodemographic characteristics, sexual behavior, and respondent perception of parental supervision and have been vaccinated for HPV. Age-specific vaccination rates were analyzed in girls aged 9 to 13 at the time of public vaccination (eligible for public policy), as well among those 14 to 17 years old not eligible by the Ministry of Health for vaccination. We used Poisson regression models to investigate associated factors. Results HPV vaccine coverage was 83.5 and 21.8% among eligible and non-eligible populations, respectively. In both populations, the chance of being vaccinated decreased with older age. In the eligible population there is a greater chance of being vaccinated among ethnic group ""pardas"" but not with other indicators of socioeconomic status. In the non-eligible population, there was a clear association between higher vaccine coverage and greater maternal education and living with the mother. Conclusion Our findings highlight the importance of public policies to minimize inequities in access to cancer prevention measures in vulnerable adolescents. A public policy of HPV vaccination for older female adolescents would increase coverage with possible reduction of HPV-related diseases in this group of women.
- Food environments in schools and in the immediate vicinity are associated with unhealthy food consumption among Brazilian adolescents(2016) AZEREDO, Catarina Machado; REZENDE, Leandro Fornias Machado de; CANELLA, Daniela Silva; CLARO, Rafael Moreira; PERES, Maria Fernanda Tourinho; LUIZ, Olinda do Carmo; FRANCA-JUNIOR, Ivan; KINRA, Sanjay; HAWKESWORTH, Sophie; LEVY, Renata BertazziBackground. Evidence of the influence of the school food environment on adolescent diet is still little explored in low-and middle-income countries. We aimed to evaluate the association between food environment in schools and the immediate vicinity and the regular consumption of unhealthy food among adolescents. Methods. We used cross-sectional data collected by the Brazilian National Survey of School Health (PeNSE) from a representative sample of adolescents attending 9th grade public and private schools in Brazil, in 2012. We estimated students' regular consumption (>5 days/week) of unhealthy food (soft drinks, bagged salty snacks, deep fried salty snacks and sweets) and school availability, in the cafeteria or an alternative outlet, of the same food plus some healthy options (fruit and natural fruit juice). We performed multilevel logistic regression models. Results. Having a cafeteria inside school selling soft drinks (private schools OR = 1.23; 95% CI = 1.14-1.33; public schools OR = 1.13; 95% CI = 1.06-1.20) and deep fried salty snacks (private schools OR = 1.41 95% CI = 1.26-1.57; public schools OR = 1.16 95% CI = 1.08-1.24) was associated with a higher consumption of these unhealthy foods of among students. In private schools, cafeteria selling fruit and natural fruit juice was associated with lower student consumption of bagged salty snacks (OR = 0.86; 95% CI 0.77-0.96) and soft drinks (OR = 0.85; 95% CI = 0.76-0.94). In addition, eating meals from the Brazilian School Food Program in public schools was associated with a lower consumption of unhealthy foods. Conclusions. Foods available in the school food environment are associated with the consumption of unhealthy food among adolescents in Brazil.
- Association between Community Violence, Disorder and School Environment with Bullying among School Adolescents in Sao Paulo - Brazil(2023) AZEREDO, Catarina Machado; MARQUES, Emanuele Souza; OKADA, Leticia Martins; PERES, Maria Fernanda TourinhoThe role of contextual-level factors in bullying is still not clear, and evidence is mostly from high-income countries. Our objective was to investigate the association between community violence, disorder, school environment and bullying among school adolescents. We used data from a representative sample of 9th grade Brazilian adolescents (n = 2108) from the Sao Paulo Project for the social development of children and adolescents (SP - PROSO). Multilevel logistic regression models stratified by sex were used to assess the association between variables at student and school/neighbourhood level and bullying victimization or perpetration. For both sexes, we found that adolescents who perceived high violence between students and high school disorder were more likely to be bullies and victims. Boys who perceived high community violence and disorder in their neighbourhood were more likely to be bullies (OR3tertile = 2.73 CI95%: 1.57-4.74). Girls attending schools where the principal reported high community violence and disorder in the neighbourhood (ORhigh = 10.24 CI95%: 2.11-49.59) and inside the school (ORhigh = 6.83 CI95%: 1.48-31.56) were more likely to be bullies. Boys from schools whose principal perceived violence between students were less likely to be victims (ORhigh = 0.35 CI95%: 0.16-0.78) and bullies (ORhigh = 0.21 CI95%: 0.07-0.64). Girls attending schools with signs or posters about tolerance/gender equality and about violence were less (OR = 0.12 CI95%: 0.03-0.50) and more likely (OR = 25.88 CI95%: 4.28-156.63) to report being bullies, respectively. Community violence, disorder and school environment were associated with bullying victimization and perpetration among adolescents. Sex-specific associations should be further investigated. Prevention and management of school violence in adolescence should consider contextual-level characteristics.
- COMBINED EFFECT OF COMMUNITY AND DOMESTIC VIOLENCE AND SELF-RATED HEALTH IN THE BRAZILIAN POPULATION(2018) ANDRADE, Alice Barone de; AZEREDO, Catarina Machado; PERES, Maria Fernando Tourinho
- A Revista de Saúde Pública na produção bibliográfica sobre Violência e Saúde (1967-2015)(2016) SCHRAIBER, Lilia Blima; BARROS, Claudia; DOLIVEIRA, Ana Flavia Pires Lucas; PERES, Maria Fernanda TourinhoThis article retrieved the publications from the Revista de Saude Publica journal (from 1967 to 2015) on violence and health, on the SciELO and PubMed bases, by searching for the terms ""violence"", ""suicide"", ""aggression"", ""bullying"", and ""external causes"",registered in any part of the text. We found 130 articles (the first one published in 1974). We observed: increase of publications over time, with decrease in the last five years; similar production volume in lethal and non-lethal violence; later publication of the latter; few studies in qualitative research; mostly descriptive production; and visualization of the problem more by the acts than by contexts or motivations and aggressors. Social markers were little approached, appearing, from largest to smallest frequency, social class, gender, race/ethnicity, and generation. Human rights were little used and only recently used as analytical framework, connected more to gender than to social class. Although Revista de Saude Publica has registered the theme in its publications, consolidating it as scientific production line, there is still great explanatory theoretical rarefaction and little intersectionality between violence, social inequalities, and human rights.
- Victims, bullies and bully-victims: prevalence and association with negative health outcomes from a cross-sectional study in Sao Paulo, Brazil(2020) LOCH, Ana Paula; ASTOLFI, Roberta Corradi; LEITE, Maria Alvim; PAPA, Cassio Henrique Gomide; RYNGELBLUM, Marcelo; EISNER, Manuel; PERES, Maria Fernanda TourinhoObjectives To estimate the prevalence of self-reported bullying as victims, bullies or bully-victims among 9th grade adolescents in the city of Sao Paulo, Brazil; to investigate association between bullying with negative health outcomes. Methods Cross-sectional data were obtained in 2017 from a sample of Brazilian adolescents (n = 2680) using a structured, self-administered questionnaire. Bivariate and multivariate Poisson regression were employed to assess in which extent the experience of bullying in position of victim, bully or bully-victim affects adolescents' health. Results Prevalence of bullying victimization was 18.3%, while victimization/perpetration and perpetration corresponded to 10.42% and 4.9%, respectively. Adolescents who experienced bullying victimization were more likely to present high levels of internalizing symptoms, to report self-harm, to present negative self-rated health and to use tobacco, when compared with those not involved. Bullies were more likely to use alcohol and to binge drinking. bully-victims presented a higher prevalence of all health outcomes, except for tobacco use. Conclusions Our findings highlight the effect of bullying in adolescents' health, regardless of the position. Planned intersectoral efforts between parents, health and education systems to prevent bullying could therefore reduce negative health outcomes during adolescence.
- Effects of age, period, and birth cohort on homicide mortality in the city of Sao Paulo, Brazil, from 1996 to 2015(2022) ANDRADE, Flavia Reis de; MENEZES, Fabricio dos Santos; OLIVEIRA, Max Moura de; CONCEICAO, Gleice Margarete de Souza; PERES, Maria Fernanda Tourinho; LATORRE, Maria do Rosario Dias de OliveiraAlthough Sao Paulo is the most populous city in Brazil - one of the world's most violent countries - a significant reduction in its homicide mortality rate (HMR) has been detected. This study aims to estimate the effects of age, period, and birth cohort on the trend of homicide mortality according to sex in the city of Sao Paulo, from 1996 to 2015. An ecological study was undertaken with data on deaths by homicide for both sexes, in all age brackets, in the city of Sao Paulo. Poisson models were adjusted for each sex to estimate the age-period-cohort effects. In total, 61,833 deaths by homicide were recorded among males and 5,109 among females. Regardless of the period, the highest HMR occurred in the 20-24 age bracket. Higher HMRs were found in those born in the 1970s and 1980s. The complete model, with age-period-cohort effects, were the best fit to the data. The risk of death by homicide declined over the periods, with lower intensity in the final five years (2011-2015), for both males (RR = 0.48; 95%CI: 0.46; 0.49) and females (RR = 0.52; 95%CI: 0.47; 0.57). A reduction was found in the risk of homicide, regardless of the sex or age bracket, and also in recent cohorts. However, the intensity of such reductions has been decreasing over time, which suggests that the public policies adopted have limited potential to maintain these achievements.
- Assessing the measurement invariance and antecedents of legal cynicism in Sao Paulo, Zurich, and Montevideo(2020) NIVETTE, Amy; TRAJTENBERG, Nico; EISNER, Manuel; RIBEAUD, Denis; PERES, Maria Fernanda TourinhoIntroduction: This paper accomplishes two goals. First, we assesses the measurement invariance of legal cynicism among adolescents in Sao Paulo, Brazil, Montevideo, Uruguay, and Zurich, Switzerland. Second, we evaluate a series of social and individual antecedents that are expected to influence legal cynicism across contexts. Methods: This paper first evaluates the measurement invariance of legal cynicism using Multigroup Confirmatory Factor Analysis with three randomized clustered samples of adolescents in Zurich (n = 1447), Sao Paulo (n = 2680) and Montevideo (n = 2204). Second, we assessed the correlates for legal cynicism in each city using structural equation modelling techniques. Results: The results demonstrated metric invariance, but not scalar invariance among adolescents in Sao Paulo, Zurich, and Montevideo. We were able to establish partial measurement invariance for legal cynicism in Sao Paulo and Zurich, and therefore proceeded with the comparison of latent means and antecedents. The results show that on average legal cynicism is higher in Zurich, but that the size and strength of antecedents were similar across cities. Low self-control was by far the strongest correlate of legal cynicism. Conclusions: Overall, our results suggest that current operationalizations of legal cynicism may not be rooted in social structural context and experiences with legal authorities, but rather reflect how individuals interpret legal boundaries and dispositions towards rule-breaking. Researchers must reconsider how legal cynicism fits into models of legal socialization, and whether developmental models of self-control may help us understand the origins and nature of legal cynicism, as it is currently measured.
- Regimes espaciais: dinâmica dos homicídios dolosos na cidade de São Paulo entre 2000 e 2008(2012) NERY, Marcelo Batista; PERES, Maria Fernanda Tourinho; CARDIA, Nancy; VICENTIN, Diego; ADORNO, SergioObjective. To identify the existence of spatial and temporal patterns in the occurrence of intentional homicides in the municipality of Sao Paulo (MSP), Brazil, and to discuss the analytical value of taking such patterns into account when designing studies that address the dynamics and factors associated with the incidence of homicides. Methods. A longitudinal ecological study was conducted, having as units of analysis 13 205 census tracts and the 96 census districts that congregate these sectors in Sao Paulo. All intentional homicides reported in the city between 2000 and 2008 were analyzed. The gross homicide rates per 100 000 population was calculated as well as the global and local Bayesian estimates for each census tract during the study period. To verify the possibility of identifying different patterns of the spatial distribution of homicides, we used BoxMap and Moran's I index. Results. The homicide trends in the city of Sao Paulo in the last decade were not homogeneous and systematic. Instead, seven patterns of spatial distribution were identified; that is, seven spatial regimes for the occurrence of intentional homicides, considering the homicide rates within each census tract as well as the rates in adjacent tracts. These spatial distribution regimes were not contained within the limits of the census tracts and districts. Conclusions. The results show the importance of analyzing the spatial distribution of social phenomena without restriction of political and administrative boundaries.
- Trends in verbal bullying, domestic violence, and involvement in fights with firearms among adolescents in Brazilian state capitals from 2009 to 2015(2019) SILVA, Aline Natalia; MARQUES, Emanuele Souza; PERES, Maria Fernanda Tourinho; AZEREDO, Catarina MachadoThis study analyzes time trends in verbal bullying, domestic violence, and involvement in fights with firearms among adolescents in Brazilian state capitals from 2009 to 2015. The study of trends uses data from the Brazilian National Survey of School Health (PeNSE) in 2009, 2012 and 2015 among ninth-graders enrolled in public and private schools in the country's 26 state capitals and the Federal District. The analysis focused on domestic violence, verbal bullying, and involvement in fights with cold steel weapons and firearms in the 30 days prior to the interview. Logistic regression was performed, adjusted fir sociodemographic and behavioral characteristics, with analysis of each type of violence in Brazil and in the capital cities, according to sex. The trends were spatialized. For the capital cities as a whole, from 2009 to 2015 there was an increase of 12% (95%CI: 1.111.14) in domestic violence, 10% (95%CI: 1.08-1.11) in verbal bullying, and 7% (95%CI: 1.05-1.09) and 7% (95%CI: 1.05-1.08) in involvement in fights with firearms and cold steel weapons, respectively. Domestic violence increased in all the capital cities. In 96.3%, 70.4%, and 629% of the capital cities, respectively, there were increases in verbal bullying and involvement in fights with cold steel weapons and firearms, while there were stationary trends in the other capital cities. There was an upward trend in these forms of violence in the majority of the capital cities, evidencing the need to implement public policies to mitigation the different types of violence among adolescents.