César Coelho Xavier

The franciscana dolphin (_Pontoporia blainvillei_), a small cetacean native to the Southwestern Atlantic Ocean (SAO), is critically threatened by bycatch in gillnet fisheries and habitat degradation. The Franciscana Management Area (FMA) Ia, located in Espírito Santo, Brazil, harbors the most endangered population of small cetaceans in the SAO. The Doce River region represents a vital habitat for this species, particularly following the 2015 mining waste spill, which further disrupted local ecosystems. Through drone-based monitoring, this study investigates the diving and surface behavior of franciscana dolphins, providing valuable insights for refining population estimates and advancing conservation strategies. The average surface time was 17 seconds (±15s), and the average dive time was 64 seconds (±26s). The diving time was almost four times longer than the surface time. These findings underscore the importance of ongoing monitoring to support effective management of this vulnerable population.

Objetivo: Estimar a prevalência de hipertensão arterial sistêmica (HAS) e diabetes mellitus (DM) autorreferidas e verificar os fatores associados. Métodos: Estudo transversal realizado em 2015 que utilizou dados do inquérito populacional Saúde em Vespasiano. A amostra compôs-se por 1.206 adultos para os quais se calcularam e compararam-se as razões de prevalências de hipertensão arterial sistêmica (HAS), diabetes mellitus (DM) e HAS+DM e seus respectivos intervalos de confiança de 95%, segundo sexo, faixa etária, escolaridade e renda, utilizando regressão de Poisson com variância robusta. Resultados: Encontraram-se as seguintes prevalências de HAS, DM e HAS+DM, respectivamente, de 21,8%; 7,8% e 5,3%. Para os três grupos de doenças, a prevalência mostrou-se maior em mulheres, com idade superior a 65 anos, ensino fundamental incompleto e renda inferior a dois salários mínimos (valor-p<0,05). Conclusão: A maior prevalência e distribuição de HAS e DM observou-se entre mulheres idosas, com menor tempo de escolaridade e dependentes do Sistema Único de Saúde (SUS).

Introduction: Family Health Strategy (FHS) is a tool for Primary Health Care (PHC) consolidation in Brazil, coexisting with the Traditional Health model (THS). Aim: To evaluate PHC attributes, from the user's perspective, according to PHC models in Vespasiano, Brazil. Methods: A population-based cross-sectional study carried out between 2015-2016 with home users registered in the HIPERDIA Program, using the Primary Care Assessment Tool (PCATOOL). Descriptive and comparative analyzes were performed according to PHC models. Results: 1,227 adults participated in the study. Almost all the attributes evaluated showed inadequate orientation to PHC, except the Coordination. The FHS model obtained a better evaluation when compared to the THS model (p-value <0.05). Conclusions: Users' perception of PHC was unsatisfactory in practically all dimensions/attributes, with a slightly more positive evaluation for the FHS model. Greater attention must be paid to the contact and recognition of community’s needs by PHC health professionals. RESUMO Introdução: A Estratégia Saúde da Família (ESF) é um instrumento para consolidação da Atenção Primária à Saúde (APS) no Brasil, coexistindo com o modelo tradicional. Objetivo: Avaliar os atributos da APS, na perspectiva do usuário, segundo modelos de APS em Vespasiano, Brasil. Métodos: Estudo transversal de base populacional realizado entre 2015-2016 com usuários domiciliares e cadastrados no Programa HIPERDIA, utilizando o Primary Care Assessment Tool (PCATOOL). Análises descritivas e comparativas foram realizadas segundo os modelos de APS. Resultados: Participaram do estudo 1.227 adultos, cuja avaliação mostrou inadequada orientação dos serviços para a APS, exceto para o atributo Coordenação. O modelo ESF obteve melhor avaliação quando comparado ao modelo tradicional (p-valor<0,05). Conclusões: A percepção dos usuários foi insatisfatória para praticamente todos os atributos, sendo mais positiva para o modelo da ESF. Maior atenção deve ser dada ao contato e reconhecimento das necessidades da comunidade pelos profissionais de saúde da APS.

This study aimed to investigate the association of individual and environmental characteristics with walking for transportation among older Brazilian people living in a large urban area. Data from 825 participants (≥ 60 years) from a multistage household survey in Belo Horizonte, Brazil, were used. Walking for transportation was evaluated using the International Physical Activity Questionnaire. The environmental variables included six perceived neighborhood scales (walkability, quality of services, physical disorder, safety, social disorder, and social cohesion). A Poisson regression analysis with robust variance was performed. The walking for transportation was significantly associated with walkability scale, lower family income (up to four minimum wages), very good/good self-rated health, and high social participation. Our results suggest that promoting adequate conditions for walkability in urban areas, expanding the opportunities for social participation, and improving general health is essential to increase walking levels for transportation among this older Brazilian population.

Objective: The present study aims to analyze the association of noise annoyance with individual and sociodemographic factors and self-perception of the neighborhood in an urban center. Methods: Data were collected through a population-based cross-sectional study held in two of the nine health districts in the city of Belo Horizonte, Minas Gerais, Brazil, from 2008 to 2009. The study included 3,934 individuals of both genders, aged 18 years and older. The response variable was the self-perception of noise, investigated by the question: “In your neighborhood, does the noise bother you?” The explanatory variables were grouped into the following domains: sociodemographic, social determinants, self-rated health, and self-reported diseases. Results: The prevalence of noise annoyance was 47% for women and 39.8% for men. For both genders, noise annoyance was independently associated with bad traffic and the presence of loud music, discussions, and late-night parties. Conclusion: Gender differences were identified in the association of noise annoyance with sociodemographic characteristics and self-reported morbidity. Traffic and social customs were the main sources of noise in the regions under study.

Few studies have examined the neighborhood features related to falls in the older population in low-and-middle-income countries, including Brazil. This study aimed to evaluate if perceived neighborhood features are related to falls among older Brazilian adults living in a large urban area. This cross-sectional study was conducted using data from 834 participants (≥60 years) from a multistage household survey in Belo Horizonte, Brazil. The association between fall history in the previous year and perceived neighborhood features (quality of services, physical and social disorder, and safety) was examined using multilevel logistic regression. The fall prevalence was 13.6%. Older adults living in neighborhoods with a higher physical disorder were more likely to report fall in the previous year, even after controlling for demographic, clinical and social variables (OR = 2.59; 95% CI = 1.14–5.87). The other neighborhood features investigated were not associated with a fall history. Our findings suggest that improving the physical environment represents an important strategy to prevent falls in the Brazilian urban older population.

RESUMO: Objetivos: Investigar a associação entre a densidade de estabelecimentos de venda de bebidas alcoólicas no entorno da residência dos adolescentes e a prevalência de consumo de álcool na vida e atual, ajustado por fatores individuais e familiares. Métodos: As informações provêm da pesquisa domiciliar por amostragem probabilística estratificada e por conglomerados em três estágios (setor censitário, domicílio, adulto e adolescente), realizada em Belo Horizonte, Brasil (Saúde em Beagá, 2008-9) e de fontes oficiais de estabelecimentos que comercializam bebidas alcoólicas, devidamente georreferenciados. O desfecho foi o autorrelato de consumo de álcool na vida e atual pelos adolescentes. A variável de exposição foi a densidade de estabelecimentos definida como número de locais de venda de bebida dentro do buffer de 200 metros da residência dos adolescentes. A associação foi estimada pela regressão de Poisson ajustada por fatores individuais e familiares. Resultados: Participaram 601 adolescentes de 14-17 anos; 53,3% eram homens e 71% tinham renda familiar até cinco salários mínimos. A prevalência de consumo de álcool na vida foi de 57,0% (intervalo de confiança de 95% - IC95% 51,5 - 62,6) e o atual de 11,9% (IC95% 8,7 - 15,0). Na análise multivariada, verificou-se associação significativa entre o consumo atual de bebidas alcoólicas e a densidade de lanchonetes (razão de prevalência - RP = 1,13; IC95% 1,03 - 1,24), bares (RP = 1,21; IC95% 1,05 - 1,38) e restaurantes (RP = 1,11; IC95% 1,02 - 1,21). Interações significativas entre densidade de estabelecimentos com sexo e idade foram encontradas. Conclusão: O consumo atual de álcool pode ser potencializado pela presença de alguns tipos de estabelecimentos localizados no buffer de 200 metros da residência dos adolescentes.

Individual attributes have been investigated to explain sedentary behavior. However, few studies have evaluated this association at the neighborhood level. This study aimed to determine the association between screen time (ST) among adolescents and perceived neighborhood characteristics. This cross-sectional study was conducted using a multistage household survey in Vespasiano, Brazil, in 2015–2016. Logistic regression analyses were performed to assess the associations between the adolescent self-reported ST (television, computer, and video game > 2 h/day) and neighborhood characteristics (green space, sidewalk maintenance, street lighting, social disorder, safety during the day, and risk of violence) reported by an adult. Four hundred and twenty-three adolescents aged 11–17 participated in the study. ST was reported by 74.0% of the adolescents. After adjustment for confounder variables, neighborhood characteristics did not remain associated with ST. The results evidence no associations between ST among adolescents and perceived neighborhood environment and indicate the need for future studies of this relation.

SUMMARY: Objectives: This study aimed to estimate the prevalence and characterise potential blood donors and non‐donors in a well‐populated and representative urban area of Southeastern Brazil.Background: Studies on blood donation usually evaluate individuals who donate. Population‐based studies may contribute to characterise those who never reach the blood centre, trying to increase the range of donors.Study Design and Methods: This was a secondary analysis of a population‐based survey and a blood donor motivation study [Recipient Epidemiology and Donor Evaluation study (REDS II) International]. In a cross‐sectional study 4047 individuals representing a metropolitan area answered the question ‘Have you ever donated blood at least once in your life?’. The profiles (‘Yes/No’) were compared. Non‐donors from this reference population were compared with donors of a local blood center, in a case control analysis.Results: A total of 69·0% of the population had never donated blood and was composed mostly of women, younger than 30 years old, people not contributing to social security and not subscribing to newspapers. In the case–control study, the likelihood of donating was higher for: men, younger than 50 years old, longer time of education, married, participating in political campaigns and with a good self‐perception of health. The factors associated with no blood donation were: self‐reported mixed or white race/ethnicity, income higher than two minimum wages and belonging to trade union, political, religious/spiritual, or other social group and worse self perception of health.Conclusions: This population‐based study allowed us to characterise a high proportion of people that never reaches the blood centre. The results may be used to diversify the donor profile, creating strategies to target those least likely to donate blood, as women, white people and those with higher income and purchasing power.

OBJETIVO: Avaliar a implantação do método canguru em hospitais capacitados pelo Ministério da Saúde (MS). MÉTODO: Estudo transversal que avaliou 176 (60,1%) dos 293 hospitais maternidades (HM) capacitados entre 2000 e 2003 no Brasil. O estudo foi conduzido em duas fases. A primeira consistiu no envio de um questionário para os 293 HM, e a segunda fase realizou-se mediante visita in loco em uma amostra de 29 destes HM. O instrumento de coleta de dados da primeira fase foi enviado por correio, fax ou e-mail via Ministério da Saúde a todos os hospitais capacitados e abordava as dimensões da avaliação normativa: estrutura, processos e resultados. A segunda fase consistiu exclusivamente na avaliação de processo utilizando-se roteiro de observação não participante e estruturado. Para estimar a confiabilidade da variável “implantação das etapas do método”, entre o questionário e a visita local utilizou-se o teste de kappa. RESULTADOS: A primeira etapa do método canguru foi implantada em 84,9% dos hospitais, porém apenas 47,3% implantaram as três etapas conforme regulamenta a norma brasileira. Os resultados do teste de kappa indicam concordância moderada para a primeira etapa e substancial para a segunda e terceira etapas do método. CONCLUSÃO: A capacitação foi importante para o início do processo de implantação do método canguru, mas não suficiente para promover a implantação das três fases do método. OBJECTIVE: To evaluate the implementation of the kangaroo mother method in hospitals trained by the Brazilian Ministry of Health. METHOD: Cross-sectional study, evaluating 176 (60.1%) out of 293 hospitals that were trained by the Brazilian Ministry of Health from 2000 to 2003 in Brazil. This study was conducted in two phases. The first phase consisted of sending a questionnaire to 293 hospitals; in the second phase an in loco visit was made in a sample of 29 among those hospitals. The instrument for data collection was sent to all hospitals by mail, fax or e-mail through the Ministry of Health and they addressed the three dimensions of the normative assessment: structure, processes, and results. The second phase consisted of an evaluation of the process, using a structured guide of non-participant observation. To estimate the reliability of the variable “deployment of the steps of the method” between questionnaire and site visit, we used the kappa test. RESULTS: The first stage of the kangaroo mother method was implemented in 84.9% of the hospitals, but only 47.3% of them implemented the three stages according to the Brazilian norm. The kappa test results indicated a moderate agreement for the first stage, and substantial for the second and third stages of the method. CONCLUSION: Hospital training was important for triggering the implementation process of the kangaroo mother method. However, they were not enough to promote the implementation of the three phases of the method