cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.14292045.v1
title: Incorporated antivirals for chronic hepatitis B in Brazil: a cost-effectiveness analysis

description: OBJECTIVE To evaluate the cost-effectiveness of different drug therapies for chronic hepatitis B in adult patients. METHODS Using a Markov model, a hypothetical cohort of 40 years for HBeAg-positive or HBeAg-negative patients was constructed. Adefovir, entecavir, tenofovir and lamivudine (with rescue therapy in cases of viral resistance) were compared for treating adult patients with chronic hepatitis B undergoing treatment for the first time, with high levels of alanine aminotransferase, no evidence of cirrhosis and without HIV co-infection. Values for cost and effect were obtained from the literature, and expressed in effect on life years (LY). A discount rate of 5% was applied. Univariate sensitivity analysis was conducted to assess model uncertainties. RESULTS Initial treatment with entecavir or tenofovir showed better clinical outcomes. The lowest cost-effectiveness ratio was for entecavir in HBeAg-positive patients (R$ 4,010.84/LY) and lamivudine for HBeAg-negative patients (R$ 6,205.08/LY). For HBeAg-negative patients, the incremental cost-effectiveness ratio of entecavir (R$ 14,101.05/LY) is below the threshold recommended by the World Health Organization. Sensitivity analysis showed that variation in the cost of drugs may make tenofovir a cost-effective alternative for both HBeAg-positive and HBeAg-negative patients. CONCLUSIONS Entecavir is the recommended alternative to start treating patients with chronic hepatitis B in Brazil. However, if there is a reduction in the cost of tenofovir, it can become a cost-effective alternative.
DOI: 10.6084/m9.figshare.14292041.v1
title: Introduction and expansion of human American visceral leishmaniasis in the state of Sao Paulo, Brazil, 1999-2011

description: OBJECTIVE : To analyze the spread of human American visceral leishmaniasis and identify the key municipalities for developing surveillance and control activities. METHODS : The area of the study was composed of the 316 municipalities in the state of Sao Paulo belonging to the five health districts in which human American visceral leishmaniasis occurs, using data on autochthonous cases and deaths according to the reporting year and municipality in which the death occurred. The incidence, mortality and case fatality rates for each municipality and for the entire area were calculated. An empirical Bayes estimator was used to calculate the local Bayesian incidence and rates of mortality per municipality, and Kriging was used to visualize the spatial distribution of temperature and rainfall. RESULTS : A total of 73 municipalities with transmission of the disease were identified. Human American visceral leishmaniasis was first detected in areas with higher temperatures and lower rainfall, but it also spread in cooler and wetter areas. The expansion of human American visceral leishmaniasis occurred along a main axis of dissemination, from Northwest to Southeast, following the Marechal Rondon highway and the Bolivia-Brazil gas pipeline, and along a secondary axis that was derived from the main axis, which runs both North and South, following the highway network. Rates of incidence according to health district exhibit a peak, followed by a fall, except the Sao Jose do Rio Preto region. Higher concentrations of municipalities with high incidence and mortality rates were observed in the Araçatuba, Presidente Prudente and Marília health districts. CONCLUSIONS : This study indicates possible determinants of the spread of disease, including the Marechal Rondon highway and the construction of the Bolivia-Brazil gas pipeline. Climatic factors seemed to play no role in the spread. The use of spatial analysis techniques allowed the municipalities where cases and deaths are possibly underreported to be identified, which indicated the municipalities which should be prioritized for the development of surveillance and control activities.
DOI: 10.6084/m9.figshare.14292037.v1
title: Validity study of the "Physical Activity Checklist" in children

description: OBJECTIVE: To assess the validity and operational equivalence of the "Physical Activity Checklist" in children.METHODS: This study complements the cross-cultural adaptation of the Physical Activity Checklist Interview, conducted with 118 school children aged between seven and ten years old, enrolled from the second to the fifth grades of primary education in the city of Sao Paulo, SP, Southeastern Brazil, in 2009. The questionnaire enables the quantification of time spent in moderate and vigorous physical activities and sedentary activities and the total and weighted metabolic costs. The accelerometer was adopted as a criterion measure of physical activity. The variables total physical activity (counts/min) and time spent in moderate to vigorous physical activity were quantified. The concurrent validity was assessed by Pearson's correlation coefficient while the operational equivalence was assessed by data concerning the duration and evaluation of the interview.RESULTS: The values for the correlation coefficient between the results from the questionnaire and the accelerometer ranged from 0.34 to 0.40. It was found that LAF overestimates time spent doing moderate and vigorous physical activity when compared to the accelerometer. The average duration of the interviews was 24 minutes (minimum = 13 min, maximum = 41 min, sd = 5 min). The interview item showing the poorest result was the children's ability to estimate time (poor or fair in 24.8% of interviews).CONCLUSIONS: In relation to the original version, the questionnaire "Physical Activity Checklist" presents similar indices of concurrent validity and operational equivalence, confirming the appropriateness of the cross-cultural adaptation.
DOI: 10.6084/m9.figshare.14292035.v1
title: Cultural adaptation of the Brazilian version of the Godin-Shephard Leisure-Time Physical Activity Questionnaire

description: OBJECTIVE: To conduct the cultural adaptation of the Brazilian version of the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) and to assess its content validity, practicability, acceptability and reliability.METHODS: The stages of translation, synthesis, back translation, expert committee review and pre-test were carried out, followed by the evaluation of the practicability, acceptability and reliability (test-retest). The judges assessed its semantic, idiomatic, conceptual, cultural and metabolic equivalences. The adapted version was submitted to the pre-test (n = 20), and test-retest (n = 80), in healthy individuals and in those suffering from cardiovascular disease in Limeira, SP, Southeastern Brazil, between 2010 and 2011. The proportion of agreement of the committee of judges was assessed using the Content Validity Index. Reliability was assessed by the criterion of stability, with 15 days between applications. Practicability was evaluated by the time spent interviewing and acceptability was estimated as the percentage of unanswered items and the proportion of patients who responded to all items.RESULTS: The translated version of the questionnaire showed evidence of appropriate semantic-idiomatic, conceptual, cultural and metabolic equivalence, with substitutions of several physical activities more appropriate to the Brazilian population. The practicability analysis showed short time needed for the application of the instrument (mean 3.0 minutes). As for acceptability, all patients answered 100% of the items. The test-retest analysis suggested that stability was good (Intraclass Correlation Coefficient value of 0.84).CONCLUSIONS: The Brazilian version of the questionnaire showed satisfactory measures of the qualities in question. Its application to diverse populations in future studies is recommended in order to provide robust measures of these qualities.
DOI: 10.6084/m9.figshare.14292033.v1
title: Gender and racial inequalities in trends of oral cancer mortality in Sao Paulo, Brazil

description: OBJECTIVE:To analyse recent trends in oral cancer mortality, focusing specifically on differences concerning gender and race.METHODS:Official information on deaths and population in the city of Sao Paulo, 2003 to 2009, were used to estimate mortality rates from oral cancer (C00 to C10, International Classification of Diseases, 10th Revision), adjusted for age and stratified by gender (females and males) and race (blacks and whites). The Prais-Winsten auto-regression procedure was used to analyse the time series.RESULTS:During the study period, 8,505 individuals living in the city of Sao Paulo died of oral cancer. Rates increased for females (rate of yearly increase = 4.4%, 95%CI 1.4;7.5), and levelled off for men, which represents an inversion of previous trends among genders in the city. Increases were identified for blacks, with a high rate of yearly increase of 9.1% (95%CI 5.5;12.9), and levelled off for whites. Oral cancer mortality in blacks almost doubled during the study period, and surpassed mortality in whites for almost all categories.CONCLUSIONS:Mortality presented a higher increase among women than in men, and it doubled among backs. The surveillance of trends of oral cancer mortality across gender and racial groups may contribute to implementing socially appropriate health policies, which concurrently reduce the burden of disease and the attenuation of unfair, avoidable and unnecessary inequalities in health.
DOI: 10.6084/m9.figshare.14292027.v1
title: Association between Schistosomiasis mansoni and hepatitis C: systematic review

description: OBJECTIVE: To perform a systematic review of the prevalence of the HCV/ S. mansoni co-infection and associated factors in Schistosoma mansoni -infected populations. METHODS: The bibliographic search was carried out using the Medline, Lilacs, SciELO, Cochrane Library and Ibecs databases. The criteria for the studies' selection and the extraction data were based on systematic review methods. Forty five studies were found, with nine being excluded in a first screening. Thirteen articles were used for data extraction. RESULTS: The HCV infection rates in schistosomiasis populations range from 1% in Ethiopia to 50% in Egypt. Several studies had poorly defined methodologies, even in areas characterized by an association between hepatitis C and schistosomiasis, such as Brazil and Egypt, which meant conclusions were inconsistent. HCV infection rates in schistosomotic populations were heterogeneous and risk factors for acquiring the virus varied widely. CONCLUSIONS: Despite the limitations, this review may help to identify regions with higher rates of hepatitis C and schistosomiasis association. However, more studies are necessary for the development of public health policies on prevention and control of both diseases.
DOI: 10.6084/m9.figshare.14292025.v1
title: Access to pediatric cancer care in Brazil: mapping origin-destination flows

description: OBJECTIVE: To analyze fl ows of travel between place of residence and health care services by children and adolescents with cancer. METHODS: The flows of travel between place of residence and the health care service for children and adolescents receiving care in Brazil’s Unifi ed Health System (SUS) were monitored between 2000 and 2007. The unit of analysis was the health care district. The geographical information system data and network methodology, by type of treatment received (chemotherapy and radiotherapy) and hospital admissions were used. RESULTS: The SUS made 465,289 authorizations for chemotherapy, 29,151 for radiotherapy and 383,568 for hospital admissions for the treatment of children and adolescents with a diagnosis of cancer. The dominant fl ow formed 48 networks for chemotherapy, 53 for radiotherapy and 112 for hospital admissions. Most of the volume of treatment occurred in the health districts of Brazil’s 12 largest cities (with strong links between them and each having an extensive area of direct infl uence accompanying the structure of the Brazilian urban system. CONCLUSIONS: Identifying the networks formed by utilization of SUS facilities providing care for children and adolescents with cancer shows that overall most patients are covered by the existing networks. However, about 10% of travel occurs outside the dominant structure, indicating the need for alternative regionalization. These results show the importance of planning the distribution of services to meet the population’s needs.
DOI: 10.6084/m9.figshare.14292023.v1
title: Human risk assessment of benzene after a gasoline station fuel leak

description: OBJECTIVE: To assess the health risk of exposure to benzene for a community affected by a fuel leak. METHODS: Data regarding the fuel leak accident with, which occurred in the Brasilia, Federal District, were obtained from the Fuel Distributor reports provided to the environmental authority. Information about the affected population (22 individuals) was obtained from focal groups of eight individuals. Length of exposure and water benzene concentration were estimated through a groundwater flow model associated with a benzene propagation model. The risk assessment was conducted according to the Agency for Toxic Substances and Disease Registry methodology. RESULTS: A high risk perception related to the health consequences of the accident was evident in the affected community (22 individuals), probably due to the lack of assistance and a poor risk communication from government authorities and the polluting agent. The community had been exposed to unsafe levels of benzene (&gt; 5 µg/L) since December 2001, five months before they reported the leak. The mean benzene level in drinking water (72.2 µg/L) was higher than that obtained by the Fuel Distributer using the Risk Based Corrective Action methodology (17.2 µg/L).The estimated benzene intake from the consumption of water and food reached a maximum of 0.0091 µg/kg bw/day (5 x 10-7 cancer risk per 106 individuals). The level of benzene in water vapor while showering reached 7.5 µg/m3 for children (1 per 104 cancer risk). Total cancer risk ranged from 110 to 200 per 106 individuals. CONCLUSIONS: The population affected by the fuel leak was exposed to benzene levels that might have represented a health risk. Local government authorities need to develop better strategies to respond rapidly to these types of accidents to protect the health of the affected population and the environment.
DOI: 10.6084/m9.figshare.14291975.v1
title: The militarization of responses to COVID-19 in Democratic Latin America

description: Abstract Latin America has been severely affected by the COVID-19 pandemic, prompting its governments to take action. In this context, countries within Latin America have used their armed forces for an array of tasks to serve citizens. But how militarized is the response to COVID-19 in Latin America? This paper proposes a typology of tasks provided by the armed forces as a response to COVID-19. The descriptive findings allow us to map these tasks, attributing scores to the fourteen Latin American democracies. We also show evidence for the potential consequences of some tasks. Policing the streets to enforce stay-at-home orders may lead to the military committing human rights violations, assuming eminently civilian posts to manage the public health crisis can result in long term implications for the civil-military balance that are detrimental to the democratic control over the military.
DOI: 10.6084/m9.figshare.14291973.v1
title: The role of intergovernmental relations in response to a wicked problem: an analysis of the COVID-19 crisis in the BRICS countries

description: Abstract Globally, policy environments have become increasingly more complex with the growth in the number of wicked problems, such as that posed by the COVID-19 pandemic. In their response to these problems, public administrations have, from necessity, become heavily reliant on their intergovernmental relations systems, as the challenges posed generally require multilevel responses. This paper analyzes the role of intergovernmental relations in shaping the responses of the BRICS countries when confronted with COVID-19. We develop an analytical framework to understand the dynamics of intergovernmental relations in these countries. Based on this we assess the capacity of the state and political systems to manage intergovernmental relations and ensure effective responses to the COVID-19 crisis. This framework is based on an analysis of three dimensions of the policy domain: the political and state system, formal and informal institutions, and the political alignment between them. Whilst state and political systems were found to be instrumental in formulating an immediate response to the crisis, informal institutions and political processes also played a prominent role in determining the extent to which strategies were implemented, particularly in countries that are more decentralized. Countries lacking the robust formal institutions needed to facilitate intergovernmental relations and to ensure swift policy responses, tend to deliver ineffective and inefficient results when confronted with wicked problems.
DOI: 10.6084/m9.figshare.14291971.v1
title: COVID-19 in Africa: a comparative analysis of early policy responses

description: Abstract The COVID-19 pandemic has caused turmoil around the world. In Africa, some similarities and differences could be observed in the nature of the outbreak and the policy responses across the continent. This article discusses the policy responses and reflects on their effectiveness as a containment strategy. We speculate on why these strategies seem to work or not, and the lessons therein. The analysis also examines the setting up of crisis teams and whether they indicate lack of trust in the existing public administration system. The article argues that though South African cases and testing diverged significantly from the rest of the continent, a wider similarity can be observed in pandemic management across the continent. The article identifies some factors including quick and early measures, recent experience managing epidemic/health crises, and a display of some form of community resilience acquired over years of living in a state of poor governance as some of the important factors in the management of the pandemic. We find there is a dearth of scholarship on crisis management in the context of public administration and suggest this should be an object of future study in the field. The use of ad-hoc crisis teams that assume emergency powers is a common practice, but there is insufficient rigorous analysis to show their effectiveness and impact on existing bureaucratic institutions.
DOI: 10.6084/m9.figshare.14291969.v1
title: Comparing strategies against COVID-19: Italy and Switzerland

description: Abstract The COVID-19 pandemic has all features of a wicked problem. It is not only a crisis of intensive care but also a more complex health, social, economic, and humanitarian crisis. Moreover, its risks will continue until mass vaccination is undertaken, hence, the control of contagiousness relies on citizens’ responsible behavior. Strategies to fight COVID-19 in Lombardy, Veneto (Italy) and in Ticino (Switzerland) have shown that a more balanced approach focusing not exclusively on hospitals but also on a territorial basis, pays off. Therefore, a more integrated approach is beneficial from a clinical, social, and economic point of view providing procedures for future emergencies.
DOI: 10.6084/m9.figshare.14291967.v1
title: How does a populist government interpret and face a health crisis? Evidence from the Mexican populist response to COVID-19

description: Abstract In 2020, governments were faced with addressing the health crisis caused by the COVID-19 pandemic, without certainty about what would work best to reduce the health crisis without ruining the economy. Through all the uncertainty, national governments based their responses to COVID-19 on beliefs and political ideas, which was reflected on the diversity of the responses: liberal, authoritarian, centralized, decentralized, transparent, or opaque. In this article we focus on one of these responses, populism, and seek to understand how populist beliefs drive bureaucratic actions taken by a populist government to handle the health crisis. We conducted a comparative case study between the Mexican populist federal government and the non-populist Jalisco state government. Our findings suggest that the administrative actions chosen by the Mexican populist government were based on negative beliefs towards expert scientific knowledge from outside the government; a disinterest in searching for more information from distant or unfamiliar sources; and a strengthening of flagship programs as the main way to address the upcoming economic crisis. We also found that the Mexican government shows a peculiar manifestation of populism, which we refer as downsizing populism. Our article advances our understanding about how populism may affect the form and function of bureaucracies.
DOI: 10.6084/m9.figshare.14291965.v1
title: The costs and benefits of duality: Colombia’s decentralization and the response to the COVID-19 pandemic

description: Abstract Colombia’s duality between the relative strength of the central government and the broad process of decentralization towards subnational and local governments has shaped the country’s response to the COVID-19 pandemic. Substantial tensions have arisen between the national and subnational governments in the handling of the crisis. Thus, blurred policy boundaries challenge multi-level government coordination. Yet, intergovernmental relations and multi-level governance have worked at some extent. Meanwhile, leadership styles, the level of political support, the local governance environment and the level of local institutional capacity have affected the strategies of local government leaders and their success to tackle the pandemic. Moreover, uneven healthcare capacity across the Colombian territory posits further challenges for a national response to the pandemic that ensures both effectiveness and equity.
DOI: 10.6084/m9.figshare.14291963.v1
title: The impact of COVID-19 on education provision to indigenous people in Mexico

description: Abstract As a result of the COVID-19 pandemic, measures have been taken globally to shut down schools at all levels and move education to the online arena, which entails a strong dependence on access to the internet and electronic gadgets. Measures such as these are bound to deepen already existing inequality and bring about major disruptions in the students’ learning process. In this context, the makeup of our diverse Mexican society and school communities calls for a political framework that promotes equal education and ensures a way of constructing knowledge that is accessible to all; a perspective in education that respects traditional groups and cultures, especially those who are usually financially disadvantaged, such as indigenous people. This article examines measures taken to support provision of online education, in general, and indigenous groups, in particular. The data collection approach to support the findings consisted of reviewing official websites from UNESCO, the Mexican Ministry of Education, and three states with the largest number of indigenous people (IP). The findings suggest that the production of TV programs and school booklets in indigenous languages show a considerable effort to reach out to indigenous communities throughout the country. Nevertheless, the measures taken by the national and state governments may still be deemed limited and somewhat biased in favor of monolingual students.