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This study aimed to analyze space-time distribution of the prevalence of food and nutritional insecurity (FNI) in the Brazilian Federative Units and their correlation with vulnerability markers. This is an ecological study, with data from the National Household Sample Survey (2004, 2009 and 2013) and Atlas Brazil (2010). A time analysis of the spatial distribution of FNI prevalence was performed. Moran's Index was used in bivariate spatial analysis. The prevalence of FNI have decreased along the years studied and showed a negative and moderate spatial correlation with the Human Development Index; a positive and moderate correlation with the percentage of the extremely poor, child mortality, social vulnerability index, human capital social vulnerability index; and positive and strong correlation with income and work social vulnerability index. We can conclude that there was a lower prevalence of FNI in the analyzed years and that the Brazilian territory showed two distinct patterns: territories with higher FNI prevalence and worse conditions as regards income, work and child health in the North and Northeast; and territories with lower FNI prevalence and lower vulnerability in the Midwest, Southeast and South.

Objectives To analyze trends in pancreatic cancer incidence and mortality in Latin American countries. Methods An ecological study with incidence data from the International Agency for Research on Cancer and mortality data from the World Health Organization. The trend of incidence by Joinpoint regression, the variation of the annual average and the 95% confidence interval were analyzed. Results There were increasing trends in incidence in Brazil, in males, aged 40-59 years, and reduction in Costa Rica. In females, there was stability in all age groups. The mortality rates increased in the elderly in Brazil (AAPC: 1.09%; 95% CI: 0.76; 1.42), Peru (AAPC: 1.76%; 95% CI: 0.36; 3.17) and El Salvador (AAPC: 2.88%; 95% CI: 0.38; 5.43), while in Mexico, there was a reduction. In females, this rate increased in Brazil (AAPC: 1.38%; 95% CI: 1.07; 1.69), Peru (AAPC: 2.25%; 95% CI: 0.68; 3.85), Chile (AAPC: 3.62%; 95% CI:1.96; 5.31), Nicaragua (AAPC: 2.51%; 95% CI: 0.36; 4.71) and Paraguay (AAPC: 1.17%; 95% CI: 0.37; 1.98) and a downward trend was observed in Colombia and Ecuador. Conclusions Pancreatic cancer had a higher incidence in the elderly population of both sexes and an increase of the mortality trend in females was noted.

This study aimed to analyze the prevalence and factors associated with suicidal ideation among farmers. Cross-sectional study carried out between 2019 and 2020 with 450 farmers in Rio Grande do Norte. The prevalence of suicidal ideation was evaluated using the Beck Suicidal Ideation Inventory, and sociodemographic, health, income, work and alcohol abuse variables were analyzed. The Chi-square test was used to compare the proportions of the outcome between the categories of each variable. Poisson regression with robust variance was used to analyze associated factors and estimate prevalence ratios [PR]. The prevalence of suicidal ideation was 12.4% [95%CI 9.69–15.84] and, in the bivariate analysis, it was associated with sociodemographic, health, income and work variables. In the final multivariate model, the variables that remained significant and were associated with a higher prevalence of SI were: female gender [PR = 3.28], diagnosis of mental disorder in the family [PR = 2.37], presence of common mental disorder [PR = 2.50], alcohol abuse [PR = 2.22] and employment relationship–salaried or temporary [R = 1.91]. Thus, suicidal ideation among farmers is mainly associated with health aspects, especially mental health, work and the female sex, and signals the need to strengthen public policies for suicide prevention with the targeting of effective strategies for the farmers.

We sought to identify the prevalence and factors associated with alcohol abuse among farmers living in a medium-sized municipality in northeastern Brazil during 2019 and 2020. Trained interviewers applied the standardized questionnaire to 450 participants. Sociodemographic, health, income and work characteristics were investigated. The tracking of alcohol misuse was done using the CAGE questionnaire (Cut down, Annoyed by criticism, Guilty and Eye-opener), being the cut-off point ≥ 2. Poisson Regression was applied with robust estimation to verify the reasons of prevalence (RP) in bivariate and multivariate analysis. The prevalence of alcohol abuse among farmers was 32% (95% CI 27.8–36.4). Factors such as being male, having a diagnosis of mental disorder in the family, being a smoker, and using drugs were associated with the higher prevalence of the outcome. Being 60 years old or older was associated with a lower prevalence of alcohol abuse. These results indicate the need for social support to this group of workers in the context of occupational health.

This review aimed to investigate the factors associated with suicidal behavior in farmers in the scientific literature. Two researchers participated independently in searching databases, specifically PubMed/MEDLINE, LILACS, Web of Science, Scopus, PsycINFO, and SciELO. Only observational studies were included. The quality of the selected studies was assessed with a critical assessment checklist for cross-sectional analytical and case-control studies, prepared by the Joanna Briggs Institute. Data related to the publication were collected (author and year; city/country); methodological design; sample/population (gender; average age), outcome, measuring instrument and factors associated with suicidal behavior. A total of 14 studies were included in the systematic review, and factors associated with farmers’ behavior in mental health (depression), seasonal impacts (drought), and work exposures (herbicides and insecticides) were identified. However, heterogeneity was found in terms of the method, measurement of suicidal behavior, and associated factors, which indicates the need for further studies.

The aim of this study is to analyze the relationship between intestinal constipation and functioning in adult women living in a municipality in the interior of northeast Brazil. This is a cross-sectional study conducted with 195 adult women in the city of Santa Cruz-RN. Constipation was diagnosed using the Rome III criteria. Functioning was measured through WHODAS 2.0. Social conditions, habits and lifestyle were also investigated. Inferential analysis was performed using the chi-squared test and the Mann-Whitney -test, and the effect size was determined by eta squared (η ). Multivariate analysis was performed using multiple linear regression to analyze the relationship between the WHODAS total score and constipation, being adjusted by covariates with p≤0.20 in the bivariate. A statistical significance level of p<0.05 was considered. Most of the participants in this study were aged 19 to 39 years (69.7%) and had an income of up to 1 minimum monthly salary (79.5%). WHODAS scores showed that women with constipation had more disability in the cognitive (p <0.001), mobility (p <0.002), self-care (p <0.001), and participation (p <0.001) domains, as well as the total score (p <0.001). After multiple linear regression analysis, the total WHODAS score remained associated with constipation (p <0.001), in which this condition increases the score by nine points. The results of this study show that there is a reduction in functioning associated with the presence of constipation in adult women, mainly affecting the cognition, mobility, self-care and participation domains, in addition to the total score.

For many years, discussions about health care for people with disabilities (PwD) in Brazil have not been treated as a priority; however, based on the advances made at the beginning of this century, new policies have been developed with the aim of improving access of these people to health services. Therefore, the aim of this study was to analyze how individual characteristics and contextual indicators are associated with access to rehabilitation services for PwD in Brazil. A multivariate analysis was performed based on data from the National Health Survey 2013, considering access to rehabilitation services by PwD as the primary outcome and individual and contextual factors selected from Andersen's behavioral model as independent variables. The contextual variables were reduced to two composite indicators (1-primary health care coverage and unfavorable socioeconomic conditions, and 2-economic inequality) from the analysis of the principal components. Poisson regression analysis with robust variance was performed to estimate the prevalence ratio (PR) and the respective 95% confidence interval (95%CI). Access to rehabilitation services by PwD was more prevalent in people aged 0 to 17 years (PR = 3.28; 95%CI 2.85-3.78), who are illiterate (PR = 1.24; 95%CI 1.09-1.40), whose socioeconomic level is A or B (PR = 1.60; 95%CI 1.35-1.88), who have health insurance (PR = 1.31; 95%CI 1.15-1.49), who have severe limitations (PR = 3.09; 95%CI 2.64-3.62), who live in states with a good offer of Specialized Rehabilitation Centers, both type II (PR = 1.20; CI95% 1.08; 1.33) and type IV (PR = 1.29; CI95% 1.15; 1.44), and who have greater coverage of primary health care, but unfavorable socioeconomic conditions (PR = 1.15; CI95% 1.03-1.28). The results clarify the social inequities that exist regarding access to rehabilitation services for PwD in Brazil and highlight the need to formulate and implement public policies that guarantee the realization of the rights of these people.

Mental and behavioral disorders constitute a serious public health problem and require adequate access among women and men for promotion, prevention and treatment of mental illness. For the writing of this protocol we will use the guidelines of the PRISMA-P Checklist (Main Items for Reporting Systematic Reviews and Meta-analyzes). This protocol was registered under the number: CRD42021243263. To this end, research will be conducted in the PubMed, Web of Science, Scopus, CINAHL and ScienceDirect databases in search of cross-sectional studies that assess the prevalence of access to mental health services among women and men. All cross-sectional studies that examined the prevalence of mental health services accessibility among women and men will be included. The search will be conducted by two independent researchers who will identify the articles; they will exclude duplicate studies. Through a blinded assessment, they will select articles using the Rayyan QCRI application. The methodological quality of the included studies will be assessed by the Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies. Meta-analyses will be performed according to the conditions of the included data. For the development of this study, there is no need for ethical review, as this is a systematic review that will use secondary studies. The conclusions of this study will be disseminated through peer-reviewed publications, conference presentations and condensed abstracts to key stakeholders and partners in the field. The database search is scheduled to start on May 10th, 2021. The entire review process is expected to be completed by August 30th, 2021.

Background Reports suggest that Latin American and Caribbean (LAC) countries have not reduced leukemia mortality compared to high-income countries. However, updated trends remain largely unknown in the region. Given that leukemia is the leading cause of cancer-related death in LAC children, we evaluated mortality trends in children (0-14y) from 15 LAC countries for the period 2000–2017 and predicted mortality to 2030. Methods We retrieved cancer mortality data using the World Health Organization Mortality Database. Mortality rates (standardized to the world standard SEGI population) were analyzed for 15 LAC countries. We evaluated the average mortality rates for the last 5 years (2013–2017). Joinpoint regression analysis was used to evaluate leukemia mortality trends and provide an estimated annual percent change (EAPC). Nordpred was utilized for the calculation of predictions until 2030. Results Between 2013 and 2017, the highest mortality rates were reported in Venezuela, Ecuador, Nicaragua, Mexico, and Peru. Upward mortality trends were reported in Nicaragua (EAPC by 2.9% in boys, and EAPC by 2.0% in girls), and Peru (EAPC by 1.4% in both sexes). Puerto Rico experienced large declines in mortality among both boys (EAPC by − 9.7%), and girls (EAPC by − 6.0%). Leukemia mortality will increase in Argentina, Ecuador, Guatemala, Panama, Peru, and Uruguay by 2030. Conclusion Leukemia mortality is predicted to increase in some LAC countries by 2030. Interventions to prevent this outcome should be tailor to reduce the socioeconomic inequalities and ensure universal healthcare coverage.

Vitamins and essential metals have been studied as potential risk and prognostic factors in amyotrophic lateral sclerosis (ALS). This study aimed to evaluate the prevalence of inadequate micronutrient intake in ALS patients, comparing subgroups according to the disease severity. Data were obtained from the medical records of 69 individuals. Assessment of disease severity was determined by the revised ALS Functional Scale (ALSFRS-R), using the median as the cutoff. The prevalence of inadequate micronutrient intake was estimated using the Estimated Average Requirements (EAR) cut-point method. The prevalence of inadequate vitamin D, E, riboflavin, pyridoxine, folate, cobalamin, calcium, zinc, and magnesium intake was considered severe. Patients with lower ALSFRS-R scores had lower intakes of vitamin E (p < 0.001), niacin (p = 0.033), pantothenic acid (p = 0.037), pyridoxin (p = 0.008), folate (p = 0.009) and selenium (p = 0.001). Therefore, ALS patients should be monitored regarding dietary intake of micronutrients essential in neurological processes.