Evaluating the impact of social determinants, conditional cash transfers and primary health care on HIV/AIDS: Study protocol of a retrospective and forecasting approach based on the data integration with a cohort of 100 million Brazilians.

BACKGROUND: Despite the great progress made over the last decades, stronger structural interventions are needed to end the HIV/AIDS pandemic in Low and Middle-Income Countries (LMIC). Brazil is one of the largest and data-richest LMIC, with rapidly changing socioeconomic characteristics and an important HIV/AIDS burden. Over the last two decades Brazil has also implemented the world's largest Conditional Cash Transfer programs, the Bolsa Familia Program (BFP), and one of the most consolidated Primary Health Care (PHC) interventions, the Family Health Strategy (FHS). OBJECTIVE: We will evaluate the effects of socioeconomic determinants, BFP exposure and FHS coverage on HIV/AIDS incidence, treatment adherence, hospitalizations, case fatality, and mortality using unprecedently large aggregate and individual-level longitudinal data. Moreover, we will integrate the retrospective datasets and estimated parameters with comprehensive forecasting models to project HIV/AIDS incidence, prevalence and mortality scenarios up to 2030 according to future socioeconomic conditions and alternative policy implementations. METHODS AND ANALYSIS: We will combine individual-level data from all national HIV/AIDS registries with large-scale databases, including the "100 Million Brazilian Cohort", over a 19-year period (2000-2018). Several approaches will be used for the retrospective quasi-experimental impact evaluations, such as Regression Discontinuity Design (RDD), Random Administrative Delays (RAD) and Propensity Score Matching (PSM), combined with multivariable Poisson regressions for cohort analyses. Moreover, we will explore in depth lagged and long-term effects of changes in living conditions and in exposures to BFP and FHS. We will also investigate the effects of the interventions in a wide range of subpopulations. Finally, we will integrate such retrospective analyses with microsimulation, compartmental and agent-based models to forecast future HIV/AIDS scenarios. CONCLUSION: The unprecedented datasets, analyzed through state-of-the-art quasi-experimental methods and innovative mathematical models will provide essential evidences to the understanding and control of HIV/AIDS epidemic in LMICs such as Brazil.

Evidências sobre a pobreza multidimensional na região Norte do Brasil / Pruebas en pobreza multidimensional del norte de Brasil / Evidences on multidimensional poverty in the northern region of Brazil

Resumo O presente artigo tem como objetivo apresentar novas perspectivas para a compreensão da pobreza multidimensional na região Norte do Brasil nos anos de 2006 a 2013, com a finalidade de auxiliar a administração pública no desenvolvimento de políticas focadas no combate à pobreza e na aceleração do processo de desenvolvimento. Foi utilizada uma metodologia construída por Bourguignon e Chakravarty (2003), que apresenta uma forma alternativa de medir a multidimensionalidade da pobreza. Por meio de dados construídos da Pesquisa Nacional por Amostra de Domicílio (Pnad), os resultados das seis dimensões analisadas revelaram uma redução da proporção de pobres multidimensionais da população nortista, de 30,71% em 2006, para 25,79% em 2013. Para as análises isoladas das regiões metropolitana, urbana e rural, verificou-se que a pobreza foi mais intensa na região rural.

Resumen Este artículo tiene como objetivo presentar nuevas perspectivas para la comprensión de la pobreza multidimensional en el norte de Brasil, en los años 2006-13, con el fin de ayudar al gobierno en el desarrollo de políticas centradas en la lucha contra la pobreza y la aceleración del proceso de desarrollo. Se utilizó una metodología construida por Bourguignon y Chakravarty (2003), que presenta una forma alternativa de medir la multidimensionalidad de la pobreza. Construido a partir de datos de la Encuesta Nacional de Hogares por Muestreo (Pnad), los resultados de las seis dimensiones analizadas revelaron una reducción en la proporción de pobres multidimensionales de la población del norte, 30,71% en 2006 a 25,79% en 2013. Para el análisis aislado de las regiones metropolitanas, urbanas y rurales, se encontró que la pobreza es más intensa en el campo.

Abstract This paper aims to present new perspectives for the understanding on multidimensional poverty in northern Brazil in the years 2006-13, in order to assist the government in developing policies focused on fighting poverty and advancing the development process. The study used a methodology built by Bourguignon and Chakravarty (2003), which presents an alternative way of measuring the multidimensionality of poverty. The data was collected from the National Household Sample Survey (PNAD) and the results of six dimensions analyzed revealed a reduction in the proportion of multidimensional poor of the northern population, from 30.71% in 2006 to 25.79% in 2013. As for isolated analysis of metropolitan regions in urban and rural areas, it was found that poverty was more intense in rural areas.

Síndrome de Pallister-Killian / Pallister-Killian syndrome

A Síndrome de Pallister-Killian (SPK) é uma doença genética rara, que acarreta muitas alterações no desenvolvimento neuropsicomotor.O presente estudo teve como objetivo contribuir para o conhecimento e tratamento fisioterapêutico da SPK. Tratou-se de um estudo de caso de uma paciente de 15 anos, acompanhada na Clínica de Fisioterapia da Faculdade Anhanguera de Campinas.Foi realizada uma avaliação fisioterapêutica da paciente, e aplicadoum questionário à mãe para colher informações sobre o períodopré-natal, perinatal e pós-natal. Os resultados mostraram fáciescaracterística, retardo mental, falta de linguagem, sensibilidadepreservada, hipotonia generalizada, ausência de alguns reflexos,deformidades ósseas nos pés e marcha independente como funçãomais alta. Dentre as alterações encontradas, cabe destacar o retardomental, que dificulta o processo de desenvolvimento e reabilitação.

The Pallister-Killian Syndrome (PKS) is a rare genetic disease impairing the neurological development. This study aimed to contribute for knowledge and physical therapy of PKS. It was a casereport of a 15 years old patient, attended at Clínica de Fisioterapia daFaculdade Anhanguera de Campinas. It was done a physical therapyevaluation of the patient and her mother answered a questionnaireasking information on the prenatal, perinatal and postnatal periods.The results showed face characteristics, mental retardation, lack of language abilities, preserved sensation, generalized hypotonic, someabsence of reflexes absence, feet bones deformities and independentmarch as the most achieved function. Among the anomalies diagnosed,it is necessary to highlight the mental retardation, which complicates both development and rehabilitation processes.