Determinants of the use of health care services: multilevel analysis in the Metropolitan Region of Sao Paulo

OBJECTIVE To evaluate the individual and contextual determinants of the use of health care services in the metropolitan region of Sao Paulo.METHODS Data from the Sao Paulo Megacity study – the Brazilian version of the World Mental Health Survey multicenter study – were used. A total of 3,588 adults living in 69 neighborhoods in the metropolitan region of Sao Paulo, SP, Southeastern Brazil, including 38 municipalities and 31 neighboring districts, were selected using multistratified sampling of the non-institutionalized population. Multilevel Bayesian logistic models were adjusted to identify the individual and contextual determinants of the use of health care services in the past 12 months and presence of a regular physician for routine care.RESULTS The contextual characteristics of the place of residence (income inequality, violence, and median income) showed no significant correlation (p > 0.05) with the use of health care services or with the presence of a regular physician for routine care. The only exception was the negative correlation between living in areas with high income inequality and presence of a regular physician (OR: 0.77; 95%CI 0.60;0.99) after controlling for individual characteristics. The study revealed a strong and consistent correlation between individual characteristics (mainly education and possession of health insurance), use of health care services, and presence of a regular physician. Presence of chronic and mental illnesses was strongly correlated with the use of health care services in the past year (regardless of the individual characteristics) but not with the presence of a regular physician.CONCLUSIONS Individual characteristics including higher education and possession of health insurance were important determinants of the use of health care services in the metropolitan area of Sao Paulo. A better understanding of these determinants is essential for the development of public policies that promote equitable use of health care services.

Factors associated with exclusive breastfeeding in the first six months of life in Brazil: a systematic review

ABSTRACT OBJECTIVE To identify factors associated with exclusive breastfeeding in the first six months of life in Brazil. METHODS Systematic review of epidemiological studies conducted in Brazil with exclusive breastfeeding as outcome. Medline and LILACS databases were used. After the selection of articles, a hierarchical theoretical model was proposed according to the proximity of the variable to the outcome. RESULTS Of the 67 articles identified, we selected 20 cross-sectional studies and seven cohort studies, conducted between 1998 and 2010, comprising 77,866 children. We identified 36 factors associated with exclusive breastfeeding, being more often associated the distal factors: place of residence, maternal age and education, and the proximal factors: maternal labor, age of the child, use of a pacifier, and financing of primary health care. CONCLUSIONS The theoretical model developed may contribute to future research, and factors associated with exclusive breastfeeding may subsidize public policies on health and nutrition.

Um retrato do Empreendedorismo em Malanje-Angola: análise de negócios criados entre 2008-2012

Dissertação de Mestrado em Empreendedorismo e Internacionalização apresentada ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Empreendedorismo e Internacionalização, sob orientação de Professora Doutora Celsa Maria Carvalho Machado e Mestre Maria Luísa Verdelho Alves

Occupational and domiciliary contact with dogs as factors of risk to human infection with Toxocara larvae

The contact with dogs at home or place of work has been investigated as factors of risk in the occurrence of the visceral larva migrans syndrome caused by Toxocara, in man. Through the E.L.I.S.A. (enzyme-linked immunosorbent assay) technique, the presence of antibodies to Toxocara was searched in the sera of 79 women who have been raising or had raised dogs at home in the last two years and 123 men, who were municipal public employees in charge of the capture and keeping of stray dogs. The control groups were constituted by 205 sera from women who denied domiciliary contact with dogs, at least in the last two years, and 139 sera from men whose occupation did not urge them to contact with dogs. A significant more elevated frequency of antibodies to Toxocara was observed among women with domiciliary contact with dogs; nevertheless, there was not a significant difference in the positive rates in the case of men with occupational contact with dogs.

Preventing human trafficking for the purpose of sexual exploitation: the need for a bottom-up approach : the case-study of Brazilians trafficked to Portugal

Masters Thesis – Academic Year 2007/2008 - European Master’s Degree in Human Rights and Democratization (E.MA) - European Inter-university Centre for Human Rights and Democratization (EIUC) -Faculdade de Direito, Universidade Nova de Lisboa (UNL)

O papel do inapem no fomento do empreendedorismo na provincia do Kwanza Norte-Angola

Dissertação de Mestrado apresentada ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Empreendedorismo e Internacionalização, sob orientação de Celsa Maria Carvalho Machado e Adalmiro Álvaro Malheiro de Castro Andrade Pereira

Is there space for senior civil servants hybrid management models across political- administrative systems?

Comunicação apresentada na 17.ª conferência anual da NISPACee, realizada de 14 a 16 de Maio de 2009.

How are top officials hybrid management models present across political-administrative systems?

Comunicação apresentada na 4th Annual ICPA - International Conference on Public Administration "Building bridges to the future: leadership and collaboration in public administration", na Universidade de Minnesota nos Estados Unidos, de 24 a 26 de setembro de 2008

Como pode a Administração Pública contribuir para debelar as crises

Apresentação ao 7.º Congresso Nacional de Administração Pública, realizado no Centro de Congressos de Lisboa, de 10 a 11 de Novembro de 2010.

Transição para a vida independente de jovens com deficiência : políticas públicas e práticas de gestão familiar

Apresentação realizada no Colóquio "Olhares sobre os Jovens em Portugal: saberes, políticas, acções", a 2 de junho de 2011.

Análise de políticas públicas

Apresentação realizada no Centro de Estudos Transdisciplinares para o Desenvolvimento da Universidade de Trás-os-montes e Alto Douro, em Vila Real a 15 de Julho de 2010

La participación pública y la innovación social en la elaboration de políticas públicas

Comunicação apresentada no XVI Congresso International do Centro Latino Americano para el Desarollo (CLAD), Asunción, Paraguay de 8 a 11 Novembro 2011.

Características do modelo português de providência de bem estar como factor de fragilidade económica e social dos/as cidadãos/ãs e famílias, numa perspectiva de género

Comunicação apresentada no 7º Congresso Nacional de Administração Pública, realizado em Lisboa a 10 e 11 de novembro de 2009

Avaliação das actividades de enriquecimento curricular (AEC) no 1º ciclo de ensino básico do concelho de Oeiras

Comunicação apresentada no 6º Congresso Nacional de Administração Pública, realizado pelo INA em Lisboa em 29 e 30 de Outubro de 2008

O mainstreaming de género nas políticas públicas como estratégia de promoção da igualdade de género e do desenvolvimento sustentável

Apresentação realizada no 6º Congresso Nacional de Administação Pública, em Lisboa de 29 a 30 de Outro de 2008