Advocacy for active transport: advocate and city council perspectives

Background  

Effective advocacy is an important part of efforts to increase population participation in physical activity. Research about effective health advocacy is scarce, however, the health sector can learn from the experiences and knowledge of community advocates and those who are on the receiving end of this advocacy. The aim of this study is to explore advocacy for active transport from the perspectives of community advocates and representatives from City councils.     

Pesticide sales and adult male cancer mortality in Brazil

In Brazil, where the use of pesticide grows rapidly, studies that evaluate the impact of pesticide exposure on cancer incidence and mortality are very scarce. In this study, we evaluated the degree of correlation between pesticide sales in 1985 in eleven Brazilian states and cancer mortality rates during 1996-1998. Information of all cancer deaths occurred in men 30-69 years old from 1996 to 1998 were collected from National Mortality System. Single and multiple linear regression coefficients were obtained to assess the relationship between per capita sales of pesticides in 1985, specific-site cancer mortality rates (prostate, soft tissue, larynx, leukemia, lip, esophagus, lung, pancreas, bladder, liver, testis, stomach, brain, non-Hodgkin's lymphoma, and multiple myeloma) during 1996-1998, and several covariates. In addition, states were stratified into three groups according to tertiles of pesticides sales and cancer mortality rate ratios (MRR) were then calculated using first tertile as reference. Finally, a factor analysis was performed to reveal unapparent relationships between pesticide use and cancer mortality. Pesticide sales showed statistically significant correlation with the mortality rates for the cancers of prostate (r=0.69; p=0.019), soft tissue (r=0.71; p=0.015), leukemia (r=0.68; p=0.021), lip (r=0.73; p=0.010), esophagus (r=0.61; p=0.046), and pancreas (r=0.63; p=0.040). Moderate to weak correlations were observed for the cancers of larynx, lung, testis, bladder, liver, stomach, brain, and NHL and multiple myeloma. In addition, correlation between pesticide sales and specific-site cancer mortality rates was reinforced by multiple regression analysis. For all specific-sites, cancer mortality rates were significantly higher in the states of moderate (2nd tertile) and high (3rd tertile) pesticide sales, with MRR ranging from 1.11 to 5.61. Exploring hidden relationships between pesticide sales and cancer mortality in Brazil, through a factor analysis, revealed that affluence; public policies and lifestyle behaviors may explain almost 70% of the variance of the studied association. The results suggest that population exposure to pesticides in the 1980s in some Brazilian States may have been associated with selected cancer sites observed a decade later.     

Human papillomavirus (HPV) 16 and the prognosis of head and neck cancer in a geographical region with a low prevalence of HPV infection

Background

The role of human papillomavirus (HPV) on head and neck squamous cell carcinoma (HNSCC) survival in regions with low HPV prevalence is not yet clear. We evaluated the HPV16 infection on survival of HNSCC Brazilian patient series.

Methods

This cohort comprised 1,093 HNSCC cases recruited from 1998 to 2008 in four Brazilian cities and followed up until June 2009. HPV16 antibodies were analyzed by multiplex Luminex assay. In a subset of 398 fresh frozen or paraffin blocks of HNSCC specimens, we analyzed for HPV16 DNA by L1 generic primer polymerase chain reaction. HNSCC survival according to HPV16 antibodies was evaluated through Kaplan–Meier method and Cox regression.

Results

Prevalence of HPV16 E6 and E6/E7 antibodies was higher in oropharyngeal cancer than in other head and neck tumor sites. HPV16 DNA positive in tumor tissue was also higher in the oropharynx. Seropositivity for HPV16 E6 antibodies was correlated with improved HNSCC survival and oropharyngeal cancer. The presence of HPV16 E6/E7 antibodies was correlated with improved HNSCC survival and oropharyngeal cancer survival. The death risk of oropharyngeal squamous cell carcinoma patients HPV16 E6/E7 antibodies positive was 78 % lower than to those who test negative.

Conclusion

Oropharyngeal squamous cell carcinoma is less aggressive in the HPV16 E6/E7 positive serology patients. HPV16 E6/E7 antibody is a clinically sensible surrogate prognostic marker of oropharyngeal squamous cell carcinoma.     

Cancer mortality trends in Rio Branco, Acre State, Brazil, 1980-2006

Time trends in cancer incidence and mortality in the Western Amazon remain unknown. This study explored age-standardized cancer mortality rates according to anatomical site in Rio Branco, Acre State, Brazil, by constructing linear regression time trend models. Cancer mortality showed an increasing but inconstant trend in men and stability in women. At the end of the time series, the highest cancer rates among women were for the cervix, lung, liver and intrahepatic biliary tract, stomach, and breast. Among men, the highest rates were for cancer of the lung, prostate, liver and intra-hepatic biliary tract, stomach, and esophagus. The study showed an increasing mortality time trend for cancer of the prostate, breast, and lung and declining mortality rates for cervical cancer in women, lung cancer in men, and stomach cancer in both sexes. The high mortality rate from liver cancer merits attention, considering the high hepatitis B and C infection rates in the State of Acre.     

Prevalence of uterine cervical cancer testing in Rio Branco, Acre State, Brazil, and factors associated with non-participation in screening

The objective of the study was to determine the self-reported prevalence of uterine cervical cancer testing in Rio Branco, Acre State, Brazil, and to analyze factors associated with non-participation in screening. A population-based cross-sectional study with a sample of 772 women 18 to 69 years of age and living in Rio Branco was conducted in 2007 and 2008. Data were analyzed with Stata 10.0, and prevalence rates were estimated with Poisson multivariate regression (95%CI). 85.3% of women reported at least one cervical cancer screening test in the previous three years. The majority of women (72.8%) were screened in the Brazilian Unified National Health System. After adjusting for selected variables, statistically significant prevalence rates for absence of screening were found in women 18-24 and 60-69 years of age, single, and with low income and low schooling. The prevalence rates were consistent with findings from other studies, highlighting the need for greater intervention in the group of women most vulnerable to cervical cancer incidence and mortality.     

Elderly people victims of traffic accidents in the municipality of Ribeirao Preto-SP,in 1998

The considerable increase in the elderly population is resulting in several studies on the effects of external accidents to the population included in this age band. This study aimed at characterizing the elderly people victimized by traffic accidents and assisted in a public hospital in the City of Ribeir?o Preto-SP, Brazil. A retrospective study was conducted using the data collected by the Epidemiological Surveillance Services of the University of S?o Paulo at Ribeir?o Preto Faculty of Medicine. The data referring to 112 victims aged 60 to 85 years were analyzed from January to December, 1998. In this way, it can be observed that, among them, 56.3% of the victims are males and 42% are aged 60 to 64 years. Most of the subjects were pedestrians (41.4%) and their most frequently injured body area was the head (36.7%). It is important to point out that 50.9% had some type of sequel resulting from the trauma. This work aimed at emphasizing such theme by pointing out the importance of studies in the area of gerontology associated with traffic accidents.