Objective To analysis the epidemiological scenery of the congenital syphilis (CS) in Brazil employing spatial analysis techniques. Design Ecological study. Settings This study was conducted in Brazil Sample A total of 151 601 CS cases notified to the Diseases and Notification Information System from 2007 to 2018 from children aged 0–23 months and born from mothers living in Brazil were included in this study. Primary outcome measures The CS incidence rates were calculated by triad (2007–2010, 2011–2014 and 2015–2018) for all Brazilian municipalities following the Boxcox transformation to remove the discrepant values. The transformed rates were analysed through the spatial autocorrelation of Moran, Kernel density estimative and spatial scan. Results From 2007 to 2018, the CS incidence rates increased in all Brazilian regions. The CS spread towards the interior of Brazil, and a higher expansion was noticed between 2015 and 2018. The municipalities that were greatly affected by the CS were those having a high migration of people, such as the ones bordering other countries and the touristic cities. Recife, Campo Grande, Rio de Janeiro, Porto Alegre and Manaus were the capitals with the greatest spatial and spatiotemporal risk. Conclusion This study provides assistance to health authorities to fight CS in Brazil. More investment is necessary in prenatal care quality focusing on pregnant women and their partners to guarantee their full access to preventive resources against sexually transmitted infections.

Objective: To describe the use of Photovoice as a pedagogical tool to promote experiential learning and critical dialogue among participants on an undergraduate community health course. Design: A descriptive study of the use of the pedagogical tool Photovoice, based on three foundational education theories. Results: Based on teachers’ reflective evaluation of student responses, Photovoice emerged as a useful tool for encouraging dialogic engagement in the classroom, for experiential learning through interaction with the physical environment and for increasing student agency by reducing the teacher as authority model. Conclusion: Photovoice may be useful in a variety of college courses as a way to foster critical thinking, to promote agency among students, to enhance understanding of complex social phenomena and to expand the ways in which both students and teachers think about their physical and social worlds.

Introduction: HIV infection as a chronic disease has emerged from treatment advances over the past three decades. From this perspective, the diseases associated with AIDS are not a main threat for patients who use Antiretroviral Therapy (ART). A new set of HIV associated complications have emerged resulting in comorbidities related to aging and ART exposure as cardiovascular disease (CVD). This study aimed to evaluate the cardiovascular risk factors in people living with HIV (PLWH) in Brazil. Methodology: This was a cross-sectional study carried out at all Specialized Care Services for people living with HIV in the Southeast of Brazil. A sociodemographic and clinical questionnaire was used and cardiovascular risk assessed through the Framingham Score. Data analysis was performed by Chi-square, Fisher’s exact test and logistic regression. Results: The majority were male, over 40 years old and they showed a mean age of 44 years. Current hypertension, diabetes, altered body mass index, presence of metabolic syndrome and altered abdominal circumference were also associated with cardiovascular risk. After regression analysis, male sex, older age, smoking, diabetes, hypertension and metabolic syndrome were related as predictive factors for a higher cardiovascular risk. Conclusions: The results demonstrate that combination of the prevention of modifiable risk factors with considerable changes in lifestyle are determining factors for success in the therapeutic of PLWH. High levels of motivation are essential for behavioral changes, and nurses are ideally position to provide safe care with nonpharmacological strategies for CVD risk reduction.

Objective: To build and validate an e-book about cardiovascular risk in people living with the human immunodeficiency virus. Methods: Methodological study based on the evaluation research theory with analysis of outcome. It involved technological production comprising the phases of analysis and planning, modeling, implementation, and evaluation. Cardiovascular risk factors and strategies to reduce them were discussed. The e-book was validated with experts from all over the country between October 2017 and August 2018 using the Content Validity Index. Results: As the e-book was written to meet the needs of the population, accessible language was used for an easier understanding of the content. Several aspects of the e-book were evaluated by experts. Afterwards, the most frequent criticisms and/or suggestions were analyzed. A concordance rate of 80.5% was observed after analysis of the global CVI. All items had satisfactory agreement rates, with a CVI of 86.6% for general impression, 96.8% for objective, 92.0% for content and 90.4% for relevance. Conclusion: The e-book was evaluated in several aspects by experts and a global agreement index of 80.5% was found. Suggestions were accepted aiming at ensuring a more complete, cohesive, easy to read and updated material. According to the evaluation between experts, the material proved to be valid for use by people living with HIV in order to understand their cardiovascular risk and to know healthier habits that may help in prevention of cardiovascular diseases.

Resumo Objetivo Construir e validar um e-book sobre risco cardiovascular em pessoas vivendo com o vírus da imunodeficiência humana. Métodos Estudo metodológico fundamentado na teoria da pesquisa avaliativa com análise de resultado. Envolveu a produção tecnológica compreendendo as fases de análise e planejamento, modelagem, implementação e avaliação. Foram discutidos os fatores de risco cardiovascular e as estratégias para reduzi-los. O e-book foi validado por especialistas de todo o país entre outubro de 2017 e agosto de 2018 por meio do [...] Resumo Objetivo Construir e validar um e-book sobre risco cardiovascular em pessoas vivendo com o vírus da imunodeficiência humana. Métodos Estudo metodológico fundamentado na teoria da pesquisa avaliativa com análise de resultado. Envolveu a produção tecnológica compreendendo as fases de análise e planejamento, modelagem, implementação e avaliação. Foram discutidos os fatores de risco cardiovascular e as estratégias para reduzi-los. O e-book foi validado por especialistas de todo o país entre outubro de 2017 e agosto de 2018 por meio do

Globalization and geoclimatic changes are driving the emergence and spread of infectious diseases. Today, nearly two thirds of emerging Infectious diseases are zoonotic in nature (75% originating in wildlife). Despite individuals generally having little contact with wildlife (or livestock), public health continues to rely on reactionary surveillance in humans and livestock to track disease incidence and prevalence. It is only after the pathogen has spilled over from wild animal hosts, established itself among human or livestock populations, and become a cause of morbidity and mortality, that most current public health systems are able to detect or track. This chapter examines the role dogs may play in a sentinel surveillance system to track hepatitis E in humans. It is based on a seroprevalence study in Texas. In this study, a total of 144 dogs were sampled from three different types of care facility. The overall Hepatitis E prevalence was 48%. The type of care facility was significantly associated with infection rates. We explore the utility of different types of surveillance systems, yet circle back to domestic animal sentinel surveillance, and specifically hepatitis E (genotypes 3/4) in domestic dogs, as both an early warning system and baseline monitoring system that allows public health practitioners across the globe to address this pathogen before outbreaks occur.