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The purpose of this study was to identify a set of management practices towards financial sustainability for Brazilian private health insurance and plans companies.

The present paper uses a bimodal two-step approach. The first step was quantitative, with the data envelopment analysis (DEA) technique in 521 Brazilian private health companies (PHCs). At this stage, the objective was to obtain scores to rank the PHCs regarding their financial performance and services in 2013. From the quantitative analysis, two PHCs displaying contrasting performances were selected and interviewed to identify differentiating management practices.

The Group Medicine PHCs displayed a higher performance in the financial approach. Following the qualitative comparative analysis, the financially sustainable PHC presented the following differentials: a high level of financial management professionalization, a deliberate policy for the control and prevention of claims and a larger share of revenues from health plans over service revenues.

However, a limitation of the study lies in the fact that by not using any cash flow or financial result variables, the financial efficiency model used in the study does not evaluate the generation capacity of long-term results. It is noteworthy that, because it is a multiple case study, the results found cannot be generalized and should be understood only as characteristics of the studied PHCs in here.

The present paper can contribute to managers of Brazilian PCHs towards the implementation of management tools aimed at the sustainability of those organizations.

Despite the importance of the Supplemental Health Insurance System for public health in Brazil, PHCs have received a high volume of complaints and struggled with constant financial problems.

The purpose of this study is to describe the prevalence of a sedentary lifestyle (<150 min of physical exercise/week) and associated factors of this behavior in Brazil.

An observational study was conducted through an online questionnaire in August–September 2020 (5.5 months after the beginning of the pandemic in the country). Socioeconomic, lifestyle, anthropometric, dietary and perceived stress data were evaluated as possible related factors to a sedentary lifestyle through multiple logistic regression analysis.

A total of 1,347 individuals were evaluated (median of 31 years old, 80.1% women), of whom 76.7% were considered sedentary. Associated factors to a sedentary lifestyle were being overweight; a greater difference between current weight and prepandemic weight; female sex; lower percentage of home-cooked meals; greater increase in the frequency of consumption of alcoholic beverages; higher frequency of consumption of cereals, sausages and sweets during the pandemic; and higher score of perceived stress.

To the best of the authors’ knowledge, no studies have aimed to reveal the associated factors to a sedentary lifestyle during the COVID-19 pandemic in Brazil. Protective factors against a sedentary lifestyle were eating breakfast, being a student, living with parents, a higher frequency of fruit consumption, a higher rate of alcohol consumption and a higher cognitive restriction of food intake during the pandemic. Most of the study participants were sedentary, especially women. A sedentary lifestyle was associated with worse lifestyle/eating habits and stress. Such findings encourage an interdisciplinary approach because habits and lifestyle have numerous interferences.

This study aims to identify comfort food (CF) consumption and its associated factors during the pandemic period. The study also involves an online survey conducted five months after the quarantine started in Brazil.

Data on lifestyle, eating habits and anthropometric data were collected before and during the pandemic, and the differences in these habits were analyzed. Univariate and multivariate logistic regression models were performed to identify predictors of CF consumption by gender.

A total of 1,363 individuals were included in the sample, with a median age of 31 years old, of whom 80.3% were women. Since individuals were free to respond about the food consumed without predetermined categories, it was possible to carry out a faithful assessment of the occurrence of this behavior. At the same time, allowing the subjectivity and symbolism inherent to the concept of CF to be embraced. CF consumption was present for 54%, with “sweets” being the most mentioned group by both genders. The factors associated with CF consumption in women during the pandemic were increased snacking, increased bread, candies and alcoholic beverage intake, increased time spent at work, worsened sleep quality, reduced meals, perceived stress (PS), emotional eating (EE), age and increased frequency of meat intake. In men, the predictors for CF consumption were remote full-time work/study, PS, EE and early waking time. For both genders, CF consumption during the pandemic period was associated with PS and EE.

This study provides an important overview of the possible contributions of the pandemic on behaviors and food choices related to the consumption of CF in Brazilians. This information is valuable to support further studies to investigate and treat the impacts of the pandemic on lifestyle, eating habits and behavior, mental health and other factors in the postpandemic period.

The purpose of this study is to investigate the effect of a 15-week dietary intake of cactus flour on metabolic parameters, body weight and dietary intake of rats.

Male Wistar rats were divided into four experimental groups (n = 8-10): control or westernized diets added or not of cactus flour. The following parameters were evaluated during the period of dietary manipulation: body weight, food intake, glycemic and lipid profile (oral glucose tolerance test, metabolic parameters, hepatic and muscular glycogen dosage), visceral and body fat (relative weight to body weight). Data were analyzed using Graphpad Prism®5, p = 0.05.

Animals fed on a Western-style diet together with flour cactus presented lower weight gain (335.7 ± 20.0, p = 0.05) over the evaluated period, even when the volume of food intake was not different among the groups. The addition of cactus flour to a Western-style diet appears to lower glucose levels at 30 and 60 min (p = 0.05), as shown in the glucose tolerance curve. There was a downward trend does fat stores, cholesterol levels and triglycerides. Therefore, it was concluded that this addition cactus flour is effective even when the diet is hyperlipidic, demonstrating its ability to attenuate risk parameters for the occurrence of metabolic syndromes such as sub fraction high cholesterol levels and glucose tolerance.

The addition of functional foods to diets may work to improve the harmful effects of this type of diet. Opuntia ficus indica has high nutritional value and has hypoglycemic and hypolipemic properties besides being antioxidant.

The purpose of this study is to evaluate the nutritional effects in Wistar rats of supplementation with stand-alone saturated fatty acid (SFA) or monounsaturated fatty acid (MUFA), the replacement of SFA by MUFA and the combination of both (SFA + MUFA) over a long period of time (13 weeks).

In total, 30 Wistar rats were used and randomly assigned to receive (n = 6): control – lab chow; lard (L20%) – lab chow with added lard (20%); olive oil (O20%) – lab chow with added olive oil (20%); lard replacement with olive oil (L20% –O20%) – during six weeks lab chow with added lard (20%) replaced by lab chow with added olive oil (20%) given during the past seven weeks of the trial; lard combination with olive oil (L10% + O10%) – lab chow with added lard (10%) and olive oil (10%). Food and caloric intake, weight gain, food and energy efficiency, body mass index, bone mineral composition and blood biochemistry were evaluated.

All diets with added fatty acids showed higher energy intake (p < 0.001), weight gain (p = 0.01), accumulation of adipose tissue (p = 0.02) and food and energy efficiency (p = 0.01) compared to the control group. All groups exhibited higher levels of blood triglycerides compared to the control group (p = 0.02). In addition, the L10% + O10% group developed hyperglycemia (p < 0.001); the L group showed higher amounts of non- high density lipoprotein (HDL-c) (p = 0.04); and the L20%−O20% group exhibited high levels of the triglyceride/HDL-c ratio (p = 0.04) in relation to the control.

These results indicate that regardless of the fatty acid type, consumption in large quantities of fatty acids for long periods of time can cause obesity and dyslipidemia.

This study aims to understand, from the analysis of the work of a Brazilian network of non-governmental organizations (NGOs), how advocacy on human rights issues is developed to defend causes before the legislative branch, identifying its contributions and effectiveness. For this, were observed, the strategies and tactics employed in the implementation of two advocacy campaigns promoted by a Brazilian NGOs network.

The research adopts the method of inductive investigation with a qualitative approach and uses the techniques of semi-structured in-depth interviews and documentary research. The paper is developed within the scientific field of public relations (PR), uses as reference the critical theory and the rhetorical theory of PR, and is based on the concept of advocacy.

Some results of the advocacy are observed, such as the greater awareness of political decision-makers, in addition to the influence on the definition of the political agenda and on the action of the political decision-makers.

Among the limitations of this study are the time span for analyzing the campaigns' actions, which could be extended to observe long-term results, as well as the dedication of the study exclusively to the legislative branch since the campaigns also sought to influence decision-making in the executive branch.

The results found encourage the strengthening of the democratic environment since it increases the power and influence of civil society in the political decision-making of the legislative branch.

The study showed that advocacy, as a PR activity, increases civil society participation in political decisions.

The purpose of this paper is to address the gaps in research on strategic planning for the social impacts of small-scale events in rural areas and small cities. This is achieved by investigating the social utility inferred by small-scale art festivals with a creative tourism element in terms of increasing social capital and positive social change, from an event stakeholder perspective.

The identified gap in knowledge is addressed by using interviews and fieldnotes from participant observation to co-create meaning with the organizers of four small-scale art festivals in small cities and rural areas in Portugal. Theoretical frameworks relating to creative tourism development and social capital creation are used to analyze the social utility of small-scale art festivals.

Creative tourism activities are integrated within small-scale art festivals in small cities and rural areas in various ways, mainly through art-related workshops. Significant empirical data give insight into how small-scale art festivals create social value by increasing the host community’s pride and reinforcing the social fabric of the festival’s local and “portable” community, in part through these creative tourism activities.

One of the limitations of this study is that it focuses on the perspectives and insights of the festival organizers. An analysis of the festival participants’ views, local community stakeholder analysis and community impact analyses would offer further insights into how the creative tourism experiences and other moments of shared meaning generation within small-scale art festivals influence the creation of social utility.

This paper offers insights into how creative tourism activities are being integrated into small-scale art festivals in small cities and rural contexts, and how these activities foster social connections among festival participants and with the local community. This addresses significant gaps in the literature on strategic planning for the social impacts of events, particularly in the context of small-scale events in rural areas/small cities, and the strategic value of including creative tourism activities within small-scale festivals.

The purpose of this paper is to examine the associations of dietary patterns with sociodemographic and lifestyle characteristics in a cardiometabolic risk population.

In this cross-sectional study data from 295 (n=123 men/172 women, 42±16 years) participants in a Cardiovascular Health Care Program were included. After a 24-hour recall interview the dietary patterns were determined using principal component analysis. Sociodemographic, clinical and lifestyle data were collected by medical records.

Subjects with diabetes and hypertension had a higher adherence in the “traditional” pattern (rice, beans, tubers, oils and meats). Poisson regression models showed that male subjects with low schooling and smokers had greater adherence to the “traditional” pattern. Also, students, women, and those with higher schooling and sleeping =7 h/night showed higher adherence to healthy patterns (whole grains, nuts, fruits and dairy). Women, young adults and those with higher schooling and fewer sleep hours had greater adherence to healthy dietary patterns. Those with low schooling and unhealthy lifestyle showed more adherence to the “traditional” pattern.

The results indicate the importance to personalized nutritional therapy and education against cardiometabolic risk, considering the dietary patterns specific to each population.

Socioeconomic and lifestyle characteristics can influence dietary patterns and this is one of the few studies that investigated this relationship performing principal component analysis.

Baru is a fruit of the Brazilian Cerrado, important to the local economy and social culture. The use in food formulation is due to it being highly available and its nutritional profile; however, the changes in the texture of products are still unclear. In this study, an experimental design was conducted to develop cakes by replacing different levels of wheat flour with baru nut flour, and comparing them.

Cakes were developed with 20, 40, 60, and 80 replacement of wheat flour by baru nut flour and compared with standard formulation (100% wheat flour). The physical-chemistry composition of the flour, nutritional composition of the cakes and texture profile analysis were evaluated.

Baru nut flour showed greater protein, lipids, and ash than wheat flour, and this result was also observed in the cakes developed. The cake with 80% of almond baru flour showed an increase of 60.3% in protein. The texture profile analysis showed that the addition of baru nut flour affected the texture of products. The cakes showed more hardness and chewiness; however, the springiness and cohesiveness were decreased.

The findings of this study demonstrate that baru nut flour is a great option as a new ingredient for bakery products, due the increase of protein. This is the first study analyzing the effect of baru nut flour addition on the texture profile of bakery products. These results can orientate future studies, especially sensory assays.

This study analyzes the impacts of trust in the confessional institution of primary education on a students’ spirituality and performance and the moderating effect of the families' religion on the relationship between trust in the school and the student's spirituality as perceived by parents and guardians.

This study takes the form of a survey with 346 parents and guardians from a Brazilian Adventist education network. The authors used partial least squares structural equation modeling by SmarPLS 4 to analyze the data.

The results reveal that parents' and guardians' trust in the confessional institution of primary education positively influences their perception of students' spirituality, which, in turn, has a positive impact on their performance. In addition, the families’ religion does not strengthen the relationship between school trust and students’ spirituality. It does not matter to which religious group the family belongs – as their overall spiritual development that favors the students’ academic performance.

The research contributes to the literature on school management, individual spirituality and relationship marketing – particularly customer relationship management in schools, involving parents, guardians and students.