Factors associated with overweight in children living in the neighbourhoods of an urban area of Brazil

Objective: The present study aimed to investigate the individual and family determinants of being overweight among children younger than 10 years of age. Design: Cross-sectional survey. Direct data on children's age, food intake, physical activity, type of transportation used and anthropometric measurements, as well as the education level of the mothers, were collected by trained interviewers. Setting: Population-based study in the city of Santos, Brazil. Subjects: A total of 531 children under 10 years of age (302 aged <6 years, >= 6 aged years), living in the city of Santos. Results: The overall prevalence of overweight and obesity (BMI-for-age Z-score >1) was 35.4% for children under 6 years and 38.9% for children aged 6-10 years. The socio-economic status of the family was associated with being overweight for both age groups. Logistic regression analysis showed that the lower the socio-economic status, the higher the likelihood of being overweight, among both younger children (OR = 7.73; P = 0.02) and older children (OR = 1.98; P = 0.04). The use of active transportation was associated with a lower likelihood of being overweight, but only among younger children (OR = 1.70; P = 0.05). Conclusions: Socio-economic status seems to be an important individual-level determinant of overweight in children. Public policies should consider promoting the use of active transportation, as the results showed it to have a positive effect on reducing overweight issues. The high prevalence of overweight in younger children suggests that this age group should be a priority in health-promoting interventions.

Atrial Fibrillation and Dementia: Results from the Sao Paulo Ageing & Health Study

Background: Atrial fibrillation (AF) is a controversial risk factor for dementia. Objective: The objective of this study was to assess the association between AF and dementia in the "Sao Paulo Ageing & Health" (SPAH) study participants. Methods: SPAH is a cross-sectional, population-based study of elderly people living in a deprived neighborhood in Sao Paulo, Brazil. Dementia diagnosis was performed according to the 10/66 study group protocol based on Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Diagnosis of AF was made using a 12-lead electrocardiogram (ECG) recording, which was assessed by two cardiologists. Data on demographics and cardiovascular risk factors were also obtained. Results: Dementia was diagnosed in 66 (4.3%) and AF in 36 (2.4%) of 1,524 participants with a valid ECG. The crude odds ratio (OR) for dementia in participants with AF was 2.8 (95% confidence interval [CI]: 1.0-8.1; p=0.06) compared with individuals without AF. When analyzing data according to sex, a positive relationship was found in women (OR 4.2; 95% CI: 1.24-15.1; p=0.03). After age-adjustment, however, this association was no longer significant (OR 2.2; 95% CI: 0.6-8.9; p=0.26). Conclusion: There was no independent association between AF and dementia in this sample. The prevalence of AF may be low in this population owing to premature cardiovascular death. (Arq Bras Cardiol 2012;99(6):1108-1114)

Sugar-Sweetened Beverage Taxes in Brazil

Objectives. We investigated whether taxing sugar-sweetened beverages (SSBs) would improve the diets of households in Brazil. Methods. We used household food consumption data that the Brazilian Institute of Geography and Statistics collected in 2002-2003 from a nationally representative sample of 48470 Brazilian households. The consumption of SSBs is expressed as the total SSB calories consumed and as the SSB percentage of the total calories purchased. We investigated price elasticity with regression models, controlling for demographic variables, income, and prices of all other foods and drinks. Results. Increases in the price of SSBs led to reductions in consumption. A 1.00% increase in the price of SSBs led to a 0.85% reduction of SSB calories consumed (1.03% reduction for the poor and 0.63% for the nonpoor). Increased income had a positive effect on SSB consumption, but the effect was less than half the size of the price elasticity (0.41% increase in SSB calories consumed for every 1.00% increase in income). Conclusions. High SSB price elasticity in Brazil indicates that a tax on purchased weight or volume would lead to reductions in SSB consumption. (Am J Public Health. 2012;102:178-183. doi:10.2105/AJPH.2011.300313)

Stigma and higher rates of psychiatric re-hospitalization: Sao Paulo public mental health system

Objective: The aim of this study was to assess re-hospitalization rates of individuals with psychosis and bipolar disorder and to study determinants of readmission. Methods: Prospective observational study, conducted in Sao Paulo, Brazil. One hundred-sixty-nine individuals with bipolar and psychotic disorder in need of hospitalization in the public mental health system were followed for 12 months after discharge. Their families were contacted by telephone and interviews were conducted at 1, 2, 6 and 12 months post-discharge to evaluate readmission rates and factors related. Results: One-year re-hospitalization rate was of 42.6%. Physical restraint during hospital stay was a risk factor (OR = 5.4-10.5) for readmission in most models. Not attending consultations after discharge was related to the 12-month point readmission (OR = 8.5, 95% CI 2.3-31.2) and to the survival model (OR = 3.2, 95% CI 1.5-7.2). Number of previous admissions was a risk factor for the survival model (OR = 6.6-11.9). Family's agreement with permanent hospitalization of individuals with mental illness was the predictor associated to readmission in all models (OR = 3.5-10.9) and resulted in shorter survival time to readmission; those readmitted were stereotyped as dangerous and unhealthy. Conclusions: Family's stigma towards mental illness might contribute to the increase in readmission rates of their relatives with psychiatric disorders. More studies should be conducted to depict mechanisms by which stigma increases re-hospitalization rates.

Magnetic fabric of Araguainha complex impact structure (Central Brazil): Implications for deformation mechanisms and central uplift formation

The weakening mechanisms involved in the collapse of complex impact craters are controversial. The Araguainha impact crater, in Brazil, exposes a complex structure of 40 km in diameter, and is an excellent object to address this issue. Its core is dominated by granite. In addition to microstructural observations, magnetic studies reveal its internal fabric acquired during the collapse phase. All granite samples exhibit impact-related planar deformation features (PDFs) and planar fractures (PFs), which were overprinted by cataclasis. Cataclastic deformation has evolved from incipient brittle fracturing to the development of discrete shear bands in the center of the structure. Fracture planes are systematically decorated by tiny grains (<10 mu m) of magnetite and hematite, and the orientation of magnetic lineation and magnetic foliation obtained by the anisotropies of magnetic susceptibility (AMS) and anhysteretic remanence (AAR) are perfectly coaxial in all studied sites. Therefore, we could track the orientation of deformation features which are decorated by iron oxides using the AMS and AAR. The magnetic fabrics show a regular pattern at the borders of the central peak, with orientations consistent with the fabric of sediments at the crater's inner collar and complex in the center of the structure. Both the cataclastic flow revealed from microstructural observations and the structural pattern of the magnetic anisotropy match the predictions from numerical models of complex impact structures. The widespread occurrence of cataclasis in the central peak, and its orientations revealed by magnetic studies indicate that acoustic fluidization likely operates at all scales, including the mineral scales. The cataclastic flow made possible by acoustic fluidization results in an apparent plastic deformation at the macroscopic scale in the core. (C) 2012 Elsevier B.V. All rights reserved.

Evaluation of the Concentration of Nonessential and Essential Elements in Chicken, Pork, and Beef Samples Produced in Brazil

Food safety is a global concern. Meat represents the most important protein source for humans. Thus, contamination of meat products by nonessential elements is a ready source of human exposure. In addition, knowledge of the concentration of essential elements is also relevant with respect to human nutrition. The aim of the present study was to determine the concentration of 17 elements in pork, beef, and chicken produced in Brazil. Meat samples were analyzed by inductively coupled plasma mass spectrometry. The estimated daily intake for nonessential elements including arsenic (As), cadmium (Cd), lead (Pb), mercury (Hg), and antimony (Sb) through meat consumption is below the toxicological reference values. However, high levels were detected for the nonessential element cesium (Cs), mainly in beef samples, an observation that deserves future studies to identify the source of contamination and potential adverse consequences.

Neospora caninum as causative agent of bovine encephalitis in Brazil

For supporting the Brazilian bovine encephalitis surveillance program this study examined the differential diagnosis of Neospora caninum in central nervous system (CNS) by histological analysis (HE staining), immunohistochemistry (IHC), and nested-PCR using a set of primers from the Nc5 region of the genomic DNA and ITS1 region of the ribosomal DNA. A sample of 302 cattle presenting neurological syndrome and negative for rabies, aged 0 to 18 years, from herds in 10 Brazilian states was evaluated for N caninum from January 2007 to April 2010. All specimens tested negative with IHC and nested-PCR using primers from the ITS I region of ribosomal DNA, while two positive cases (0.66%) were found using primers from the Nc5 region of genomic DNA: a 20 month-old male and a 72 month-old female, both from Sao Paulo State. Only the male presented severe multifocal necrotizing encephalitis associated with mononuclear cell infiltration, a pathognomonic lesion caused by parasites of the family Sarcocystidae, and only this case was associated with N caninum thus representing 0.33% positivity. Future studies should explore the association of IHC and nested-PCR with real-time PCR, a quantitative method that could be standardized for improving the detection of N. caninum in bovine CNS specimens.

Ground-level ozone prediction using a neural network model based on meteorological variables and applied to the metropolitan area of Sao Paulo

A neural network model to predict ozone concentration in the Sao Paulo Metropolitan Area was developed, based on average values of meteorological variables in the morning (8:00-12:00 hr) and afternoon (13:00-17: 00 hr) periods. Outputs are the maximum and average ozone concentrations in the afternoon (12:00-17:00 hr). The correlation coefficient between computed and measured values was 0.82 and 0.88 for the maximum and average ozone concentration, respectively. The model presented good performance as a prediction tool for the maximum ozone concentration. For prediction periods from 1 to 5 days 0 to 23% failures (95% confidence) were obtained.

Phylogenetic analysis of rubella virus strains during an outbreak in Sao Paulo, 2007-2008

Rubella virus (RV) is an important human pathogen that causes rubella, an acute contagious disease. It also causes severe birth defects collectively known as congenital rubella syndrome when infection occurs during the first trimester of pregnancy. Here, we present the phylogenetic analysis of RV that circulated in Sao Paulo during the 20072008 outbreak. Samples collected from patients diagnosed with rubella were isolated in cell culture and sequenced. RV RNA was obtained from samples or RV-infected cell cultures and amplified by reverse transcriptase-polymerase chain reaction. Sequences were assigned to genotypes by phylogenetic analysis using RV reference sequences. Seventeen sequences were analyzed, and three genotypes were identified: 1a, 1G, and 2B. Genotypes 1a and 1G, which were isolated in 2007, were responsible for sporadic rubella cases in Sao Paulo. Thereafter, in late 2007, the epidemiological conditions changed, resulting in a large RV outbreak with the clear dominance of genotype 2B. The results of this study provide new approaches for monitoring the progress of elimination of rubella from Sao Paulo, Brazil. J. Med. Virol. 84:16661671, 2012. (c) 2012 Wiley Periodicals, Inc.

Nutrient reference concentrations and trophic state boundaries in subtropical reservoirs

Nutrient criteria as reference concentrations and trophic state boundaries are necessary for water management worldwide because anthropogenic eutrophication is a threat to the water uses. We compiled data on total phosphorus (TP), nitrogen (TN) and chlorophyll a (Chl a) from 17 subtropical reservoirs monitored from 2005-2009 in the Sao Paulo State (Brazil) to calculate reference concentrations through the trisection method (United States Environmental Protection Agency). By dividing our dataset into thirds we presented trophic state boundaries and frequency curves for the nutrient levels in water bodies with different enrichment conditions. TP and TN baseline concentrations (0.010 mg/L and 0.350 mg/L, respectively) were bracketed by ranges for temperate reservoirs available in the literature. We propose trophic state boundaries (upper limits for the oligotrophic category: 0.010 mg TP/L, 0.460 mg TN/L and 1.7 mu g Chl a/L; for the mesotrophic: 0.030 mg TP/L, 0.820 mg TN/L and 9.0 mu g Chl a/L). Through an example with a different dataset (from the Itupararanga Reservoir, Brazil), we encouraged the use of frequency curves to compare data from individual monitoring efforts with the expected concentrations in oligotrophic, mesotrophic and eutrophic regional systems. Such analysis might help designing recovery programs to reach targeted concentrations and mitigate the undesirable eutrophication symptoms in subtropical freshwaters.

Occupational safety and health practices among flower greenhouses workers from Alto Tiete region (Brazil)

In this preliminary study the occupational safety and health practices among flower greenhouses workers were evaluated. The study was carried out in the alto Tiete region, located at the Sao Paulo State, Brazil. Inadequate welfare facilities; poor pesticide storage, use and disposal conditions; use of highly toxic pesticides; lack of adequate data regarding pesticide use; and incorrect use and maintenance of PPE were observed in most of the visited greenhouses. These results suggest that, in greenhouses, workers may be at higher risk of pesticide exposure, due to many factors that can intensify the exposure such as the lack of control on reentry intervals after pesticide application. Specific regulations are needed to ensure better OSH practices on pesticide use and to improve working conditions in greenhouses, in order to deal with the peculiarities of greenhouse working environment. Some of the special requirements for greenhouses workers' protection are the establishment of ventilation criteria for restricted entry interval; clear reentry restrictions; and EPI for workers other than applicators that need to enter the greenhouse before expiring REI interval. Another important way to improve OSH practices among workers includes the distribution of simple guidelines on the dos and don'ts regarding OSH practices in greenhouses and extensively training interventions to change the perception of hazards and the behavior towards risk. (C) 2011 Elsevier B.V. All rights reserved.

Rabies in southeast Brazil: a change in the epidemiological pattern

This epidemiological study was conducted using antigenic and genetic characterisation of rabies virus isolates obtained from different animal species in the southeast of Brazil from 1993 to 2007. An alteration in the epidemiological profile was observed. One hundred two samples were tested using a panel of eight monoclonal antibodies, and 94 were genetically characterised by sequencing the nucleoprotein gene. From 1993 to 1997, antigenic variant 2 (AgV-2), related to a rabies virus maintained in dog populations, was responsible for rabies cases in dogs, cats, cattle and horses. Antigenic variant 3 (AgV-3), associated with Desmodus rotundus, was detected in a few cattle samples from rural areas. From 1998 to 2007, rabies virus was detected in bats and urban pets, and four distinct variants were identified. A nucleotide similarity analysis resulted in two primary groups comprising the dog and bat antigenic variants and showing the distinct endemic cycles maintained in the different animal species in this region.

Soil properties in a sugarcane plantation after the application of treated sewage effluent and phosphogypsum in Brazil

In a field experiment performed in Lins County (Sao Paulo State, Brazil), treated sewage effluent (TSE) irrigation increased sugarcane yield but caused an excessive increase in the exchangeable sodium percentage (ESP) and clay dispersion after 16 months due to an intense irrigation regime (2500 mm/16 months) with sodium rich effluents. After two additional complete cycles with lower TSE irrigation rates (1200 mm year(-1)), 1700 kg ha(-1) of phosphogypsum was added to a section of the irrigated plots to evaluate its residence time and its implications on Na+ dynamics and other soil properties. Undisturbed soil cores were taken 2 years after phosphogypsum application to verify soil physical properties up to 0.2 m depth, and disturbed soil samples were taken every year up to 1 m depth for chemical analyses. After 5 years of consecutive TSE irrigation (2005-2010), soil acidity (pH approximate to 5) and basic cations (Ca approximate to 12, Mg approximate to 6 and K approximate to 2 mmol(c) kg(-1)) were maintained in adequate conditions for plant development without the necessity of liming, while acidity was increased (pH approximate to 4.5) and Ca (approximate to 9 mmol(c) kg(-1)), and the Mg (approximate to 4.5 mmol(c) kg(-1)) concentration decreased in the rainfed without phosphogypsum treatment. An increase in water retention capacity at -30 (from 0.14 to 0.17 m(3) m(-3)) and -1500 kPa (from 0.08 to 0.12 m(3) m(-3)) potentials was also observed in all TSE irrigated treatments. The plots with a phosphogypsum treatment showed average increases of 2 mmol(c) kg(-1) of Ca2+ and 7 mg kg(-1) of S-SO42- in all soil profiles and an average reduction of 2 mmol(c) kg(-1) of Na+ up to 0.4 m from 2008 to 2009. However, the extent of the chemical effects was greater after the first year compared to the second year. The high concentration of Na+ found in previous studies performed in the same area returned to low concentrations after continued TSE irrigation at lower rates, even without the phosphogypsum application. An unusual phosphorus migration was observed to the 0.4-0.8 m soil layer as a result of TSE irrigation, most likely due to a high pH and a Na carbonate-dominated TSE. (C) 2012 Elsevier B.V. All rights reserved.

Spatial clusters of suicide in the municipality of Sao Paulo 1996-2005: an ecological study

Background: In a classical study, Durkheim mapped suicide rates, wealth, and low family density and realized that they clustered in northern France. Assessing others variables, such as religious society, he constructed a framework for the analysis of the suicide, which still allows international comparisons using the same basic methodology. The present study aims to identify possible significantly clusters of suicide in the city of Sao Paulo, and then, verify their statistical associations with socio-economic and cultural characteristics. Methods: A spatial scan statistical test was performed to analyze the geographical pattern of suicide deaths of residents in the city of Sao Paulo by Administrative District, from 1996 to 2005. Relative risks and high and/or low clusters were calculated accounting for gender and age as co-variates, were analyzed using spatial scan statistics to identify geographical patterns. Logistic regression was used to estimate associations with socioeconomic variables, considering, the spatial cluster of high suicide rates as the response variable. Drawing from Durkheim's original work, current World Health Organization (WHO) reports and recent reviews, the following independent variables were considered: marital status, income, education, religion, and migration. Results: The mean suicide rate was 4.1/100,000 inhabitant-years. Against this baseline, two clusters were identified: the first, of increased risk (RR = 1.66), comprising 18 districts in the central region; the second, of decreased risk (RR = 0.78), including 14 districts in the southern region. The downtown area toward the southwestern region of the city displayed the highest risk for suicide, and though the overall risk may be considered low, the rate climbs up to an intermediate level in this region. One logistic regression analysis contrasted the risk cluster (18 districts) against the other remaining 78 districts, testing the effects of socioeconomic-cultural variables. The following categories of proportion of persons within the clusters were identified as risk factors: singles (OR = 2.36), migrants (OR = 1.50), Catholics (OR = 1.37) and higher income (OR = 1.06). In a second logistic model, likewise conceived, the following categories of proportion of persons were identified as protective factors: married (OR = 0.49) and Evangelical (OR = 0.60). Conclusions: This risk/ protection profile is in accordance with the interpretation that, as a social phenomenon, suicide is related to social isolation. Thus, the classical framework put forward by Durkheim seems to still hold, even though its categorical expression requires re-interpretation.

A SURVEY OF NEOSPORA CANINUM AND TOXOPLASMA GONDII INFECTION IN URBAN RODENTS FROM BRAZIL

Toxoplasma gondii is a protozoan parasite that infects humans and other warm-blooded animals; it uses feral and domestic cats as the definitive hosts. Neospora caninum is a protozoan parasite of animals whose life cycle is very similar to T. gondii but uses canids as definitive hosts. Small rodents play an important role in the life cycle of T. gondii, and a few findings indicated that they may be natural intermediate hosts for N. caninum. The present study was aimed at identifying infections by T. gondii and N. caninum in urban rodents. Infections by T. gondii were quantified using isolation of the parasite by bioassay in mice; molecular methods were also used for both parasites. Overall, 217 rodents were captured. Brain and heart tissues of all rodents were bioassayed in mice for the detection of T. gondii infection. Brain and heart tissues of 121 rodents had the DNA extracted for molecular analysis. Toxoplasma gondii was isolated by bioassay from a single rodent. From the 121 rodents tested for the presence of T. gondii DNA, 2 animals were positive. In contrast, DNA of N. caninum was not detected in any of the samples. In conclusion, the surveys of N. caninum and T. gondii infection in Rattus rattus, Rattus norvegicus, and Mus musculus captured in urban areas of Sao Paulo reveal a striking low frequency of occurrence of these infections.