Sensitivity analysis of an ocean carbon cycle model in the North Atlantic: an investigation of parameters affecting the air-sea CO2 flux, primary production and export of detritus

The sensitivity of the biological parameters in a nutrient-phytoplankton-zooplankton-detritus (NPZD) model in the calculation of the air-sea CO2 flux, primary production and detrital export is analysed. We explore the effect on these outputs of variation in the values of the twenty parameters that control ocean ecosystem growth in a 1-D formulation of the UK Met Office HadOCC NPZD model used in GCMs. We use and compare the results from one-at-a-time and all-at-a-time perturbations performed at three sites in the EuroSITES European Ocean Observatory Network: the Central Irminger Sea (60° N 40° W), the Porcupine Abyssal Plain (49° N 16° W) and the European Station for Time series in the Ocean Canary Islands (29° N 15° W). Reasonable changes to the values of key parameters are shown to have a large effect on the calculation of the air-sea CO2 flux, primary production, and export of biological detritus to the deep ocean. Changes in the values of key parameters have a greater effect in more productive regions than in less productive areas. The most sensitive parameters are generally found to be those controlling well-established ocean ecosystem parameterisations widely used in many NPZD-type models. The air-sea CO2 flux is most influenced by variation in the parameters that control phytoplankton growth, detrital sinking and carbonate production by phytoplankton (the rain ratio). Primary production is most sensitive to the parameters that define the shape of the photosynthesis-irradiance curve. Export production is most sensitive to the parameters that control the rate of detrital sinking and the remineralisation of detritus.

An assessment of air-sea heat fluxes from ocean and coupled reanalyses

Sixteen monthly air–sea heat flux products from global ocean/coupled reanalyses are compared over 1993–2009 as part of the Ocean Reanalysis Intercomparison Project (ORA-IP). Objectives include assessing the global heat closure, the consistency of temporal variability, comparison with other flux products, and documenting errors against in situ flux measurements at a number of OceanSITES moorings. The ensemble of 16 ORA-IP flux estimates has a global positive bias over 1993–2009 of 4.2 ± 1.1 W m−2. Residual heat gain (i.e., surface flux + assimilation increments) is reduced to a small positive imbalance (typically, +1–2 W m−2). This compensation between surface fluxes and assimilation increments is concentrated in the upper 100 m. Implied steady meridional heat transports also improve by including assimilation sources, except near the equator. The ensemble spread in surface heat fluxes is dominated by turbulent fluxes (>40 W m−2 over the western boundary currents). The mean seasonal cycle is highly consistent, with variability between products mostly <10 W m−2. The interannual variability has consistent signal-to-noise ratio (~2) throughout the equatorial Pacific, reflecting ENSO variability. Comparisons at tropical buoy sites (10°S–15°N) over 2007–2009 showed too little ocean heat gain (i.e., flux into the ocean) in ORA-IP (up to 1/3 smaller than buoy measurements) primarily due to latent heat flux errors in ORA-IP. Comparisons with the Stratus buoy (20°S, 85°W) over a longer period, 2001–2009, also show the ORA-IP ensemble has 16 W m−2 smaller net heat gain, nearly all of which is due to too much latent cooling caused by differences in surface winds imposed in ORA-IP.

Geographical distribution of American cutaneous leishmaniasis and its phlebotomine vectors (Diptera: Psychodidae) in the state of Sao Paulo, Brazil

Background: American cutaneous leishmaniasis (ACL) is a re-emerging disease in the state of Sao Paulo, Brazil. It is important to understand both the vector and disease distribution to help design control strategies. As an initial step in applying geographic information systems (GIS) and remote sensing (RS) tools to map disease-risk, the objectives of the present work were to: (i) produce a single database of species distributions of the sand fly vectors in the state of Sao Paulo, (ii) create combined distributional maps of both the incidence of ACL and its sand fly vectors, and (iii) thereby provide individual municipalities with a source of reference material for work carried out in their area. Results: A database containing 910 individual records of sand fly occurrence in the state of Sao Paulo, from 37 different sources, was compiled. These records date from between 1943 to 2009, and describe the presence of at least one of the six incriminated or suspected sand fly vector species in 183/645 (28.4%) municipalities. For the remaining 462 (71.6%) municipalities, we were unable to locate records of any of the six incriminated or suspected sand fly vector species (Nyssomyia intermedia, N. neivai, N. whitmani, Pintomyia fischeri, P. pessoai and Migonemyia migonei). The distribution of each of the six incriminated or suspected vector species of ACL in the state of Sao Paulo were individually mapped and overlaid on the incidence of ACL for the period 1993 to 1995 and 1998 to 2007. Overall, the maps reveal that the six sand fly vector species analyzed have unique and heterogeneous, although often overlapping, distributions. Several sand fly species - Nyssomyia intermedia and N. neivai - are highly localized, while the other sand fly species - N. whitmani, M. migonei, P. fischeri and P. pessoai - are much more broadly distributed. ACL has been reported in 160/183 (87.4%) of the municipalities with records for at least one of the six incriminated or suspected sand fly vector species, while there are no records of any of these sand fly species in 318/478 (66.5%) municipalities with ACL. Conclusions: The maps produced in this work provide basic data on the distribution of the six incriminated or suspected sand fly vectors of ACL in the state of Sao Paulo, and highlight the complex and geographically heterogeneous pattern of ACL transmission in the region. Further studies are required to clarify the role of each of the six suspected sand fly vector species in different regions of the state of Sao Paulo, especially in the majority of municipalities where ACL is present but sand fly vectors have not yet been identified.

Physical disability, recent illnesses and health self-assessment in a population-based study in Sao Paulo, Brazil

Objectives. To investigate health self-assessment and to estimate the prevalence of chronic diseases and recent illnesses in people with and without physical disabilities (PD) in the state of Sao Paulo, southeastern Brazil. Study design. A Cross-sectional study comprising two population-based health surveys conducted in 2002 and 2003. Methods. A total of 8317 persons (165 with PD) were interviewed in the two studies. Variables concerning to health self-assessment; chronic disease and recent illness were compared in the people with and without PD. Negative binomial regression was used in the analysis. Results. Subjects with PD more often assessed their health as poor/very poor compared to non-disabled ones. They reported more illnesses in the 15 days prior to interview as well as more chronic diseases (skin conditions, anaemia, chronic kidney disease, stroke, depression/anxiety, migraine/headache, pulmonary diseases, hypertension, diabetes, arthritis/arthrosis/rheumatic conditions and heart disease). This higher disease prevalence can be either attributed to disability itself or be associated to gender, age and schooling. Conclusions. Subjects with PD had more recent illnesses and chronic diseases and poorer health self-assessment than non-disabled ones. Age, gender, schooling and disability have individual roles in disease development among disabled people.

Health surveys and use of maternal and child health care services in three municipalities within the Sao Paulo metropolitan area

Objectives. To describe the changes in the use of maternal and child health care services by residents of three municipalities-Embu, Itapecerica da Serra, and Taboao da Serra-in the Sao Paulo metropolitan area, 12 years after the implementation of the Unified Health System (SUS) in Brazil, and to analyze the potential of population-based health care surveys as sources of data to evaluate these changes. Methods. Two population-based, cross-sectional surveys were carried out in 1990 and 2002 in municipalities located within the Sao Paulo metropolitan area. For children under 1 year of age, the two periods were compared in terms of outpatient services utilization and hospital admission; for the mothers, the periods were compared in terms of prenatal care and deliveries. In both surveys, stratified and multiple-stage conglomerate sampling was employed, with standardization of interview questions. Results. The most important changes observed were regarding the location of services used for prenatal care, deliveries, and hospitalization of children less than 1 year of age. There was a significant increase in the use of services in the surrounding region or hometown, and decrease in the utilization of services in the city of Sao Paulo (in 1990, 80% of deliveries and almost all admissions for children less than 1 year versus 32% and 46%, respectively, in 2002). The use of primary care units and 24-hour walk-in clinics also increased. All these changes reflect care provided by public resources. In the private sector, there was a decrease in direct payments and payments through company-paid health insurance and an increase in payments through self-paid health insurance. Conclusions. The major changes observed in the second survey occurred simultaneous to the changes that resulted from the implementation of the SUS. Population-based health surveys are adequate for analyzing and comparing the utilization of health care services at different times.

Sex and socioeconomic inequalities of lung cancer mortality in Barcelona, Spain and Sao Paulo, Brazil

The objective of this paper was to assess sex and socioeconomic inequalities in lung cancer mortality in two major cities of Europe and South America. Official information on mortality and population allowed the estimation of sex- and age-specific death rates for Barcelona, Spain and Sao Paulo, Brazil (1995-2003). Mortality trends and levels were independently assessed for each city and subsequently compared. Rate ratios assessed by Poisson regression analysis addressed hypotheses of association between the outcome and socioeconomic covariates (human development index, unemployment and schooling) at the inner-city area level. Barcelona had a higher mortality in men (76.9/100000 inhabitants) than Sao Paulo (38.2/100 000 inhabitants); although rates were decreasing for the former (-2%/year) and levelled-off for the [after. Mortality in women ranked similarly (9.1 for Barcelona, 11.5 for Sao Paulo); with an increasing trend for women aged 35-64 years (+ 7.7%/year in Barcelona and + 2.4%/year in Sao Paulo). The socioeconomic gradient of mortality in men was negative for Barcelona and positive for Sao Paulo; for women, the socioeconomic gradient was positive in both cities. Negative gradients indicate that deprived areas suffer a higher burden of disease; positive gradients suggest that prosmoking lifestyles may have been more prevalent in more affluent areas during the last decades. Sex and socioeconomic inequalities of lung cancer mortality reinforce the hypothesis that the epidemiologic profile of cancer can be improved by an expanded access to existing technology of healthcare and prevention. The continuous monitoring of inequalities in health may contribute to the concurrent promotion of well-being and social justice.

Density and survival rate of Culex quinquefasciatus at Parque Ecologico do Tiete, Sao Paulo, Brazil

Parity rate, gonotrophic cycle length, and density of a Culex quinquefasciatus female population was estimated at the Parque Ecologico do Tiete (PET), Sao Paulo, Brazil. Adult Cx. quinquefasciatus females were collected from vegetation along the edges of a polluted drainage canal with the use of a battery-powered backpack aspirator from September to November 2005 and from February to April 2006. We examined 255 Cx. quinquefasciatus ovaries to establish the parity rate of 0.22 and determined the gonotrophic cycle length under laboratory conditions to be 3 and 4 days. From these data, we calculated the Cx. quinquefasciatus survival rate to be 0.60 and 0.68 per day. Density of the Cx. quinquefasciatus female (5.71 females per m(2)) was estimated based on a population size of 28,810 individuals divided by the sampled area of 5,040 m(2). Results of all experiments indicate medium survivorship and high density of the Cx. quinquefasciatus female population. This species is epidemiologically relevant in the PET area and should be a target of the vector control program of Sao Paulo municipality.

Prevalence of untreated caries in deciduous teeth in urban and rural areas in the state of Sao Paulo, Brazil

Objectives. To describe the prevalence of dental caries in children with deciduous teeth in urban and rural areas in the state of Sao Paulo, Brazil, and to identify associated factors. Methods. The study included 24 744 children ( 5 - 7 years of age) examined as part of an epidemiological survey on oral health carried out in the state of Sao Paulo ( Levan-tamento Epidemiologico de Sa de Bucal do Estado de Sao Paulo). Multilevel analysis was used to investigate whether the prevalence of untreated caries was associated with the sociodemographic characteristics of the children examined or with the socioeconomic aspects of the participating cities. Results. Being black or brown ( adjusted odds ratio ( OR) = 1.27), attending school in rural areas ( adjusted OR = 1.88), and attending public school ( adjusted OR = 3.41) were identified as determinants for an increased probability of presenting deciduous teeth with untreated caries. Being a female ( adjusted OR = 0.83) was identified as a protective factor. The negative coefficients obtained for second- level independent variables indicate that the oral health profile of the cities included in the study were positively impacted by a higher municipal human development index ( beta = - 0.47) and fluoridated drinking water ( beta = - 0.32). Conclusions. The prevalence of untreated caries is influenced by individual and sociodemographic factors. The present study provides epidemiological information concerning the rural areas in the state of Sao Paulo. This information is useful for strategic planning and for establishing guidelines for oral health actions in local health systems, thereby contributing to oral health equity.

Dietary Quality and Associated Factors among Factory Workers in the Metropolitan Region of Sao Paulo, Brazil

The workplace is a manageable community-based setting for ensuring proper nutrition. This study aimed to evaluate dietary quality and associated factors among adult workers at a cosmetics factory in the metropolitan area of Sao Paulo, Brazil. This factory was actively participating in the Brazilian Workers` Meal Program, which was created to ensure workers` nutritional health. In this cross-sectional study, data on 202 adult workers were assessed using questionnaires (sociodemographic, anthropometric, and lifestyle characteristics) administered during August and September 2006. Dietary intake, measured by 24-hour dietary recall, was used to calculate the modified Healthy Eating Index (HEI). A repeated administration of the 24-hour dietary recall was applied in a random subsample to calculate the modified HEI adjusted for the within-person variation in intake. Mean adjusted modified HEI scores were analyzed using multiple linear regression adjusted for energy. The mean adjusted modified HEI score was 72.3 +/- 8.0. The lowest adjusted modified HEI components scores were ""milk and dairy products"" (4.4 +/- 3.2) and ""sodium"" (3.7 +/- 3.1). Two percent of workers had ""poor diet"" (adjusted modified HEI score <51 points) and the majority (87%) had ""diet that needs modification"" (adjusted modified HEI score between 51 and 80), despite their participation in the meal program. Adjusted modified HEI scores were considerably higher for men (74.7 +/- 7.0) than for women (66.9 +/- 8.2) and for normal body mass index (calculated as kg/m(2)) (73.3 +/- 7.8) than for overweight/obese (70.9 +/- 8.1). Based on these results, the vast majority of workers were found to have diets that needed improvement. Individuals with higher-quality diets were more likely to have lower body mass index and to be male. J Am Diet Assoc. 2010;110:786-790.

Dietary Quality Index and Associated Factors among Adolescents of the State of Sao Paulo, Brazil

Objective To assess dietary quality and associated factors in adolescents. Study design We conducted a population-based cross-sectional study in a sample of 1584 adolescents living in areas of the state of Sao Paulo, Brazil. Dietary intake was measured with the 24-hour recall method, and dietary quality was assessed by means of the Health Eating Index (HEI), adapted to fit to the local requirements. Linear regression analyses were performed to assess the association between the HEI and demographic, socioeconomic, and lifestyle variables. Results A total of 97.1% of the adolescents studied had an inadequate diet or a diet that needed improvement. The mean overall HEI score was 59.7. Lower mean HEI scores were found for fruits, dairy products, and vegetables. Male adolescents who were physically active and lived in a house or apartment had higher HEI scores. The multiple regression analyses showed that the quality of the diet improved as age decreased. Adolescents who lived in houses or apartments had higher HEI scores than adolescents living in shacks or slums, regardless of age and energy intake. Conclusions Dietary quality is associated with income and age. A better understanding of the factors associated can provide input to the formulation of policies and development of nutritional actions. (J Pediatr 2010; 156:456-60).

Detection of assemblages A and B of Giardia duodenalis in water and sewage from Sao Paulo state, Brazil

Giardia duodenalis is a protozoan that parasitizes humans and other mammals and causes giardiasis. Although its isolates have been divided into seven assemblages, named A to G, only A and B have been detected in human faeces. Assemblage A isolates are commonly divided into two genotypes, AI and AII. Even though information about the presence of this protozoan in water and sewage is available in Brazil, it is important to verify the distribution of different assemblages that might be present, which can only be done by genotyping techniques. A total of 24 raw and treated sewage, surface and spring water samples were collected, concentrated and purified. DNA was extracted, and a nested PCR was used to amplify an 890 bp fragment of the gdh gene of G. duodenalis, which codes for glutamate dehydrogenase. Positive samples were cloned and sequenced. Ten out of 24 (41.6%) samples were confirmed to be positive for G. duodenalis by sequencing. Phylogenetic analysis grouped most sequences with G. duodenalis genotype AII from GenBank. Only two raw sewage samples presented sequences assigned to assemblage B. In one of these samples genotype AII was also detected. As these assemblages/genotypes are commonly associated to human giardiasis, the contact with these matrices represents risk for public health.

Investigating Environmental Determinants of Diet, Physical Activity, and Overweight among Adults in Sao Paulo, Brazil

There is worldwide recognition that the burden of noncommunicable diseases (NCDs) and obesity-related health problems is rapidly increasing in low- and middle-income countries. Environmental determinants of obesity are likely to differ between countries, particularly in those undergoing rapid socioeconomic and nutrition transitions such as Brazil. This study aims to describe some built environment and local food environment variables and to explore their association with the overweight rate and diet and physical activity area-level aggregated indicators of adults living in the city of Sao Paulo, the largest city in Brazil. This formative study includes an ecological analysis of environmental factors associated with overweight across 31 submunicipalities of the city of Sao Paulo using statistical and spatial analyses. Average prevalence of overweight was 41.69% (95% confidence interval 38.74, 44.64), ranging from 27.14% to 60.75% across the submunicipalities. There was a wide geographical variation of both individual diet and physical activity, and indicators of food and built environments, favoring wealthier areas. After controlling for area socioeconomic status, there was a positive correlation between regular fruits and vegetables (FV) intake and density of FV specialized food markets (r = 0.497; p < 0.001), but no relationship between fast-food restaurant density and overweight prevalence was found. A negative association between overweight prevalence and density of parks and public sport facilities was seen (r = -0.527; p < 0.05). Understanding the relationship between local neighborhood environments and increasing rates of poor diet, physical activity, and obesity is essential in countries undergoing rapid economic and urban development, such as Brazil, in order to provide insights for policies to reduce increasing rates of NCDs and food access and health inequalities.