Relations between Depression, Alcohol and Gender in the Metropolitan Region of Sao Paulo, Brazil

As part of the GENACIS project, this paper sought to assess the prevalence of depression in an urban sample in the city of Sao Paulo, Brazil, as well as the association between depression and alcohol abuse according to gender. To achieve this, an epidemiological survey was conducted using a stratified probability sample, including 2,083 adults. CIDI SF was used to identify depression. The Rao Scott test and multivariate logistic regression were used for statistical analysis. The response rate was 74.9%. Females (58.3%) under 40 years of age (52%) were predominant. The prevalence of depression was 28.3% for women and 12.7% for men. Most men declared being drinkers (61.1%) in the last year. Depression was associated with an alcohol drinking pattern, mostly binge drinking, in addition to the occurrence of problems derived from alcohol use. Most women declared being abstainers (69.5%). Depression was associated with cohabiting with spouses with alcohol-related problems. Results reveal that the association between depression and alcohol consumption is distinct between genders.

Ozone sounding in the Metropolitan Area of Sao Paulo, Brazil: Wet and dry season campaigns of 2006

In the Metropolitan Area of Sao Paulo (MASP), located in southeastern Brazil, surface ozone concentrations are often well above the national air quality standards. In this experimental study, we attempted to characterize the vertical profile of atmospheric ozone and transport of the ozone plume in the boundary layer, using data from the first ozone soundings ever taken in the MASP. In 2006, we launched fifteen ozonesondes: eight from 15 to 18 May (dry season); and seven from 30 October to 1 November (wet season). Vertical ozone mixing ratios in the troposphere were approximately 40 ppb, reaching maximum values of approximately 60 ppb during the dry-season campaign and approximately 100 ppb during the wet-season campaign. In the first and second campaigns, the mean tropospheric ozone column abundance was 28.2 and 41.3 DU, respectively, which can be attributed to the considerable variation in the annual temperature cycle over the region. To determine the effect that biomass burning has on ozone concentrations over the MASP, we analyzed wind trajectories and satellite-derived fire counts. We cannot state unequivocally that biomass burning contributed to higher ozone concentrations above the boundary layer during the experimental campaigns. In the boundary layer, ozone concentrations increase with altitude, peaking at the base of the inversion layer, suggesting that local emissions of volatile organic compounds and nitrogen oxides play a significant role in the lower troposphere over MASP, influencing ozone formation not only at the surface but also vertically in the atmosphere and in distant regions. (C) 2012 Elsevier Ltd. All rights reserved.

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.

Exposure of small mammals to ticks and rickettsiae in Atlantic Forest patches in the metropolitan area of Recife, North-eastern Brazil

Between December 2007 and March 2009, small mammals were captured in 6 Atlantic Forest patches in Brazil. We assessed tick-host associations and whether they differ among forest strata, sites, seasons, and host age classes or between sexes. Moreover, we assessed the exposure of animals to Rickettsia spp. In total, 432 animals were captured and 808 ticks were found on 32-9% of them. Significant differences were found among host species, collection sites, and forest strata; microhabitat preference was a strong risk factor for tick infestation. The highest tick density rates were recorded in forest fragments settled in rural areas; 91.3% of the ticks were collected from animals trapped in these forest fragments. A high prevalence (68.8%) of antibodies to Rickettsia spp. was detected among animals. This study suggests that disturbed Atlantic Forest fragments provide an environment for ticks and small mammals, which are highly exposed to rickettsiae. It also indicates that forest patches settled in rural areas are usually associated with higher small mammal diversity as well as with higher tick density rates.

Lifetime Prevalence, Age and Gender Distribution and Age-of-Onset of Psychiatric Disorders in the Sao Paulo Metropolitan Area, Brazil: Results from the Sao Paulo Megacity Mental Health Survey

Objectives: To estimate prevalence, age-of-onset, gender distribution and identify correlates of lifetime psychiatric disorders in the Sao Paulo Metropolitan Area (SPMA). Methods: The Sao Paulo Megacity Mental Health Survey assessed psychiatric disorders on a probabilistic sample of 5,037 adult residents in the SPMA, using the World Mental Health Survey Version of the Composite International Diagnostic Interview. Response rate was 81.3%. Results: Lifetime prevalence for any disorder was 44.8%; estimated risk at age 75 was 57.7%; comorbidity was frequent. Major depression, specific phobias and alcohol abuse were the most prevalent across disorders; anxiety disorders were the most frequent class. Early age-of-onset for phobic and impulse-control disorders and later age-of-onset for mood disorders were observed. Women were more likely to have anxiety and mood disorders, whereas men, substance use disorders. Apart from conduct disorders, more frequent in men, there were no gender differences in impulse-control disorders. There was a consistent trend of higher prevalence in the youngest cohorts. Low education level was associated to substance use disorders. Conclusions: Psychiatric disorders are highly prevalent among the general adult population in the SPMA, with frequent comorbidity, early age-of-onset for most disorders, and younger cohorts presenting higher rates of morbidity. Such scenario calls for vigorous public health action.

Risk factors for inadequate prenatal care use in the metropolitan area of Aracaju, Northeast Brazil

Abstract Background The aim of prenatal care is to promote good maternal and foetal health and to identify risk factors for adverse pregnancy outcomes in an attempt to promptly manage and solve them. Although high prenatal care attendance is reported in most areas in Brazil, perinatal and neonatal mortalities are disproportionally high, raising doubts about the quality and performance of the care provided. The objective of the present study was to evaluate the adequacy of prenatal care use and the risk factors involved in inadequate prenatal care utilization in the metropolitan area of Aracaju, Northeast Brazil. Methods A survey was carried out with puerperal women who delivered singleton liveborns in all four maternity hospitals of Aracaju. A total of 4552 singleton liveborns were studied. The Adequacy of Prenatal Care Utilization Index, modified according to the guidelines of the Prenatal Care and Birth Humanization Programme, was applied. Socioeconomic, demographic, biological, life style and health service factors were evaluated by multiple logistic regression. Results: Prenatal care coverage in Aracaju was high (98.3%), with a mean number of 6.24 visits. Prenatal care was considered to be adequate or intensive in 66.1% of cases, while 33.9% were considered to have inadequate usage. Age < 18 to 34 years at delivery, low maternal schooling, low family income, two or more previous deliveries, maternal smoking during pregnancy, having no partner and prenatal care obtained outside Aracaju were associated with inadequate prenatal care use. In contrast, private service attendance protected from inadequate prenatal care use. Conclusion Prenatal care coverage was high. However, a significant number of women still had inadequate prenatal care use. Socioeconomic inequalities, demographic factors and behavioural risk factors are still important factors associated with inadequate prenatal care use.

Characterization of ozone transport among metropolitan regions

The aim of this work is to determine the interaction in terms of ozone transport between two metropolitan regions of São Paulo State: The Metropolitan Region of Campinas (MRC) and Metropolitan Region of São Paulo (MRSP), with different characteristics and dimensions. In order to describe the interaction between both regions, 3-D Eulerian photochemical CIT model was used with a new approach for São Paulo regions since most previous studies deal with individual areas considering the contribution of other areas only as boundary conditions. The results from the photochemical simulations showed that the ozone concentration in the MRC is associated to local emissions and the transport of ozone and its precursors from the MRSP, demonstrating the significant impact of a megacity in its neighborhood and the importance of meteorological and topography conditions in the transport of air pollutants from the local source to distant regions.

Relations between Depression, Alcohol and Gender in the Metropolitan Region of São Paulo, Brazil

As part of the GENACIS project, this paper sought to assess the prevalence of depression in an urban sample in the city of São Paulo, Brazil, as well as the association between depression and alcohol abuse according to gender. To achieve this, an epidemiological survey was conducted using a stratified probability sample, including 2,083 adults. CIDI SF was used to identify depression. The Rao Scott test and multivariate logistic regression were used for statistical analysis. The response rate was 74.9%. Females (58.3%) under 40 years of age (52%) were predominant. The prevalence of depression was 28.3% for women and 12.7% for men. Most men declared being drinkers (61.1%) in the last year. Depression was associated with an alcohol drinking pattern, mostly binge drinking, in addition to the occurrence of problems derived from alcohol use. Most women declared being abstainers (69.5%). Depression was associated with cohabiting with spouses with alcohol-related problems. Results reveal that the association between depression and alcohol consumption is distinct between genders.

Lifetime Prevalence, age and gender distribution and age-of-onset of psychiatric disorders in the São Paulo Metropolitan Area, Brazil: results from the São Paulo Megacity Mental Health Survey

OBJECTIVES: To estimate prevalence, age-of-onset, gender distribution and identify correlates of lifetime psychiatric disorders in the São Paulo Metropolitan Area (SPMA). METHODS: The São Paulo Megacity Mental Health Survey assessed psychiatric disorders on a probabilistic sample of 5,037 adult residents in the SPMA, using the World Mental Health Survey Version of the Composite International Diagnostic Interview. Response rate was 81.3%. RESULTS: Lifetime prevalence for any disorder was 44.8%; estimated risk at age 75 was 57.7%; comorbidity was frequent. Major depression, specific phobias and alcohol abuse were the most prevalent across disorders; anxiety disorders were the most frequent class. Early age-of-onset for phobic and impulse-control disorders and later age-of-onset for mood disorders were observed. Women were more likely to have anxiety and mood disorders, whereas men, substance use disorders. Apart from conduct disorders, more frequent in men, there were no gender differences in impulse-control disorders. There was a consistent trend of higher prevalence in the youngest cohorts. Low education level was associated to substance use disorders. CONCLUSIONS: Psychiatric disorders are highly prevalent among the general adult population in the SPMA, with frequent comorbidity, early age-of-onset for most disorders, and younger cohorts presenting higher rates of morbidity. Such scenario calls for vigorous public health action.

Key issues in diagnosing and treating acute aortic syndromes: results from the metropolitan area of Bologna network

Background: Survival of patients with Acute Aortic Syndrome (AAS) may relate to the speed of diagnosis. Diagnostic delay is exacerbated by non classical presentations such as myocardial ischemia or acute heart failure (AHF). However little is known about clinical implications and pathophysiological mechanisms of Troponin T elevation and AHF in AAS. Methods and Results: Data were collected from a prospective metropolitan AAS registry (398 patients diagnosed between 2000 and 2013). Troponin T values (either standard or high sensitivity assay, HS) were available in 248 patients (60%) of the registry population; the overall frequency of troponin positivity was 28% (ranging from 16% to 54%, using standard or HS assay respectively, p = 0.001). Troponin positivity was associated with a twofold increased risk of long in-hospital diagnostic time (OR 1.92, 95% CI 1.05-3.52, p = 0.03), but not with in-hospital mortality. The combination of positive troponin and ACS-like ECG abnormalities resulted in a significantly increased risk of inappropriate therapy due to a misdiagnosis of ACS (OR 2.48, 95% CI 1.12-5.54, p = 0.02). Patients with AHF were identified by the presence of dyspnea as presentation symptom or radiological signs of pulmonary congestion or cardiogenic shock. The overall frequency of AHF was 28 % (32% type A vs. 20% type B AAS, p = 0.01). AHF was due to a variety of pathophysiological mechanisms including cardiac tamponade (26%), aortic regurgitation (25%), myocardial ischemia (17%), hypertensive crisis (10%). AHF was associated with increased surgical delay and with increased risk of in-hospital death (adjusted OR 1.97 95% CI1.13-3.37,p=0.01). Conclusions: Troponin positivity (particularly HS) was a frequent finding in AAS. Abnormal troponin values were strongly associated with ACS-like ECG findings, in-hospital diagnostic delay, and inappropriate therapy. AHF was associated with increased surgical delay and was an independent predictor of in-hospital mortality.

Studying the Roles of Nonprofits, Government, and Business in Providing Activities and Services to Youth in the Phoenix Metropolitan Area

The article addresses the questions, What do children in urban areas do on Saturdays? What types of organizational resources do they have access to? Does this vary by social class? Using diary data on children's activities on Saturdays in the Phoenix-Mesa-Scottsdale metropolitan area, the authors describe the different types of venues (households, businesses, public space, associations, charities, congregations, and government/tribal agencies) that served different types of children. They find that the likelihood of using a charity or business rather than a government or tribal provider increased with family income. Also, the likelihood of using a congregation or a government facility rather than a business, charity, or household increased with being Hispanic. The authors discuss the implications for the urban division of labor on Saturdays and offer research questions that need further investigation.