Desigualdade social no adoecimento e morte por câncer de boca e orofaríngeo no Município de São Paulo, Brasil: 1997 a 2008

A ocupação do espaço geográfico é determinada historicamente pelo modelo socioeconômico e pelo dinamismo de suas relações sociais, políticas e ideológicas. O objetivo deste trabalho é avaliar a distribuição espacial e o efeito de indicadores socioeconômicos no adoecimento e morte por câncer de boca e orofaríngeo no Município de São Paulo, Brasil, no período de 1997 a 2008. Os dados foram coletados no Registro de Câncer de Base Populacional e no Programa de Aprimoramento das Informações de Mortalidade - PRO-AIM e georreferenciados pelos softwares Terraview e GeoDa. O referencial teórico para avaliação dos resultados foi baseado na teoria de Milton Santos. As taxas de incidência apresentaram um índice de autocorrelação Global de Moran de 0,226 e as taxas de mortalidade de 0,337. A Incidência de câncer de boca e orofaríngeo não apresenta um padrão espacial bem definido no Município de São Paulo, mas é bastante desigual no que se refere à Mortalidade, concentrando as suas menores taxas na área central, mais rica e economicamente menos desigual.

Social Mobilization in Health and Sanitation in an Action Research Process in an Indigenous Community in Northwestern Amazon

The living conditions of the inhabitants of Iauarete, an indigenous area in the municipality of Sao Gabriel da Cachoeira, State of Amazonas (Northern Brazil), have been negatively affected by population density, poor sanitation and maintenance of sanitation practices that are incompatible with that reality. To improve the population's quality of life, sanitation systems that are adequate to the local socio-cultural characteristics should be implemented, as well as educational processes with emphasis on social mobilization and community empowerment. The aim of this paper is to report and discuss a training course on health and sanitation using action research, directed to the mobilization of the Iauarete indigenous people, with the objective of assisting other studies of this nature. In the meetings, issues related to environmental health were discussed, a Community Newspaper was constructed, the course participants made interviews and drew up claims documents. This experience has enhanced the participants' understanding of local problems and of the importance of social mobilization for the dialogue with governmental institutions that are responsible for providing sanitation services and for seeking better living conditions. The researchers and teachers of the training course benefitted from the construction of collective knowledge resulting from interaction with subjects of the investigated situation and from the recognition and redefinition of their representations, fulfilling the fundamental premise of action research.

Resíduos sólidos urbanos: impactos socioambientais e perspectiva de manejo sustentável com inclusão social

Com a Rio+20 retoma-se a discussão de estratégias para conciliar desenvolvimento com proteção dos ecossistemas. Um tema apenas tangenciado nessas discussões é o gerenciamento dos resíduos sólidos urbanos. Diante da institucionalização da Política Nacional de Resíduos Sólidos, busca-se contribuir para esse debate, bem como apontar caminhos para o enfrentamento dessa questão, privilegiando a inclusão social. Para isso, foram utilizados documentos e informações sobre a gestão de resíduos sólidos, e a literatura científica especializada. Observa-se que o inadequado gerenciamento dos resíduos sólidos gera impactos imediatos no ambiente e na saúde, assim como contribui para mudanças climáticas. Considerando as limitações das opções de destinação final para os resíduos, é imprescindível minimizar as quantidades produzidas por meio da redução, reutilização e reciclagem. Nesse contexto, destaca-se o papel dos catadores, que vêm realizando um trabalho de grande importância ambiental. Dadas as fragilidades desse segmento populacional, é preciso delinear políticas públicas que tornem a atividade de catação mais digna e com menos riscos e que, ao mesmo tempo, garantam renda, para assim caminhar rumo a um desenvolvimento mais saudável, justo e sustentável.

Prevalence and correlates of dizziness in community-dwelling older people: a cross sectional population based study

Abstract Background Dizziness is a common complaint among older adults and has been linked to a wide range of health conditions, psychological and social characteristics in this population. However a profile of dizziness is still uncertain which hampers clinical decision-making. We therefore sought to explore the relationship between dizziness and a comprehensive range of demographic data, diseases, health and geriatric conditions, and geriatric syndromes in a representative sample of community-dwelling older people. Methods This is a cross-sectional, population-based study derived from FIBRA (Network for the Study of Frailty in Brazilian Elderly Adults), with 391 elderly adults, both men and women, aged 65 years and older. Elderly participants living at home in an urban area were enrolled through a process of random cluster sampling of census regions. The outcome variable was the self-report of dizziness in the last year. Several feelings of dizziness were investigated including vertigo, spinning, light or heavy headedness, floating, fuzziness, giddiness and instability. A multivariate logistic regression analysis was conducted to estimate the adjusted odds ratios and build the probability model for dizziness. Results The complaint of dizziness was reported by 45% of elderly adults, from which 71.6% were women (p=0.004). The multivariate regression analysis revealed that dizziness is associated with depressive symptoms (OR = 2.08; 95% CI 1.29–3.35), perceived fatigue (OR = 1.93; 95% CI 1.21-3.10), recurring falls (OR = 2.01; 95% CI 1.11-3.62) and excessive drowsiness (OR = 1.91; 95% CI 1.11–3.29). The discrimination of the final model was AUC = 0.673 (95% CI 0.619-0.727) (p< 0.001). Conclusions The prevalence of dizziness in community-dwelling elderly adults is substantial. It is associated with other common geriatric conditions usually neglected in elderly adults, such as fatigue and drowsiness, supporting its possible multifactorial manifestation. Our findings demonstrate the need to expand the design in future studies, aiming to estimate risk and identify possible causal relations.

Genetic Control of Mosquitoes: population suppression strategies

Over the last two decades, morbidity and mortality from malaria and dengue fever among other pathogens are an increasing Public Health problem. The increase in the geographic distribution of vectors is accompanied by the emergence of viruses and diseases in new areas. There are insufficient specific therapeutic drugs available and there are no reliable vaccines for malaria or dengue, although some progress has been achieved, there is still a long way between its development and actual field use. Most mosquito control measures have failed to achieve their goals, mostly because of the mosquito's great reproductive capacity and genomic flexibility. Chemical control is increasingly restricted due to potential human toxicity, mortality in no target organisms, insecticide resistance, and other environmental impacts. Other strategies for mosquito control are desperately needed. The Sterile Insect Technique (SIT) is a species-specific and environmentally benign method for insect population suppression, it is based on mass rearing, radiation mediated sterilization, and release of a large number of male insects. Releasing of Insects carrying a dominant lethal gene (RIDL) offers a solution to many of the drawbacks of traditional SIT that have limited its application in mosquitoes while maintaining its environmentally friendly and species-specific utility. The self-limiting nature of sterile mosquitoes tends to make the issues related to field use of these somewhat less challenging than for self-spreading systems characteristic of population replacement strategies. They also are closer to field use, so might be appropriate to consider first. The prospect of genetic control methods against mosquito vectored human diseases is rapidly becoming a reality, many decisions will need to be made on a national, regional and international level regarding the biosafety, social, cultural and ethical aspects of the use and deployment of these vector control methods.

Epidemia midiática: produção de sentidos e configuração social da febre amarela na cobertura jornalística, 2007-2008

O objetivo deste artigo, situado no campo da comunicação em saúde, é analisar os sentidos atribuídos discursivamente à febre amarela silvestre durante a cobertura jornalística da epizootia da doença, ocorrida no Brasil no verão 2007-2008. Utilizando o referencial teórico das práticas discursivas e da produção de sentidos no cotidiano e as hipóteses de agendamento (agenda-setting) e enquadramento (framing) da notícia, foram analisadas todas as matérias sobre febre amarela veiculadas pelo jornal Folha de S. Paulo, no período de 21 de dezembro de 2007 a 29 de fevereiro de 2008, e todos os documentos oficiais sobre a epizootia emitidos pela autoridade brasileira de saúde pública entre 3 de janeiro e 28 de fevereiro de 2008. Os achados indicam que as estratégias discursivas da cobertura jornalística relativizaram o discurso da autoridade de saúde pública; priorizaram a divulgação do número de casos; enfatizaram a vacinação como o limite entre a vida e a morte, omitindo riscos do uso indiscriminado do imunobiológico; e propagaram a iminência de uma epidemia de febre amarela de grandes proporções. Essas estratégias deram novos sentidos à doença, deslocando o evento de sua forma silvestre, espacialmente restrita e de gravidade limitada, para a urbana, de caráter epidêmico e potencialmente mais grave. Secundariamente, o estudo permitiu identificar os impactos desse discurso midiático sobre o sistema nacional de imunização e os riscos a que a população foi exposta em função dos sentidos produzidos: em 2008, foram registrados 8 casos de reação grave à vacina, dos quais 6 foram a óbito.

Social anxiety and negative early life events in university students

INTRODUCTION: There is substantial evidence regarding the impact of negative life events during childhood on the aetiology of psychiatric disorders. We examined the association between negative early life events and social anxiety in a sample of 571 Spanish University students. METHODS: In a cross-sectional survey conducted in 2007, we collected data through a semistructured questionnaire of sociodemographic variables, personal and family psychiatric history, and substance abuse. We assessed the five early negative life events: (i) the loss of someone close, (ii) emotional abuse, (iii) physical abuse, (iv) family violence, and (v) sexual abuse. All participants completed the Liebowitz Social Anxiety Scale. RESULTS: Mean (SD) age was 21 (4.5), 75% female, LSAS score was 40 (DP = 22), 14.2% had a psychiatric family history and 50.6% had negative life events during childhood. Linear regression analyses, after controlling for age, gender, and family psychiatric history, showed a positive association between family violence and social score (p = 0.03). None of the remaining stressors produced a significant increase in LSAS score (p > 0.05). CONCLUSION: University students with high levels of social anxiety presented higher prevalence of negative early life events. Thus, childhood family violence could be a risk factor for social anxiety in such a population.

Perceived neighborhood problems: multilevel analysis to evaluate psychometric properties in a Southern adult Brazilian population

Abstract Background Physical attributes of the places in which people live, as well as their perceptions of them, may be important health determinants. The perception of place in which people dwell may impact on individual health and may be a more telling indicator for individual health than objective neighborhood characteristics. This paper aims to evaluate psychometric and ecometric properties of a scale on the perceptions of neighborhood problems in adults from Florianopolis, Southern Brazil. Methods Individual, census tract level (per capita monthly familiar income) and neighborhood problems perception (physical and social disorders) variables were investigated. Multilevel models (items nested within persons, persons nested within neighborhoods) were run to assess ecometric properties of variables assessing neighborhood problems. Results The response rate was 85.3%, (1,720 adults). Participants were distributed in 63 census tracts. Two scales were identified using 16 items: Physical Problems and Social Disorder. The ecometric properties of the scales satisfactory: 0.24 to 0.28 for the intra-class correlation and 0.94 to 0.96 for reliability. Higher values on the scales of problems in the physical and social domains were associated with younger age, more length of time residing in the same neighborhood and lower census tract income level. Conclusions The findings support the usefulness of these scales to measure physical and social disorder problems in neighborhoods.

Dietary intake of environmentally persistent plaguicides in the european population

[EN] Global pollution has become one of the most important problems of the modern societies and pesticides play a major role among the chemical contaminants that are released to the environment every year. Organochlorine compounds have been widely used in the past all over the world as pesticides and some of them are still used for the control of vectors of infectious diseases. Due to their high lipophilicity, stability and resistance to degradation, most of them have been banned or strictly regulated but their levels remain high in the environment as persistent organic pollutants (POPs). Their presence in the environment leads to their introduction into the food chain, especially affecting food of animal origin with higher fat content. Due to their liposolubility, these substances tend to be bioaccumulated into the fat tissues of living beings along their entire lives, and to be biomagnificated across trophic levels in the food chain. Thus, the main human source of these pesticides comes from the daily intake of contaminated food from environmental sources. It has been established the role of many of the POPs as endocrine disruptors and even as carcinogenic agents, being thus considered as important risk factors for health. Moreover, chronic exposure to pesticides, even at very low levels, has been related with cancer, fertility problems, immunosuppression and other diseases. For this reason, it is important to know the level of POPs contamination and to identify the main sources contributing to it. Fish, meat and dairy products are the food groups with the highest levels of pollution. However, the residue levels vary by geographic area, and are influenced by several factors as food security policies, local pesticide use patterns, environmental practices, or the time when the study is conducted. Food habits, conditioned by different social and economic factors, as well as several biological factors (i.e. gender, sex and age), determine the levels of POPs exposure in the population. The purpose of this chapter is to give an overview of the dietary intake of environmentally persistent pesticides by the European population, and the potential adverse consequences of this exposure on human health.

Population ageing, longevity and migration: an overlapping generations approach

The silent demographic revolution characterizing the main industrialized countries is an unavoidable factor which has major economic, social, cultural and psychological implications. This thesis studies the main consequences of population ageing and the connections with the phenomenon of migration, The theoretical analysis is developed using Overlapping Generations Models (OLG). The thesis is divided in the following four chapters: 1) “A Model for Determining Consumption and Social Assistance Demand in Uncertainty Conditions”, focuses on the relation between demographic impact and social insurance and proposes the institution of a non selfsufficiency fund for the elderly. 2) "Population Ageing, Longevity and Health", analyzes the effects of health investment on intertemporal individual behaviour and capital accumulation. 3) "Population Ageing and the Nursing Flow", studies the consequences of migration in the nursing sector. 4) "Quality of Multiculturalism and Minorities' Assimilation", focuses on the problem of assimilation and integration of minorities.

An equilibrium approach to modelling social interaction

The aim of this work is to put forward a statistical mechanics theory of social interaction, generalizing econometric discrete choice models. After showing the formal equivalence linking econometric multinomial logit models to equilibrium statical mechanics, a multi- population generalization of the Curie-Weiss model for ferromagnets is considered as a starting point in developing a model capable of describing sudden shifts in aggregate human behaviour. Existence of the thermodynamic limit for the model is shown by an asymptotic sub-additivity method and factorization of correlation functions is proved almost everywhere. The exact solution for the model is provided in the thermodynamical limit by nding converging upper and lower bounds for the system's pressure, and the solution is used to prove an analytic result regarding the number of possible equilibrium states of a two-population system. The work stresses the importance of linking regimes predicted by the model to real phenomena, and to this end it proposes two possible procedures to estimate the model's parameters starting from micro-level data. These are applied to three case studies based on census type data: though these studies are found to be ultimately inconclusive on an empirical level, considerations are drawn that encourage further refinements of the chosen modelling approach, to be considered in future work.

Cognitive and affective processes in social actions and decisions

The question of how we make, and how we should make judgments and decisions has occupied thinkers for many centuries. This thesis has the aim to add new evidences to clarify the brain’s mechanisms for decisions. The cognitive and the emotional processes of social actions and decisions are investigated with the aim to understand which brain areas are mostly involved. Four experimental studies are presented. A specific kind of population is involved in the first study (as well as in study III) concerning patients with lesion of ventromedial prefrontal cortex (vmPFC). This region is collocated in the ventral surface of frontal lobe, and it seems have an important role in social and moral decision in forecasting the negative emotional consequences of choice. In study I, it is examined whether emotions, specifically social emotions subserved by the vmPFC, affect people’s willingness to trust others. In study II is observed how incidental emotions could encourage trusting behaviour, especially when individuals are not aware of emotive stimulation. Study III has the aim to gather a direct psychophysiological evidence, both in healthy and neurologically impaired individuals, that emotions are crucially involved in shaping moral judgment, by preventing moral violations. Study IV explores how the moral meaning of a decision and its subsequent action can modulate the basic component of action such as sense of agency.

Peer and group relationships in preschoolers: the role of social and linguistic skills

Being able to positively interact and build relationships with playmates in preschool years is crucial to achieve positive adjustment. An update review and two studies on such topics were provided. Study 1 is observational; it investigates the type of social experience in groups (N = 443) of children (N = 120) at preschool age in child-led vs. teacher-led contexts. The results revealed that in child-led contexts children were more likely to be alone, in dyads, and in small peer groups; groups were mostly characterized by same-gender playmates who engaged in joint interactions, with few social interactions with teachers. In teacher-led contexts, on the other hand, children were more likely to be involved in small, medium and large groups; groups were mostly characterized by other-gender playmates, involved in parallel interactions, with teachers playing a more active role. The purpose of Study 2 was to describe the development of socio-emotional competence, temperamental traits and linguistic skill. It examined the role of children’s reciprocated nominations (=RNs) with peers, assessed via sociometric interview, in relation to socio-emotional competence, temperamental traits and linguistic skill. Finally, the similarity-homophily tendency was investigated. Socio-emotional competence and temperamental traits were assessed via teacher ratings, linguistic skill via test administration. Eighty-four preschool children (M age = 62.53) were recruited within 4 preschool settings. Those children were quite representative of preschool population. The results revealed that children with higher RNs showed higher social competence (tendency), social orientation, positive emotionality, motor activity and linguistic skill. They exhibited lower anxiety-withdrawal. The results also showed that children prefer playmates with similar features: social competence, anger-aggression (tendency), social orientation, positive emotionality, inhibition to innovation, attention, motor activity (tendency) and linguistic skill. Implications for future research were suggested.

Phylogeny and population dynamics in European Reticulitermes and Kalotermes genera (Insecta, Isoptera)

The aim of this thesis is to detect the phylogeny and the population dynamics of the European termites of the genera Reticulitermes and Kalotermes, by the use of different mitochondrial (16S, COI/tRNA/COII, CR) and nuclear (microsatellites and Inter-SINE) molecular markers. In the phylogenetic analyses, the obtained results have well defined the cladogenetic events that generated the nowadays species biodiversity of the genus Reticulitermes, while the analysis of the Kalotermes flavicollis taxon showed the presence of at least four genetic clades, defined on the basis of the geographical distance. The second part of the thesis is centred on the population dynamics of two species: Reticulitermes urbis and Kalotermes flavicollis. The first species, native of the Balkans, is known to be present in some cities of Italy and France. I’ve analyzed the colony genetic structure of the introduced population of Bagnacavallo (RA, Italy), using nine microsatellite loci. The obtained results are in accordance with those obtained from another population in France: this species in fact confirms its invasive and infestation capacities. The analysis of the natural population of K. flavicollis, performed with a combination of mitochondrial (control region) and nuclear (microsatellites and I-SINE) markers, clearly evidenced the presence of two genetic lineages that coexist in the same area. Moreover, results clearly indicate that the cross-breeding is allowed. Finally, the whole results are discussed in a comparative view to better understand the differences in ecology, evolutionary dynamics and colony social structure between these two genera.

Genetic characterization, population history and evolutionary medicine perspective in two native south american populations: Yanesha and Wichi

Two Amerindian populations from the Peruvian Amazon (Yanesha) and from rural lowlands of the Argentinean Gran Chaco (Wichi) were analyzed. They represent two case study of the South American genetic variability. The Yanesha represent a model of population isolated for long-time in the Amazon rainforest, characterized by environmental and altitudinal stratifications. The Wichi represent a model of population living in an area recently colonized by European populations (the Criollos are the population of the admixed descendents), whose aim is to depict the native ancestral gene pool and the degree of admixture, in relation to the very high prevalence of Chagas disease. The methods used for the genotyping are common, concerning the Y chromosome markers (male lineage) and the mitochondrial markers (maternal lineage). The determination of the phylogeographic diagnostic polymorphisms was carried out by the classical techniques of PCR, restriction enzymes, sequencing and specific mini-sequencing. New method for the detection of the protozoa Trypanosoma cruzi was developed by means of the nested PCR. The main results show patterns of genetic stratification in Yanesha forest communities, referable to different migrations at different times, estimated by Bayesian analyses. In particular Yanesha were considered as a population of transition between the Amazon basin and the Andean Cordillera, evaluating the potential migration routes and the separation of clusters of community in relation to different genetic bio-ancestry. As the Wichi, the gene pool analyzed appears clearly differentiated by the admixed sympatric Criollos, due to strict social practices (deeply analyzed with the support of cultural anthropological tools) that have preserved the native identity at a diachronic level. A pattern of distribution of the seropositivity in relation to the different phylogenetic lineages (the adaptation in evolutionary terms) does not appear, neither Amerindian nor European, but in relation to environmental and living conditions of the two distinct subpopulations.