Ethanol, acetaldehyde, and methanol in the gas phase and rainwater in different biomes and urban regions of Brazil.

In the context of the increasing global use of ethanol biofuel, this work investigates the concentrations of ethanol, methanol, and acetaldehyde, in both the gaseous phase and rainwater, across six diverse urban regions and biomes in Brazil, a country where ethanol accounts for nearly half the light-duty vehicular fuel consumption. Atmospheric ethanol median concentrations in São Paulo (SP) (12.3 ± 12.1 ppbv) and Ribeirão Preto (RP) (12.1 ± 10.9 ppbv) were remarkably close, despite the SP vehicular fleet being ∼13 times larger. Likewise, the rainwater VWM ethanol concentration in SP (4.64 ± 0.38 µmol L-1) was only 26 % higher than in RP (3.42 ± 0.13 µmol L-1). This work demonstrated the importance of evaporative emissions, together with biomass burning, as sources of the compounds studied. The importance of biogenic emissions of methanol during forest flooding was identified in campaigns in the Amazon and Atlantic forests. Marine air masses arriving at a coastal site led to the lowest concentrations of ethanol measured in this work. Besides vehicular and biomass burning emissions, secondary formation of acetaldehyde by photochemical reactions may be relevant in urban and non-urban regions. The combined deposition flux of ethanol and methanol was 6.2 kg ha-1 year-1, avoiding oxidation to the corresponding and more toxic aldehydes. Considering the species determined here, the ozone formation potential (OFP) in RP was around two-fold higher than in SP, further evidencing the importance of emissions from regional distilleries and biomass burning, in addition to vehicles. At the forest and coastal sites, the OFP was approximately 5 times lower than at the urban sites. Our work evidenced that transition from gasoline to ethanol or ethanol blends brings the associated risk of increasing the concentrations of highly toxic aldehydes and ozone, potentially impacting the atmosphere and threatening air quality and human health in urban areas.

Quantification and risk assessment of pesticides in southern Brazilian air samples using low-volume sampling and rapid ultrasound-assisted extraction.

Brazil is one of the largest pesticide consumers in the world. In the last few years, the use of permissive environmental laws and newly authorized pesticide formulations has been enlarged. Thus, the intensive and inadequate use of pesticides may present a risk to human health since these compounds may move between environmental compartments. Outdoor air samples were collected using low-volume samplers at Arapongas city in the state of Paraná, Brazil, between February and November of 2017. Polyurethane foam (PUF) cartridges were presented as a good choice to collect pesticides from atmospheric gas phase samples when compared to styrene-divinylbenzene (XAD-2). Lower limits of quantitation were obtained with PUF cartridges, which allowed a greater number of samples to be quantified in PUF than in XAD-2. Atrazine and trifluralin were quantified for the first time in Brazilian air samples. The levels of concentration ranged between 192-1731 pg m-3 (chlorpyrifos), 136-1345 pg m-3 (atrazine) and 184-1189 pg m-3 (trifluralin). Alachlor has been out of market in Brazil since 2013, and thus it was not detected in any gas phase sample. The highest daily inhalation exposure was observed in infants, 1 × 10-6 mg kg-1 d-1 for atrazine, chlorpyrifos and trifluralin. None of the analyzed pesticides were associated with a hazardous quotient (HQ) > 1, considering the worst-case scenario for infants, indicating that there is no risk associated with the exposed population. Cancer risk assessment for trifluralin resulted in values below 1 × 10-6, therefore not indicating any significant risk to human health.

An epidemiological study of childhood development in an urban setting in Brazil.

OBJECTIVE: Mental illness is an important public health concern, often starting early in life and particularly impacting children from low-and middle-income countries. Our aims were to 1) determine, in a representative sample of public preschool 4- to 5-year old children in Brazil, the prevalence of internalizing and externalizing disorders and socioemotional development delays; and 2) to identify modifiable risk factors associated with mental, behavioral, or developmental disorders (MBDD), such as microsystem (i.e., parent-child relationship), mesosystem (social support), and macrosystem contextual factors (neighborhood disadvantage). METHODS: A random sample of public preschool children was recruited in the city of Embu das Artes (São Paulo metropolitan area) (n=1,292 from 30 public preschools). Six-month prevalence of MBDD was measured using the Child Behavior Checklist (CBCL) and the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE). RESULTS: Six-month prevalence estimates were 25.4% for internalizing disorders, 12.1% for externalizing disorders, and 30.3% for socioemotional development delays. MBDD prevalence estimates were higher in families with stressful relationships and parental depression or anxiety, and in families with lower social capital. CONCLUSION: At least 25% of preschool children living in an urban area in Brazil presented a mental health disorder. These mental disorder were associated with modifiable factors such as stressful family relationships and lower social capital. Prevention and intervention measures such as family therapy are needed to decrease such high prevalence.

Excessive Screen Media Use in Preschoolers Is Associated with Poor Motor Skills.

Excessive screen media use exposure is a robust childhood predictor of sedentary behavior. The association between excessive exposure to sedentary behaviors (e.g., screen media use) and motor skills and how this association differs across sociodemographic strata is an important knowledge gap that needs to be addressed. The study aims to investigate the association of motor skills and screen media use in preschool children, taking into account sociodemographic variables, physical activity, and sleep profile. A cross-sectional survey of 926 children from 27 preschools was performed. The main outcome was defined as motor skills assessed using the general motor quotient (GMQ). Independent variables included sociodemographic variables, screen media use, screen habits, physical activity, and sleep duration. Logistic regression models were used to estimate the associations between the children's motor skills and each exposure factor. More than 55 percent of the children ate while watching television and 28 percent spent a long time watching television, playing video games, or using a computer, tablet, or cell phone. Excessive screen media use increased the risk of a low GMQ by 72 percent and inactivity in children increased the odds by 90 percent; sleep duration at night decreased the odds of a low GMQ by 51 percent and daytime sleep decreased the odds by 33 percent. Excessive screen media use has been associated with poor motor skills and increased physical inactivity in children, especially among those with prolonged exposure. Our findings can alert parents to the consequences of excessive screen media use and can motivate policymakers to encourage sports and other health-promotion strategies.

Construct validity of the Motor Development Scale (MDS).

OBJECTIVE: Construct validity for the Motor Development Scale (MDS) has not been established. The aim of this study was to examine whether the unidimensional model of MDS would be appropriate for children aged 4 to 6 years-old and provide construct validity for the items concerning this age group in Brazil. METHODS: A total of 938 children participated in the study (214 4-year-olds, 643 5-year-olds, and 81 6-year-olds). Confirmatory factor analysis (CFA) was used to evaluate construct validity of the MDS using a unidimensional model. RESULTS: The CFA for the unidimensional model showed excellent adequacy indices for age 4: χ2(2) = 0.581, p = 0.748, comparative fit index (CFI) = 1.000, Tucker-Lewis index (TLI) = 1.090, root mean square error of approximation (RMSEA) = 0.000 (90% confidence interval [90%CI] = 0.000 to 0.093, close fit [Cfit] = 0.841); age 5: χ2(2) = 2.669, p = 0.263, CFI = 0.993, TLI = 0.980, RMSEA = 0.023 (90%CI = 0.000 to 0.085, Cfit = 0.682), weighted root mean square residual (WRMR) = 0.407; and age 6: χ2(9) = 8.275, p = 0.506, CFI = 1.000, TLI = 1.010, RMSEA = 0.000 (90%CI = 0.000 to 0.118, Cfit = 0.653), WRMR = 0.495. Reliability was good: ω = 0.87 (95%CI = 0.81 to 0.92). CONCLUSION: The proposed unidimensional solution for the MDS provides a concise, parsimonious and reliable way to assess motor development in children aged 4 to 6 years.

Construct validity of the Motor Development Scale (MDS)

Abstract Objective Construct validity for the Motor Development Scale (MDS) has not been established. The aim of this study was to examine whether the unidimensional model of MDS would be appropriate for children aged 4 to 6 years-old and provide construct validity for the items concerning this age group in Brazil. Methods A total of 938 children participated in the study (214 4-year-olds, 643 5-year-olds, and 81 6-year-olds). Confirmatory factor analysis (CFA) was used to evaluate construct validity of the MDS using a unidimensional model. Results The CFA for the unidimensional model showed excellent adequacy indices for age 4: χ2(2) = 0.581, p = 0.748, comparative fit index (CFI) = 1.000, Tucker-Lewis index (TLI) = 1.090, root mean square error of approximation (RMSEA) = 0.000 (90% confidence interval [90%CI] = 0.000 to 0.093, close fit [Cfit] = 0.841); age 5: χ2(2) = 2.669, p = 0.263, CFI = 0.993, TLI = 0.980, RMSEA = 0.023 (90%CI = 0.000 to 0.085, Cfit = 0.682), weighted root mean square residual (WRMR) = 0.407; and age 6: χ2(9) = 8.275, p = 0.506, CFI = 1.000, TLI = 1.010, RMSEA = 0.000 (90%CI = 0.000 to 0.118, Cfit = 0.653), WRMR = 0.495. Reliability was good: ω = 0.87 (95%CI = 0.81 to 0.92). Conclusion The proposed unidimensional solution for the MDS provides a concise, parsimonious and reliable way to assess motor development in children aged 4 to 6 years.

Parent-Child Relationship Quality and Gender as Moderators of the Influence of Hurricane Exposure on Physical Health Among Children and Youth.

OBJECTIVE: To investigate the long-term influence of disaster exposure, parent-child relationship quality (PCRQ), and gender on child and youth physical health. METHODS: Parent-child dyads (N = 1,886) were randomly selected and interviewed approximately 18 months after Hurricane Georges hit Puerto Rico (1998), and reinterviewed 12 months later. The outcome variables were parent report of a global rating of children's physical health, and frequency of medical problems and medical visits in the past year. RESULTS: Conservative analyses that accounted for a host of postdisaster health-relevant factors showed that hurricane exposure exerted detrimental influence on physical health at both 18 and 30 months after the event. The moderating role of PCRQ in the relation between hurricane exposure and physical health varied by gender. CONCLUSION: Disasters have long-term potential to influence the physical health of children and adolescents. PCRQ serves as resource but its role in the context of disasters is complex.

Effects of inspiratory muscle training on lung volumes, respiratory muscle strength, and quality of life in patients with ataxia telangiectasia.

BACKGROUND: Ataxia telangiectasia (AT) is a genetic syndrome caused by a mutation of chromosome 11. The clinical features are cerebellar ataxia, telangiectasia, and progressive loss of muscular coordination, including an inefficient cough secondary to progression of neurological disease. OBJECTIVE: To evaluate the effects of inspiratory muscle training (IMT) on ventilation, lung volume, dyspnoea, respiratory muscle strength, and quality of life in patients with AT. METHODS: A longitudinal study was conducted with 11 AT patients and nine healthy volunteers. Ventilometry, subjective sensation of dyspnoea, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and quality of life were assessed before and after a 24-week IMT program. The IMT load used was set at 60% of the MIP, and the training was performed for 20 min daily. RESULTS: Patients with AT had lower height and weight and also had lower respiratory muscle strength and lung volume compared with healthy volunteers. Furthermore, patients with AT showed a significant improvement when pre- and post-IMT were compared for ventilatory pattern: Vt (476.5 ± 135 ml vs. 583.3 ± 66 ml, P = 0.015) and f (23.3 ± 6 rpm vs. 20.4 ± 4 rpm, P = 0.018), and VC (1,664 ± 463 ml/kg vs. 2,145 ± 750 ml/kg, P = 0.002). IMT also significantly improved the sensation of dyspnoea (median 0.5; minimum 0; maximum 1.0; P = 0.022) and respiratory muscle strength: MIP (-22.2 ± 2 cmH2O vs. -38 ± 9 cmH2O, P < 0.001) and MEP (29 ± 7 cmH2O vs. 40 ± 8 cmH2O, P = 0.001). The health and vitality domains of the SF-36 also showed significant improvement (P = 0.009 and P = 0.014, respectively) post-IMT. CONCLUSION: IMT was effective in improving ventilatory pattern, lung volume, respiratory muscle strength, and the health and vitality domains for quality of life in patients with AT. IMT may be an effective adjunct therapy to drug treatment for patients with AT.

Conhecimento médico sobre as imunodeficiências primárias na cidade de São Paulo, Brasil / Medical awareness concerning primary immunodeficiency diseases in the city of São Paulo, Brazil

OBJETIVO: Avaliar o conhecimento médico sobre as imunodeficiências primárias na cidade de São Paulo (SP). MÉTODOS: Um questionário de 14 questões sobre as imunodeficiências primárias foi aplicado a médicos que trabalhavam em hospitais gerais. Uma das questões apresentava 25 situações clínicas que poderiam ou não estar associadas às imunodeficiências primárias, e a porcentagem de respostas apropriadas gerou um indicador de conhecimento. RESULTADOS: Participaram do estudo 746 médicos, dentre os quais 215 pediatras (28,8%), 244 cirurgiões (32,7%) e 287 clínicos (38,5%). Cerca de 70% dos médicos responderam ter aprendido sobre as imunodeficiências primárias na graduação ou na residência médica. O atendimento a pacientes que usam antibióticos com frequência foi relatado por 75% dos médicos, mas apenas 34,1% já haviam investigado algum paciente e 77,8% não conheciam os dez sinais de alerta para as imunodeficiências primárias. O indicador de conhecimento obtido apresentou uma média de 45,72% (±17,87). Apenas 26,6% dos pediatras e 6,6% tanto dos clínicos quanto dos cirurgiões apresentaram indicador de conhecimento de pelo menos 67% (equivalente à resposta apropriada em dois terços das situações clínicas). CONCLUSÃO: Há uma deficiência no conhecimento médico das imunodeficiências primárias na cidade de São Paulo, mesmo entre os pediatras, a despeito do maior contato com o tema nos últimos anos. A melhora da informação sobre as imunodeficiências primárias entre a comunidade médica é um importante passo para o diagnóstico e o tratamento precoces dessas doenças.

OBJECTIVE: To evaluate medical knowledge of primary immunodeficiency in the city of São Paulo (SP). METHODS: A 14-item questionnaire about primary immunodeficiency was applied to physicians who worked at general hospitals. One of the questions presented 25 clinical situations that could be associated or not with primary immunodeficiency, and the percentage of appropriate answers generated a knowledge indicator. RESULTS: Seven hundred and forty-six participated in the study, among them 215 pediatricians (28.8%), 244 surgeons (32.7%), and 287 clinicians (38.5%). About 70% of the physicians responded that they had learned about primary immunodeficiency in graduate school or in residency training. Treatment of patients that use antibiotics frequently was reported by 75% dos physicians, but only 34.1% had already investigated a patient and 77.8% said they did not know the ten warning signs for primary immunodeficiency. The knowledge indicator obtained showed a mean of 45.72% (±17.87). Only 26.6% if the pediatricians and 6.6% of clinicians and surgeons showed a knowledge indicator of at least 67% (equivalent to an appropriate answer in two thirds of the clinical situations). CONCLUSION: There is a deficit in medical knowledge of primary immunodeficiency in the city of São Paulo, even among pediatricians, despite having greater contact with the theme over the last few years. The improvement of information on primary immunodeficiency in the medical community is an important step towards the diagnosis and treatment process of these diseases.

Peer deviance, social support, and symptoms of internalizing disorders among youth exposed to Hurricane Georges.

This study examined the influence of peers in meeting DSM-IV symptom criteria for an internalizing disorder in adolescents exposed to Hurricane Georges. Participants included a representative community sample of 905 youth (n = 476 boys) ages 11-17, residing in Puerto Rico. Data were gathered on hurricane exposure, symptoms of internalizing disorders, peer social support, peer violence, and peer substance use through in-person structured interviews with adolescents and caretakers from 1999 to 2000 in Puerto Rico, 12-27 months after Hurricane Georges. Hurricane exposure, peer violence, and peer substance use predicted whether adolescents met DSM-IV symptom criteria for a measured internalizing disorder. An interaction was found between hurricane exposure and peer violence, which indicated that hurricane exposure was significantly related to meeting DSM-IV symptom criteria for an internalizing disorder among adolescents who do not report associating with violent peers. However, for participants who reported high levels of peer violence, hurricane exposure did not convey additional risk for meeting DSM-IV symptom criteria for an internalizing disorder. With the increasing role peers play in adolescents' lives, understanding the influence of peers on the development of internalizing symptoms following hurricane exposure may assist in planning developmentally sensitive response plans.

Family influences on the long term post-disaster recovery of Puerto Rican youth.

This study focused on characteristics of the family environment that may mediate the relationship between disaster exposure and the presence of symptoms that met DSM-IV diagnostic criteria for symptom count and duration for an internalizing disorder in children and youth. We also explored how parental history of mental health problems may moderate this mediational model. Approximately 18 months after Hurricane Georges hit Puerto Rico in 1998, participants were randomly selected based on a probability household sample using 1990 US Census block groups. Caregivers and children (N = 1,886 dyads) were interviewed with the Diagnostic Interview Schedule for Children and other questionnaires in Spanish. Areas of the family environment assessed include parent-child relationship quality, parent-child involvement, parental monitoring, discipline, parents' relationship quality and parental mental health. SEM models were estimated for parents and children, and by age group. For children (4-10 years old), parenting variables were related to internalizing psychopathology, but did not mediate the exposure-psychopathology relationship. Exposure had a direct relationship to internalizing psychopathology. For youth (11-17 years old), some parenting variables attenuated the relation between exposure and internalizing psychopathology. Family environment factors may play a mediational role in psychopathology post-disaster among youth, compared to an additive role for children. Hurricane exposure had a significant relation to family environment for families without parental history of mental health problems, but no influence for families with a parental history of mental health problems.

Medical awareness concerning primary immunodeficiency diseases in the city of São Paulo, Brazil.

OBJECTIVE: To evaluate medical knowledge of primary immunodeficiency in the city of São Paulo (SP). METHODS: A 14-item questionnaire about primary immunodeficiency was applied to physicians who worked at general hospitals. One of the questions presented 25 clinical situations that could be associated or not with primary immunodeficiency, and the percentage of appropriate answers generated a knowledge indicator. RESULTS: Seven hundred and forty-six participated in the study, among them 215 pediatricians (28.8%), 244 surgeons (32.7%), and 287 clinicians (38.5%). About 70% of the physicians responded that they had learned about primary immunodeficiency in graduate school or in residency training. Treatment of patients that use antibiotics frequently was reported by 75% dos physicians, but only 34.1% had already investigated a patient and 77.8% said they did not know the ten warning signs for primary immunodeficiency. The knowledge indicator obtained showed a mean of 45.72% (±17.87). Only 26.6% if the pediatricians and 6.6% of clinicians and surgeons showed a knowledge indicator of at least 67% (equivalent to an appropriate answer in two thirds of the clinical situations). CONCLUSION: There is a deficit in medical knowledge of primary immunodeficiency in the city of São Paulo, even among pediatricians, despite having greater contact with the theme over the last few years. The improvement of information on primary immunodeficiency in the medical community is an important step towards the diagnosis and treatment process of these diseases.

Natural disaster and risk of psychiatric disorders in Puerto Rican children.

We examined the persistence of psychiatric disorders at approximately 18 and 30 months after a hurricane among a random sample of the child and adolescent population (4-17 years) of Puerto Rico. Data were obtained from caretaker-child dyads (N = 1,886) through in person interviews with primary caretakers (all children) and youth (11-17 years) using the Diagnostic Interview Schedule for Children IV in Spanish. Logistic regressions, controlling for sociodemographic variables, were used to study the relation between disaster exposure and internalizing, externalizing, or any disorder. Children's disaster-related distress manifested as internalizing disorders, rather than as externalizing disorders at 18 months post-disaster. At 30 months, there was no longer a significant difference in rates of disorder between hurricane-exposed and non-exposed youth. Results were similar across age ranges. Rates of specific internalizing disorders between exposed and unexposed children are provided. Research and clinical implications are discussed.

Measurements of ambient ozone using indigo blue-coated filters.

Ozone monitoring techniques utilize expensive instruments that are often large and heavy. These instruments are not easy to handle in the field, and their size also limits some sampling schemes, principally for indoor ozone determination. We have developed a lightweight, inexpensive, and sensitive method that offers flexibility to undertake measurements of ambient ozone in many environments, both indoor and outdoor. The method is based on the reaction of ozone with indigo blue dye. The indigo molecule contains 1 carbon double bond (C = C) that reacts with ozone and results in nearly colorless reaction products. During sample collection, 2 cellulose filters coated with 40 micro of 1.0 x 10(-3) M indigo blue were used. The determinations were done spectrophotometrically at 250 and 600 nm. The analytical parameters studied were sampling time and flow rate. Analytical curves were constructed with concentrations ranging from 37 to 123 parts per billion by volume (ppbv) of standard ozone, at 0.4 L/min and 15 min sampling time. The detection limits achieved were 6 and 9 ppbv, respectively, at 250 and 600 nm. Considering interferences, measurements made at 250 nm gave more reliable and specific values for ozone.