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Introduction: The LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics.

Methods: We combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort-specific Cox proportional hazard regression analyses in a two-step individual participant data meta-analysis.

Improving RNA Fusion Call Confidence and Reliability in Molecular Diagnostic Testing.

Next-generation sequencing is a superior method for detecting known and novel RNA fusions in formalin-fixed, paraffin-embedded tissue over fluorescence in situ hybridization and RT-PCR. However, confidence in fusion calling and true negatives may be compromised by poor RNA quality. Using a commercial panel of 507 genes and the recommended 3-million read threshold to accept results, two cases yielded false negatives while exceeding this recommendation during clinical validation.

Germline TP53 mutations undergo copy number gain years prior to tumor diagnosis.

Li-Fraumeni syndrome (LFS) is a hereditary cancer predisposition syndrome associated with germline TP53 pathogenic variants. Here, we perform whole-genome sequence (WGS) analysis of tumors from 22 patients with TP53 germline pathogenic variants. We observe somatic mutations affecting Wnt, PI3K/AKT signaling, epigenetic modifiers and homologous recombination genes as well as mutational signatures associated with prior chemotherapy.

The clinical utility of integrative genomics in childhood cancer extends beyond targetable mutations.

We conducted integrative somatic-germline analyses by deeply sequencing 864 cancer-associated genes, complete genomes and transcriptomes for 300 mostly previously treated children and adolescents/young adults with cancer of poor prognosis or with rare tumors enrolled in the SickKids Cancer Sequencing (KiCS) program. Clinically actionable variants were identified in 56% of patients. Improved diagnostic accuracy led to modified management in a subset.

Mild and moderate cognitive impairment and mortality among Brazilian older adults in long-term follow-up: The Bambui Health Aging Study.

Objective: To compare mortality in older adults with and without mild or moderate cognitive impairment over 15 years of follow-up in a middle-income country, where little information on this subject is available.

Methods: A total of 1,281 community-dwelling older adults were followed-up for a median of 13.3 years.

Diabetes, depressive symptoms, and mortality risk in old age: The role of inflammation.

Background: Both diabetes and depression increase the mortality risk in the elderly. In this study, we evaluated mortality risk associated with the comorbidity between depression and diabetes. We also assessed the moderating role of inflammation in the mortality risk in this population.

Use of mental health services by community-resident adults with DSM-IV anxiety and mood disorders in a violence-prone area: São Paulo, Brazil.

Background: While under-use of mental health services by adults with anxiety and/or depression is well established, use in a violence-prone area, and as a function of diagnosis and personality characteristics such resilience, is little known. We examine the sociodemographic and personality characteristics (specifically resilience), associated with use of mental health services in a violence-prone city by those with anxiety, depression, and their comorbidity.

Methods: The structured Composite International Diagnostic Interview was used to identify 12-month DSM-IV- and ICD-10-defined anxiety and depression in a cross-sectional, representative, community-resident sample age 15-75y (N = 2536) in São Paulo, Brazil, and their use of mental health services.

12-month prevalence and concomitants of DSM-IV depression and anxiety disorders in two violence-prone cities in Brazil.

Background: Estimating 12-month prevalence of depression, anxiety, and comorbid anxiety/depression in noninstitutionalized adults (age 15-75) in two violence-prone cities.

Methods: The Composite International Diagnostic Interview v2.1 (Portuguese), administered in population-representative surveys (age 15-75) in São Paulo (N = 2536) and Rio de Janeiro (N = 1208), yielded 12-month prevalence of violent events experienced, and DSM-IV diagnoses of depression and anxiety, which were classified into mutually exclusive groups: 1) no anxiety/depression; 2) anxiety only; 3) depression only; 4) comorbid anxiety/depression.

Prevalence and Correlates of Elder Abuse in São Paulo and Rio de Janeiro.

Objectives: To assess the prevalence of elder abuse and to investigate potential sociodemographic, health behavior, and medical correlates.

Design: Cross-sectional data were collected in face-to-face assessments.

Setting: São Paulo and Rio de Janeiro, Brazil.

Polycystic ovary syndrome and mental disorders: a systematic review and exploratory meta-analysis.

Background: The association between depression, anxiety, and polycystic ovary syndrome (PCOS) is still unclear. Therefore, a systematic review and meta-analysis was conducted to assess the rates of comorbid psychiatric disorders among women with PCOS compared to women without it.

Methods: PubMed/MEDLINE, Embase, PsycINFO, and Web of Science databases were searched from inception to November 27, 2015.

Public Stigma towards Older Adults with Depression: Findings from the São Paulo-Manaus Elderly in Primary Care Study.

This study investigates three domains of public stigma (perceived negative reactions, perceived discrimination, and dangerousness) against older adults with depression. The sample comprised of older adults registered with primary care clinics (n = 1,291) and primary health care professionals (n = 469) from São Paulo and Manaus, Brazil. Participants read a vignette describing a 70-year-old individual (Mary or John) with a depressive disorder and answered questions measuring stigma.

Differential characteristics of young and midlife adult users of psychotherapy, psychotropic medications, or both: information from a population representative sample in São Paulo, Brazil.

Objective: While the personal characteristics of users of psychotherapy and/or psychotropic medications have been examined, direct user comparison of these treatment approaches appears to be rare. Our aim is to ascertain extent of receipt of these services, and identify basic distinguishing characteristics of users.

Methods: Information on demographics, lifetime and past 12 month use of mental health services, and presence of common mental disorders (CMD), was gathered in 2002 using a multi-stage sampling procedure that yielded a population-representative, community-resident sample (N = 2000, age 18-65) for São Paulo, Brazil.

The Affordable Medicines Facility-malaria (AMFm): are remote areas benefiting from the intervention?

Background: To assess the availability, price and market share of quality-assured artemisinin-based combination therapy (QAACT) in remote areas (RAs) compared with non-remote areas (nRAs) in Kenya and Ghana at end-line of the Affordable Medicines Facility-malaria (AMFm) intervention.

Methods: Areas were classified by remoteness using a composite index computed from estimated travel times to three levels of service centres. The index was used to five categories of remoteness, which were then grouped into two categories of remote and non-remote areas.

The Relationship of Built Environment to Health-Related Behaviors and Health Outcomes in Elderly Community Residents in a Middle Income Country.

Background: Few studies have examined the impact of the built environment (BE) on health behaviours and health outcomes in middle income countries. This study examines associations between self-assessed characteristics of the home and neighbourhood environment and health-related behaviours and health outcomes in an elderly population in Brazil.

Design And Methods: In a community sample of 6963 community dwellers 60 years old and older living in the state of Rio Grande do Sul, Brazil, associations between self-reported BE conditions and health behaviours and health outcomes were assessed using a structured questionnaire.

Prevalence and correlates of physical inactivity among older adults in Rio Grande do Sul, Brazil.

Background: Current information on the epidemiology of physical inactivity among older adults is lacking, making it difficult to target the inactive and to plan for interventions to ameliorate adverse effects.

Objectives: To present statewide representative findings on the prevalence of physical inactivity among older community residents, its correlates and associated health service use.

Methods: A representative non-institutionalized random sample of 6963 individuals in Rio Grande do Sul, Brazil, aged ≥60 years, was interviewed face-to-face.

Use of psychotherapy in a representative adult community sample in São Paulo, Brazil.

Little is known about the use of psychotherapy to treat common mental disorders in a major city in a middle-income country. Our data come from in-home interviews with a stratified random sample of 2000 community residents aged 18 to 65 years in the city of São Paulo, Brazil. The information obtained included sociodemographic characteristics; psychotropic drugs; mental status; and lifetime, previous 12 months, and current use of psychotherapy.

Prison is not the right place for people with mental disorders: the Brazilian case.

The large number of individuals with severe mental disorders in prisons worldwide has alarming implications, which leads to the question of the appropriateness of the prison system for people with this type of morbidity. This article discusses these implications, the problems in therapeutic approaches and the legal aspects in the Brazilian context.