A fundamental understanding of the nanoscale details of the environment is essential for designing biomaterials that mimic the natural cellular milieu. Many features of the local environment have profound influences on cell adhesion, proliferation, maturation, and differentiation. As such, small differences in nanostructure can have macroscale impacts on tissue function. In this review, we highlight the importance of nanostructure of cellulose-based biomaterials to allow cellular adhesion, the contribution of nanostructure to macroscale mechanical properties, and several key applications of these materials for fundamental scientific research and biomedical engineering. Cellulose is a diverse material with tunable properties and can be applied to systems with vastly different biochemical and biophysical environments. Cellulose-based biomaterials offer some important advantages over conventional synthetic materials and show great promise to advance the frontier of scientific knowledge. Here we provide an up-to-date summary of the status of the field of cellulose-based biomaterials in the context of bottom-up approaches for tissue engineering. We anticipate that cellulose-based material research will continue to expand because of the diversity and versatility of biochemical and biophysical characteristics highlighted in this review.

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Cellulose Biomaterials for Tissue Engineering.

Intermittent outbreaks of infectious diseases have had profound and lasting effects on societies throughout history. Those events have powerfully shaped the economic, political, and social aspects of human civilization, with their effects often lasting for centuries. Epidemic outbreaks have defined some of the basic tenets of modern medicine, pushing the scientific community to develop principles of epidemiology, prevention, immunization, and antimicrobial treatments. This chapter outlines some of the most notable outbreaks that took place in human history and are relevant for a better understanding of the rest of the material. Starting with religious texts, which heavily reference plagues, this chapter establishes the fundamentals for our understanding of the scope, social, medical, and psychological impact that some pandemics effected on civilization, including the Black Death (a plague outbreak from the fourteenth century), the Spanish Flu of 1918, and the more recent outbreaks in the twenty-first century, including SARS, Ebola, and Zika.

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Brief History of Pandemics (Pandemics Throughout History)

The prevalence of common mental disorders has increased in many countries. Cases are often not identified and adequately treated because traditional health care services are rarely prepared to deal with this problem. The Family Health Program (FHP) has been implemented in Brazil since 1995-1996 and provides a new primary health care model with the potential for better care for these patients. This study investigates common mental disorders prevalence according to FHP coverage and associated socio-demographic factors. A large health and health care survey was conducted from January to March 2001 in areas partly covered by the FHP in a peripheral area of the city of Sao Paulo and included common mental disorders screening in 2,337 individuals > 15 years of age. There was no significant difference in common mental disorders prevalence according to FHP. Common mental disorders prevalence was significantly higher among females (PR = 1.34), elderly (PR = 1.56), and individuals with lower income (PR = 2.64) or less schooling (PR = 2.83). Common mental disorders was associated with indicators of social disadvantage, implying the need to focus on specific health problems and risk groups to improve the impact of care.

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Prevalência de transtornos mentais comuns em populações atendidas pelo Programa Saúde da Família (QUALIS) no Município de São Paulo, Brasil

A cross-sectional study with all the teachers in the municipal school system in Vitoria da Conquista, Bahia State, Brazil, investigated the association between work content (psychological demand and control over work) and the occurrence of minor psychiatric disorders (MPD) among teachers. The Karasek demand-control model was used to evaluate control over work. The Self-Report Questionnaire-20 was used to evaluate minor psychiatric disorders. MPD prevalence was 55.9% among the 808 teachers studied. Crude prevalence of MPD showed a positive and significant association with psychological demand and a negative and significant association with control over work. MPD prevalence was higher in teachers with highly demanding work, characterized by heavy demand and low control (PR = 1.74; 95%CI: 1.44-2.10), and in those with active work, with heavy demand and low control (PR = 1.35; 95%CI: 1.13-1.61), as compared to teachers with low-demand work (light demand and high control), after adjusting for confounders in a multiple logistic regression model. As a conclusion, teachers' mental health is strongly associated with their work content.

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Trabalho e distúrbios psíquicos em professores da rede municipal de Vitória da Conquista, Bahia, Brasil

The objective of this study was to determine the prevalence of common mental disorders and the association with social support in a community located in the Zona da Mata, a sugar cane plantation area in the State of Pernambuco, Brazil. A household survey was carried out and the Self-Reporting Questionnaire (SRQ-20), the Medical Outcomes Study, and socioeconomic questions were administered to all residents over 19 years of age. Total prevalence of common mental disorders was 36.0%. Multivariate logistic regression analysis showed that individuals with low social support had twice the probability of suffering from common mental disorders (OR: 2.09; 95%CI: 1.35-3.24) as compared to those with greater support, even after adjusting for age, schooling, and work force participation. The results show the importance of investments in social support networks to promote interactions between individuals and increase individuals' self-confidence and power to deal with problems.

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Common mental disorders and social support in a rural community in Zona da Mata, Pernambuco State, Brazil

OBJETIVO: Determinar a prevalencia de transtornos mentais comuns e analisar sua associacao a condicoes de vida e insercao na estrutura ocupacional. METODOS: Estudo transversal conduzido em 1993, em Olinda, PE, envolvendo 621 adultos de 15 ou mais anos em uma amostra domiciliar aleatoria, aos quais se aplicaram o Self Reporting Questionnaire (SRQ-20) e um questionario socioeconomico. Estimaram-se os odds-ratios (OR) simples e ajustados, utilizando-se regressao logistica. RESULTADOS: A prevalencia total dos transtornos mentais comuns (TMC) foi de 35%. As variaveis relativas as condicoes de vida foram ajustadas entre si e por sexo, idade e situacao conjugal. Apenas escolaridade (p<0,0001) e condicoes de moradia (p=0,02) mantiveram-se associadas aos TMC. Em relacao a estrutura ocupacional, os trabalhadores manuais informalmente inseridos no processo produtivo (OR=2,21; IC95% 1,1-4,5), e os individuos com pior situacao de renda familiar per capita (OR=2,87; IC95%1,4-5,8) apresentaram maior prevalencia de TMC. CONCLUSAO: Baixa escolaridade, baixa renda e exclusao do mercado formal de trabalho, expressoes da estrutura das classes sociais, proporcionam situacoes de estresse contribuindo para a producao dos TMC.

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Living conditions and occupational organization associated with common mental disorders

The objective of this study was to show infant mortality differentials in different areas of Recife, analyzing the relationship between living conditions and mortality risk. An ecological study design compared infant mortality coefficients in 1995 with living conditions indicators obtained from the 1991 National Demographic Census. Information on the 770 infant deaths and 27,965 live births were collected from death and birth certificates. Information on water supply, sanitation, garbage collection, literacy, schooling, income, and overcrowding were used to establish a compound indicator for living conditions, constructed through factor analysis. The neighborhoods were then ordered according to the level of living conditions and grouped in 4 clusters, through hierarchical cluster analysis. Infant, neonatal, and post-neonatal mortality coefficients were 23.94, 17.66, and 6.28, respectively, for cluster I; and 32.04, 20.24, and 11.80 for cluster IV. In general, an inverse relationship was found between infant mortality and living conditions in clusters from Recife, revealing inequalities that are disguised when coefficients are expressed as averages for the entire city.

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Living conditions and infant mortality: intra-urban differentials in Recife, Pernambuco State, Brazil

This cross-sectional study aimed to determine the profile of physical abuse against older people who underwent forensic examination at the Institute of Forensic Medicine in Recife, Pernambuco State, Brazil. The cases, with data from 1,027 forensic reports, were described according to characteristics of the incident, victim, and aggressor. Most cases of violence were produced by mechanical energy, either with blunt objects or by empty-handed attack; the most common day of the week was Sunday, most frequently in the evening, and in the victim's home; typical cases involved mild injuries on more than one part of the victim's body. The majority of the victims were men, 60 to 69 years of age, brown (mixed-race), married or living with a partner, and retirees/pensioners. The majority of the aggressors were men, known to the victim, and attacking alone. The social transcendence of violence against older people clearly calls for investment in programs to deal with the problem in order to ensure better quality of life for the elderly.

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Physical abuse of older people reported at the Institute of Forensic Medicine in Recife, Pernambuco State, Brazil

In August 2015, pediatric neurologists at public hospitals in Recife, Pernambuco State, Brazil, observed an increase in the number of disproportional microcephaly cases associated with other congenital anomalies. The fact caused social commotion and mobilization of the academic community and led the Brazilian Ministry of Health to declare a national public health emergency, followed by the declaration of a Public Health Emergency of International Concern by the World Health Organization. The hypothesis for the phenomenon was congenital Zika virus (ZIKV) infection, based on spatial-temporal correlation and the clinical-epidemiological characteristics of the two epidemics. Further evidence accumulated, and within the scope of epidemiologial reasoning fulfilled criteria that gave support to the hypothesis. The plausibility of the hypothesis is based on the neurotropism of ZIKV, demonstrated in animals, affecting neural progenitors in the developing brain, and in humans, due to neurological complications in adults following infection. Isolation of viral RNA and antigens in the amniotic fluid of infected mothers and in brains of newborns and fetuses with microcephaly further demonstrated the consistency of the hypothesis. The criterion of temporality was met by identifying adverse pregnancy outcomes in a cohort of mothers with a history of rash and positive ZIKV serology. Finally, the first case-control study demonstrated a strong association between microcephaly and congenital ZIKV infection. The knowledge built with the epidemiological paradigm was supported by the scientific community, thereby establishing the consensus for a causal relationship between ZIKV and the microcephaly epidemic.

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The microcephaly epidemic and Zika virus: building knowledge in epidemiology.

http://scielo.iec.gov.br/pdf/ess/v20n2/v20n2a10.pdf

Djalma Agripino de Melo Filho

Papers

Living conditions and occupational organization associated with common mental disorders

Living conditions and infant mortality: intra-urban differentials in Recife, Pernambuco State, Brazil

Physical abuse of older people reported at the Institute of Forensic Medicine in Recife, Pernambuco State, Brazil

The microcephaly epidemic and Zika virus: building knowledge in epidemiology.

Diferenciais intraurbanos de sífilis congênita no Recife, Pernambuco, Brasil (2004-2006)