University of São Paulo

About: University of São Paulo is a education organization based out in São Paulo, Brazil. It is known for research contribution in the topics: Population & Health care. The organization has 136513 authors who have published 272320 publications receiving 5127869 citations. The organization is also known as: USP & Universidade de São Paulo.

Haemodynamic definitions and updated clinical classification of pulmonary hypertension.

Abstract: Since the 1st World Symposium on Pulmonary Hypertension (WSPH) in 1973, pulmonary hypertension (PH) has been arbitrarily defined as mean pulmonary arterial pressure (mPAP) ≥25 mmHg at rest, measured by right heart catheterisation. Recent data from normal subjects has shown that normal mPAP was 14.0±3.3 mmHg. Two standard deviations above this mean value would suggest mPAP >20 mmHg as above the upper limit of normal (above the 97.5th percentile). This definition is no longer arbitrary, but based on a scientific approach. However, this abnormal elevation of mPAP is not sufficient to define pulmonary vascular disease as it can be due to an increase in cardiac output or pulmonary arterial wedge pressure. Thus, this 6th WSPH Task Force proposes to include pulmonary vascular resistance ≥3 Wood Units in the definition of all forms of pre-capillary PH associated with mPAP >20 mmHg. Prospective trials are required to determine whether this PH population might benefit from specific management. Regarding clinical classification, the main Task Force changes were the inclusion in group 1 of a subgroup “pulmonary arterial hypertension (PAH) long-term responders to calcium channel blockers”, due to the specific prognostic and management of these patients, and a subgroup “PAH with overt features of venous/capillaries (pulmonary veno-occlusive disease/pulmonary capillary haemangiomatosis) involvement”, due to evidence suggesting a continuum between arterial, capillary and vein involvement in PAH.

Beta Regression for Modelling Rates and Proportions

Abstract: This paper proposes a regression model where the response is beta distributed using a parameterization of the beta law that is indexed by mean and dispersion parameters. The proposed model is useful for situations where the variable of interest is continuous and restricted to the interval (0, 1) and is related to other variables through a regression structure. The regression parameters of the beta regression model are interpretable in terms of the mean of the response and, when the logit link is used, of an odds ratio, unlike the parameters of a linear regression that employs a transformed response. Estimation is performed by maximum likelihood. We provide closed-form expressions for the score function, for Fisher's information matrix and its inverse. Hypothesis testing is performed using approximations obtained from the asymptotic normality of the maximum likelihood estimator. Some diagnostic measures are introduced. Finally, practical applications that employ real data are presented and discussed.

Annual Research Review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents

Abstract: Background The literature on the prevalence of mental disorders affecting children and adolescents has expanded significantly over the last three decades around the world. Despite the field having matured significantly, there has been no meta-analysis to calculate a worldwide-pooled prevalence and to empirically assess the sources of heterogeneity of estimates. Methods We conducted a systematic review of the literature searching in PubMed, PsycINFO, and EMBASE for prevalence studies of mental disorders investigating probabilistic community samples of children and adolescents with standardized assessments methods that derive diagnoses according to the DSM or ICD. Meta-analytical techniques were used to estimate the prevalence rates of any mental disorder and individual diagnostic groups. A meta-regression analysis was performed to estimate the effect of population and sample characteristics, study methods, assessment procedures, and case definition in determining the heterogeneity of estimates. Results We included 41 studies conducted in 27 countries from every world region. The worldwide-pooled prevalence of mental disorders was 13.4% (CI 95% 11.3–15.9). The worldwide prevalence of any anxiety disorder was 6.5% (CI 95% 4.7–9.1), any depressive disorder was 2.6% (CI 95% 1.7–3.9), attention-deficit hyperactivity disorder was 3.4% (CI 95% 2.6–4.5), and any disruptive disorder was 5.7% (CI 95% 4.0–8.1). Significant heterogeneity was detected for all pooled estimates. The multivariate metaregression analyses indicated that sample representativeness, sample frame, and diagnostic interview were significant moderators of prevalence estimates. Estimates did not vary as a function of geographic location of studies and year of data collection. The multivariate model explained 88.89% of prevalence heterogeneity, but residual heterogeneity was still significant. Additional meta-analysis detected significant pooled difference in prevalence rates according to requirement of funcional impairment for the diagnosis of mental disorders. Conclusions Our findings suggest that mental disorders affect a significant number of children and adolescents worldwide. The pooled prevalence estimates and the identification of sources of heterogeneity have important implications to service, training, and research planning around the world.

The culture of control: crime and social order in contemporary, society

Abstract: Nos últimos trinta trinta anos, houve profundas mudanças na forma como compreendemos o crime e a justiça criminal. O crime tornou-se um evento simbólico, um verdadeiro teste para a ordem social e para as políticas governamentais, um desafio para a sociedade civil, para a democracia e para os direitos humanos. Segundo David Garland, professor da Faculdade de Direito da New York University, um dos principais autores no campo da Sociologia da Punição e com artigo publicado na Revista de Sociologia e Política , número 13, na modernidade tardia houve uma verdadeira obsessão securitária, direcionando as políticas criminais para um maior rigor em relação às penas e maior intolerância com o criminoso. Há trinta anos, nos EUA e na Inglaterra essa tendência era insuspeita. O livro mostra que os dois países compartilham intrigantes similaridades em suas práticas criminais, a despeito da divisão racial, das desigualdades econômicas e da letalidade violenta que marcam fortemente o cenário americano. Segundo David Garland, encontram-se nos dois países os “mesmos tipos de riscos e inseguranças, a mesma percepção a respeito dos problemas de um controle social não-efetivo, as mesmas críticas da justiça criminal tradicional, e as mesmas ansiedades recorrentes sobre mudança e ordem sociais”1 (GARLAND, 2001, p. 2). O argumento principal da obra é o seguinte: a modernidade tardia, esse distintivo padrão de relações sociais, econômicas e culturais, trouxe consigo um conjunto de riscos, inseguranças e problemas de controle social que deram uma configuração específica às nossas respostas ao crime, ao garantir os altos custos das políticas criminais, o grau máximo de duração das penas e a excessivas taxas de encarceramento.