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Potential Transformation of Contaminated Areas into Public Parks: Evidence from Sao Paulo, Brazil.

ABSTRACT: Waste-contaminated areas have been reused and requalified environmentally across the globe, aiming to reintegrate them into urban dynamics with new functions such as public parks. This practice has attracted the attention of public health and environmental control agencies due to the scarcity of free areas and vacant spaces for creation of green areas, and d the need for more sustainable planning guidelines in large cities. The present work aimed to study processes of requalification of waste-contaminated areas for transformation in parks, using as study two cases located in the city of São Paulo, Brazil. Method: Documentary research in environmental agencies, literature review and field visit. Results: In the two cases the process of requalification was unequal, with emphasis on three aspects: the actors involved in the case, the role of civil society and the action of the Public Prosecutor's Office of the State of São Paulo. Thus, it becomes evident that successful cases of waste-contaminated areas in the city of São Paulo are linked to the direct support of these aspects complemented with the private sector. Furthermore, a consensus is necessary among the public authorities regarding the laws of contaminated areas versus environmental damage full repair in the process of requalification.

SUBMITTER: Dos Santos CV

PROVIDER: S-EPMC9564805 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Potential Transformation of Contaminated Areas into Public Parks: Evidence from São Paulo, Brazil.

Dos Santos Camila Vitorino CV Ribeiro Helena H

International journal of environmental research and public health 20220921 19

Waste-contaminated areas have been reused and requalified environmentally across the globe, aiming to reintegrate them into urban dynamics with new functions such as public parks. This practice has attracted the attention of public health and environmental control agencies due to the scarcity of free areas and vacant spaces for creation of green areas, and d the need for more sustainable planning guidelines in large cities. The present work aimed to study processes of requalification of waste-co ...[more]

PMID: 36231230

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Project description:Guidelines for the treatment of psychoses recommend antipsychotic monotherapy. However, the rate of antipsychotic polytherapy has increased over the last decade, reaching up to 60% in some settings. Studies evaluating the costs and impact of antipsychotic polytherapy in the health system are scarce.To estimate the costs of antipsychotic polytherapy and its impact on public health costs in a sample of subjects with psychotic disorders living in residential facilities in the city of Sao Paulo, Brazil.A cross-sectional study that used a bottom-up approach for collecting costs data in a public health provider's perspective. Subjects with psychosis living in 20 fully-staffed residential facilities in the city of Sao Paulo were assessed for clinical and psychosocial profile, severity of symptoms, quality of life, use of health services and pharmacological treatment. The impact of polytherapy on total direct costs was evaluated.147 subjects were included, 134 used antipsychotics regularly and 38% were in use of antipsychotic polytherapy. There were no significant differences in clinical and psychosocial characteristics between polytherapy and monotherapy groups. Four variables explained 30% of direct costs: the number of antipsychotics, location of the residential facility, time living in the facility and use of olanzapine. The costs of antipsychotics corresponded to 94.4% of the total psychotropic costs and to 49.5% of all health services use when excluding accommodation costs. Olanzapine costs corresponded to 51% of all psychotropic costs.Antipsychotic polytherapy is a huge economic burden to public health service, despite the lack of evidence supporting this practice. Great variations on antipsychotic costs explicit the need of establishing protocols for rational antipsychotic prescriptions and consequently optimising resource allocation. Cost-effectiveness studies are necessary to estimate the best value for money among antipsychotics, especially in low and middle income countries.

Project description:To estimate the prevalence of one month psychotropic drug use in São Paulo, Brazil, and to assess the gap treatment between the presence of mental disorders and psychotropic drug users.A probabilistic sample of non-institutionalized individuals from the general population of São Paulo (n = 2336; turnout: 84.5%) who were 15 years or older were interviewed by a trained research staff, applying the Composite International Diagnostic Interview 2.1 (CIDI WHO) (depression, anxiety-phobia, OCD\PTSD, alcoholism sections), and an inventory investigating psychotropic drug use during the 12-month and one-month periods immediately preceding the interview. Logistic models were fitted to investigate associations between psychotropic drug use as well as socio-demographic and clinical variables.The one month prevalence of psychotropic drug use in São Paulo was 5.89%, the most commonly used drugs were antidepressants (3.15%) and tranquilizers (2.67%). A higher consumption of psychotropic drugs (overall, antidepressants and tranquilizers) was observed among women (OR:2.42), older individuals (OR:1.04), individuals with higher levels of formal education (1.06), and individuals with a family (OR:2.29) or personal history of mental illness (OR:3.27). The main psychotropic drug prescribers were psychiatrists (41%), followed by general practitioners (30%); 60% of psychotropic drugs were obtained through a government-run dispensing program. Most individuals who obtained a positive diagnosis on the CIDI 2.1 during the previous month were not using psychotropic medication (85%). Among individuals with a diagnosis of moderate to severe depression, 67.5% were not on any pharmacological treatment.There is a change in the type of psychotropic more often used in São Paulo, from benzodiazepines to antidepressants, this event is observed in different cultures. The prevalence of use is similar to other developing countries. Most of the patients presenting a psychiatric illness in the month prior to testing were not receiving any sort of psychiatric medication. This may be explained by a failure to identify cases in primary care, which could be improved (and access to treatment could be facilitated) if professionals received more specialized training in managing cases with mental health problems.

Dataset Information

Potential Transformation of Contaminated Areas into Public Parks: Evidence from Sao Paulo, Brazil.

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Potential Transformation of Contaminated Areas into Public Parks: Evidence from São Paulo, Brazil.

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