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We assessed the concentrations of microplastics in sediment samples collected in seven sites from Solimoes, Negro and Amazon rivers, upstream and downstream the metropolitan region of Manaus. Concentrations ranged from 417 to 8178 particles/kg of dried sediment (microplastics: 0.063–5 mm), and from 0 to 5725 particles/kg of dried sediment (microplastics: 0.063–1 mm). The highest microplastics concentrations were observed in samples from shallow water (water depth of 5–7 m) sites with lower water velocity of the Negro river surrounding Manaus, and the lowest concentration in farthest sample collected in deeper zone (water depth of 34 m) of the Amazon river around 110 km downstream Manaus. The variation of microplastics concentrations within the studied area can be related to hydraulic characteristics defining the erosive-depositional behavior of the sampling sites and their proximity to Manaus. Our results represent the first report to show the ubiquitous presence and widespread distribution of microplastics in sediments from the lower Solimoes, lower Negro and upper Amazon rivers.

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) INTRODUÇÃO: O principal objetivo desse estudo foi revisar a agenda de prioridades em pesquisa em saúde mental no Brasil. MÉTODO: Foram selecionados 28 especialistas (22 pesquisadores, cinco legisladores e o coordenador) de diferentes regiões. Responderam ao que consideravam mais relevante em pesquisa para a saúde mental para os próximos 10 anos. Dezessete responderam e configuraram 110 questões, que foram reavaliadas por eles, com atribuição de escore, a partir de 15 itens distribuídos segundo grau de responsividade, eficácia, aplicabilidade, equidade e impacto na redução da carga da doença mental. 35 questões, e dentre elas as 10 mais bem pontuadas, foram destacadas. RESULTADOS: Prevaleceram indicações para estudos de efetividade das intervenções, matriciamento, comparação entre modelos de intervenção e detecção e tratamento de transtornos mais prevalentes na Estratégia da Saúde da Família. Avaliação de serviços quanto às barreiras ao tratamento; custo-efetividade dos antipsicóticos, intervenções contra efeitos do álcool e outras drogas, e aplicação de tecnologias (telemedicina) para educação e supervisão dos generalistas foram outros. CONCLUSÃO: Apontou-se para necessidade de investimentos na saúde mental na atenção primária à saúde; avaliação do sistema de serviços de cuidados de saúde mental, e pesquisas para romper barreiras ao acesso e à equidade no tratamento dos transtornos mentais. BACKGROUND: The main aim of this study is to review the agenda for research priorities of mental health in Brazil. METHODOLOGY: The first step was to gather 28 experts (22 researchers, five policy makers, and the coordinator) representing all mental health fields from different geographical areas of the country. Participants were asked to list what they considered to be the most relevant mental health research questions for the country to address in the next 10 years. Seventeen participants answered this question; after redundancies were excluded, a total of 110 responses were collected. As the second step, participants were asked to rank which questions were the 35 most significant. The final step was to score 15 items for each of the 35 selected questions to determine whether it would be a) answerable, b) effective, c) deliverable, d) equitable, and e) effective at reducing the burden of mental health. The ten highest ranked questions were then selected. RESULTS: There were four questions addressing primary care with respect to a) the effectiveness of interventions, b) matrix support, c) comparisons of different models of stepped care, and d) interventions to enhance identification and treatment of common mental disorders at the Family Health Program. The other questions were related to the evaluation of mental health services for adults and children/adolescents to clarify barriers to treatment in primary care, drug addiction, and severe mental disorders; to investigate the cost-benefit relationship of anti-psychotics; to design interventions to decrease alcohol consumption; and to apply new technologies (telemedicine) for education and supervision of non-specialists. CONCLUSION: This priority-setting research exercise highlighted a need for implementing investments at the primary-care level, particularly in the family health program; the urgent need to evaluate services; and policies to improve equity by increasing accessibility to services and testing interventions to reduce barriers for seeking mental health treatment. Universidade Federal de São Paulo (UNIFESP) Department of Psychiatry Stellenbosch University Department of Psychology University of Cape Town Department of Psychiatry and Mental Health Universidade Federal do Rio Grande do Sul Hospital de Clínicas de Porto Alegre Department of Psychiatry University of London Institute of Psychiatry, King's College Health Services and Population Research Department UNIFESP, Department of Psychiatry SciELO