Background Depression is a common and recurrent condition among older adults and is associated with poor quality of life and increased health care utilization and costs. The purpose of this pilot study was to assess the feasibility of delivering a psychosocial intervention targeting depression, and to develop the procedures to conduct a cluster randomized controlled trial among older adults registered with primary care clinics in poor neighbourhoods of São Paulo, Brazil. Methods We conducted a pilot study of a two-arm cluster, non-randomized controlled trial. Two primary care clinics adhering to the Family Health Strategy were allocated to either the intervention or the control arm. In the control arm, patients received enhanced usual care consisting of staff training for improved recognition and management of depression. In the intervention arm, alongside the enhanced usual care, patients received a 17-week psychosocial intervention delivered by health workers assisted with an application installed in a tablet. Results We randomly selected 579 of 2020 older adults registered in the intervention clinic to participate in the study. Among these individuals, 353 were assessed for depression and 40 (11.0%) scored at least 10 on the PHQ-9 and were therefore invited to participate. The consent rate was 33/40 (82%) with a resulting yield of 33/579 (5.7%). In the control arm, we randomly selected 320 older adults among 1482 registered in the clinic, 223 were assessed for depression and 28 (12.6%) scored 10 or above on the PHQ-9. The consent rate was 25/28 (89%), with a resulting yield of 25/320 (7.8%). Of the 33 who consented in the intervention arm, 19 (59.4%) completed all sessions. The mean PHQ-9 at follow-up (approximately 30 weeks after inclusion) were 12.3 ( SD = 3.7) and 3.8 ( SD = 3.9) in the control and intervention arms, respectively. Follow-up rates were 92 and 94% in control and intervention arms, respectively. Conclusions Identification and engagement of clinics, randomization, recruitment of individuals, measures, and baseline and follow-up assessments all proved to be feasible in primary care clinics in São Paulo, Brazil. Results support the development of a definitive cluster randomized controlled trial. Trial registration This study was retrospectively registered with Registro Brasileiro de Ensaios Clínicos (ReBEC), number RBR-5nf6wd . Registered 06 August 2018.

Three months after the first reported case of COVID-19, it was declared a pandemic and many countries implemented full or partial lockdowns to protect human lives. The net economic impacts of such policies are still unclear, but with the warm season approaching in the Northern Hemisphere, weather may play a key role in helping governments to define better recovery strategies. Using a global cross-region panel of daily data on 416 regions and 93 days, with multiple fixed effects, we explore the exogenous variations of weather variables to find that temperature reduces COVID-19 transmission up to 8.98%. These effects are stronger in cold, arid and dry climates, diminishing propagation by 12.86%, 12.08% and 10.08%, respectively. Still, it is not clear whether climatic conditions can alone stop or slow the outbreak, but they should be included in models to predict future cases of the disease.

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Business-as-usual climate-change forecasts point to sharp temperature rises and agriculture yield losses in Brazil. We study the impact of these changes on internal migration and population distribution. We employ a spatial equilibrium model in which the climate shapes workers' locational choices through the usual amenity-value channel and the novel indirect channel via agriculture wages. Our simulations reveal that migration rates are 5.9% higher, and that half million more people migrate inter regionally under future climate conditions. Furthermore, climate change will likely exacerbate the country's regional inequalities, as the most developed regions gain population and welfare while the least developed regions lose.

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