Objective:  To determine the prevalence of depression in a community with 15 000 inhabitants in Brazil (Bambuí). Method:  The Composite International Diagnostic Interview was applied in a random sample of 1041 residents aged 18+ years. Results:  The ICD‐10 1‐month, 1‐year and lifetime prevalences of depression were 8.2% (95% CI:6.5–9.8), 10.0% (95% CI:8.2–11.8) and 15.6% (95% CI:13.4–17.8), respectively. Kappa coefficients comparing ICD‐10 and DSM‐III‐R diagnoses were high (0.73–0.79). Female sex (OR=2.4; 95% CI:1.3–4.2), age 45–59 years (OR=3.5; 95% CI:1.7–7.2) and 60 years (OR=4.0; 95% CI:1.9–8.5) and being out of work (OR=2.1; 95% CI:1.2–3.6) were independently and positively associated with 1‐month depression. Conclusion:  The 1‐month prevalence of depression was higher than that observed in similar studies in developed and developing countries. Depression may be a major unidentified disease of people living in small communities of Brazil and other developing countries, especially among older women.

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The psychological symptoms of anxiety were encountered in 57 (55.8%) participants with IBS, among which, male were 15.7% and female 84.2% respectively. Conclusion The medical students of Karachi who suffered more mental stress and anxiety resulted in a high level IBS as compared with previous study reports. There were significantly more women with IBS than men. As a consequence, key health messages and interventions to reduce stress and anxiety among students may help in curtailing the burden of this disease. Results Based on OGTT and HbA1c, 15% and 28% people had T2DM. Area under ROC curve (AUROC) was 0,727 (95% CI 0.490 to 0.964, p¼0.080, sensitivity 66.7%, specificity 78.8%) using HbA1c cut-off >6.5%. Best predictive HbA1c in this cohort was 6.3% (AUROC 0.750, p¼0.054, sensitivity 83%, specificity 67%). 33.0% of undiagnosed T2DM had HbA1c levels <6.5% (95% CI 0% to 71%) and 17% (95% Cl 0% to 45%) of people with T2DM had HbA1c levels <6.3%. Subjects with false negative HbA1c were predominantly with normal BMI (21.8+1.6 vs 42.9+7.8, p¼0.025), false positives were predominantly with higher BMI (30.6+7.8 vs 28.4+ 5.9, p¼0.273). In normal weight (BMI 18e25) individuals optimal HbA1c cut-point for detecting T2DM was >6.0% (AUROC 0.750, sensitivity 50%, specificity 100%). RR of T2DM was 7 (1.18e42.9) with HbA1c values 6.0e6.4%, than those with <6.0 in normal weight individuals. Conclusion Choosing the HbA1c strategy rather than the OGTT strategy leads to diagnose more diabetes, although the consistency of both diagnostic criteria is low. The optimal HbA1c cut-point to detect T2DM was lower than HbA1c of 6.5% in normal weight individuals. Since the first UN Conference on Human Environment held in Stockholm in 1972, up to COP16 numerous international conferences have been organised by UNEP, WMO, IPCC, AsDB/AfDB, UNDP, World Bank and of course UNFCCC. All of these prescribed economic development as the gateway to adaptation to and mitigation of emission of green house gases and global warming. Attention has been given to agriculture, fishery, topography, geography, land quality, tourism, livelihood, water resources management, waste management, forestry, environmental sanitation, public education, training, human resource development etc.; while health or disease were mentioned barely and episodically, to be forgotten in between. That health is the centre piece of development has not dawned upon. The drafters of resolutions and conference records, seems, never included any public health expert or epidemiologist. This has prompted Africa, South Asia, South East Asia, the Far East and the Pacific rim countries to request UNFCCC to accord due importance to health as a key element of adaptation to climate change. Based on a study of the relevant documents on climate change (referred to in the main paper), which evidently side tracked health as an issue of sufficient importance, we suggest that: (1) a monograph be produced by the UNFCCC on the remits and ranges of the impacts of climate change on health and disease; (2) due...

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