An��lisis de los programas de la agencia espa��ola de cooperaci��n internacional para el desarrollo dirigidos a las mujeres en la lucha contra el vih/sida en mozambique (2005-2010)

En este estudio de caso pretende dar respuesta a que factores vitalizan la cooperaci��n Espa��ola en Mozambique a trav��s del an��lisis de programas como el VITA, dirigidos espec��ficamente al desarrollo y mejoramiento de la salud en el continente Africano. Este estudio de caso se centra en el investigaci��n de los discursos de desarrollo que se fundamentan en las pol��ticas internacionales de cooperaci��n , basadas en la existencia de una enfermedad como el VIH que ha puesto en manifiesto la interacci��n entre la esfera biol��gica y social , social e individual entre el fen��meno existencial y cultural, lo que fundamenta su importancia y estudio. Se ha escogido esta herramienta de investigaci��n social, en este estudio de caso, para abordar la forma en que funciona y opera la AECID en Mozambique a trav��s de los programas con enfoque de g��nero encaminados al problema del VIH. Se pretende dar a conocer el desarrollo en materia de la cooperaci��n internacional de una organizaci��n tan importante como la AECID, cuyos proyectos gozan de una gran credibilidad en cuanto a la ejecuci��n de sus acciones y que en general dichos proyectos se adecuan a las necesidades de la poblaci��n, a los objetivos de desarrollo nacionales y a las prioridades de la cooperaci��n espa��ola.

What are the priorities for prevention and control of non-communicable diseases and injuries in sub-Saharan Africa and South East Asia?

Last year���s UN high level meeting sought to galvanise the international community into scaling up its response to the escalating global burden of non-communicable diseases. With resources tight, D Chisholm and colleagues examine which interventions should be given priority for action and investment

Development of designed site-directed pseudopeptide-peptido-mimetic immunogens as novel minimal subunit-vaccine candidates for malaria

Synthetic vaccines constitute the most promising tools for controlling and preventing infectious diseases. When synthetic immunogens are designed from the pathogen native sequences, these are normally poorly immunogenic and do not induce protection, as demonstrated in our research. After attempting many synthetic strategies for improving the immunogenicity properties of these sequences, the approach consisting of identifying high binding motifs present in those, and then performing specific changes on amino-acids belonging to such motifs, has proven to be a workable strategy. In addition, other strategies consisting of chemically introducing non-natural constraints to the backbone topology of the molecule and modifying the a-carbon asymmetry are becoming valuable tools to be considered in this pursuit. Non-natural structural constraints to the peptide backbone can be achieved by introducing peptide bond isosters such as reduced amides, partially retro or retro-inverso modifications or even including urea motifs. The second can be obtained by strategically replacing L-amino-acids with their enantiomeric forms for obtaining both structurally site-directed designed immunogens as potential vaccine candidates and their Ig structural molecular images, both having immunotherapeutic effects for preventing and controlling malaria.

3D Analysis of the TCR/pMHCII Complex Formation in Monkeys Vaccinated with the First Peptide Inducing Sterilizing Immunity against Human Malaria

T-cell receptor gene rearrangements were studied in Aotus monkeys developing high antibody titers and sterilizing immunity against the Plasmodium falciparum malaria parasite upon vaccination with the modified synthetic peptide 24112, which was identified in the Merozoite Surface Protein 2 (MSP-2) and is known to bind to HLA-DR beta 1*0403 molecules with high capacity. Spectratyping analysis showed a preferential usage of V beta 12 and V beta 6 TCR gene families in 67% of HLA-DR beta 1*0403-like genotyped monkeys. Docking of peptide 24112 into the HLA-DR beta 1*0401-HA peptide-HA1.7TCR complex containing the VDJ rearrangements identified in fully protected monkeys showed a different structural signature compared to nonprotected monkeys. These striking results show the exquisite specificity of the TCR/pMHCII complex formation needed for inducing sterilizing immunity and provide important hints for a logical and rational methodology to develop multiepitopic, minimal subunit-based synthetic vaccines against infectious diseases, among them malaria.

Using the PfEMP1 Head Structure Binding Motif to Deal a Blow at Severe Malaria

Plasmodium falciparum (Pf) malaria causes 200 million cases worldwide, 8 million being severe and complicated leading to similar to 1 million deaths and similar to 100,000 abortions annually. Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) has been implicated in cytoadherence and infected erythrocyte rosette formation, associated with cerebral malaria; chondroitin sulphate-A attachment and infected erythrocyte sequestration related to pregnancy-associated malaria and other severe forms of disease. An endothelial cell high activity binding peptide is described in several of this similar to 300 kDa hypervariable protein's domains displaying a conserved motif (GACxPxRRxxLC); it established H-bonds with other binding peptides to mediate red blood cell group A and chondroitin sulphate attachment. This motif (when properly modified) induced PfEMP1-specific strain-transcending, fully-protective immunity for the first time in experimental challenge in Aotus monkeys, opening the way forward for a long sought-after vaccine against severe malaria.

Land Restitution and Prevention of Forced Displacement in Colombia

The armed conflict in Colombia, which has generated over three million internally displaced persons, has dramatic humanitarian consequences and raises serious issues regarding the protection of displaced peoples��� rights. The underlying reasons for the displacement often lie in the dynamics associated with territorial control and land seizures undertaken for strategic, military or purely economic purposes. Domestic and international legal provisions have established the victims��� right to the restitution of their homes and property as the ���preferred remedy��� in cases of displacement. However, policies dealing with displacement, both those of the Colombian government and of several international institutions, fail to take this sufficiently into account. A comprehensive reparation policy for victims must necessarily entail the reversion of lands, territories and goods seized in Colombia under the pretext of the internal armed conflict.

Primary Prevention and Screening Strategies for Colorectal Cancer: Which Strategy Should Take?

Objective: To explore and define the utility of different strategies for primary prevention (ASA, diet, physical activity) and strategies of screening test (FOBT, sigmoidoscopy, colonoscopy, etc.) for colorectal cancer. Data source: Databases consulted were MEDLINE (1966 to 2006), DARE (1980 to 2006), Cochrane Central Register of Controlled Trials, Cochrane Collaboration���s Registry of Clinical Trials, Cochrane Database of Systematic Reviews and LILACS. Study selection: Studies such clinical trial, cohort and case-control studies of the effectiveness of tests for screening and primary prevention adenoma and colorectal cancer were identified by two reviewers. Data Extraction: The extraction of data and its evaluation is done in most of the process so paired. Limitations: Not strictly complies with the methodology of a systematic review and therefore reproducibility is questionable, the conclusions of this study should be extrapolated with caution. Conclusions: The major strategy of screening on the effectiveness of early detection of premalignant lesions or cancer is colonoscopy every 5 years, however it is necessary to evaluate this measure cost-effectiveness studies. For primary prevention, aspirin and cyclooxygenase-2 inhibitors reduce the incidence of colorectal adenomas. Aspirin can reduce colorectal cancer incidence. However, these medications may be associated with a significant risk of cardiovascular events and gastrointestinal bleeding. The balance between risks and benefits must be evaluated in future studies.

Interdisciplinary Pedagogical Experience for Health Human Resources Focused on the Holistic Promotion of Health and the Prevention of the Disease

The object of this experience is to offer the students the opportunity to take part in the construction of a pedagogic strategy centred on the ludic, for the promotion of the integral health and the prevention of the disease with an educational community; directed to supporting and qualifying the well-being so much individually as group. The project is designed to five years, about interdisciplinary character (Speech Therapy, Medicine, Psychology, Nursery, Occupational Therapy), interinstitutional (Universidad del Rosario, Universidad de San Buenaventura y Universidad de Cundinamarca) and intersectorial (Education and Health). It considers the different actors of the educational community and school and the home as propitious scenes for the strengthening potential, beside being the fundamental spaces for the construction of knowledges and learnings concerning the integral health. To achieve the target, one has come constructing from the second semester of 2003, one pedagogic strategy centred on the ludic and the creativity, from which they are planned, they develop and evaluate the actions of promotion of skills, values, behaviors and attitudes in the care of the health and the prevention of disease, orientated to the early, opportune and effective detection of risk factors and problematic of the development that they affect the integral health. The above mentioned strategy raises a so called scene Bienestar��polis: A healthy world for conquering, centred on prominent figures, spaces and elements that alternate between the fantasy and the reality to facilitate the approximation, the interiorizaci��n and the appropriation of the integral health. Across this one, the children motivated by the adults enter an imaginary world in that theirs desires, knowledges and attitudes are the axis of his development. Since Vigotsky raises it, in the game the child realizes actions in order to adapt to the world that surrounds it acquiring skills for the learning. The actions of the project have involved 410 children and 25 teachers, of the degrees Zero, The First and The Second of basic primary; 90 parents of family, and an average of 40 students and 8 teachers of the already mentioned disciplines.

Condiciones de trabajo y morbilidad percibidas entre mineros de carb��n en Guachet��, Colombia

Introducci��n: En Colombia la investigaci��n sobre condiciones de trabajo y salud en miner��a carbon��fera es escasa y no considera la percepci��n de la poblaci��n expuesta y sus comportamientos frente a los riesgos inherentes. Objetivo: Determinar la asociaci��n entre las condiciones de trabajo y morbilidad percibidas entre trabajadores de minas de carb��n en Guachet��, Cundinamarca. Materiales y m��todos: Se realiz�� un estudio transversal con 154 trabajadores seleccionados aleatoriamente del total registrado en la alcald��a municipal. Se indag�� sobre caracter��sticas sociodemogr��ficas, condiciones de trabajo y salud en las minas. Se estimaron prevalencias de los trastornos respiratorios, osteomusculares y auditivos, y se exploraron las asociaciones entre algunas condiciones de trabajo y los eventos con prevalencia superior a 30% de forma bivariada y m��ltiple, con regresiones Poisson con varianza robusta. Resultados: Los trabajadores fueron en su mayor��a hombres, con edades entre 18 y 77 a��os de edad. Los problemas de salud m��s frecuentemente reportados fueron dolor lumbar (46,10%), dolor del miembro superior (40,26%), dolor del miembro inferior (34,42%), trastornos respiratorios (17,53%) y problemas auditivos (13,64%). Existen diferencias importantes en la percepci��n dependiendo de la antig��edad laboral y las condiciones subterr��neas o no del trabajo. Conclusi��n: Los riesgos m��s reconocidos por los trabajadores son los relacionados con trastornos osteomusculares, al parecer por ser m��s evidentes en su cotidianidad. Las acciones en salud ocupacional podr��n considerar estos hallazgos en sus planes de prevenci��n de la enfermedad en las minas del carb��n colombianas.

B��squeda de selecci��n en el polimorfismo 677C>T (c.665C>T) del gen de la metilentetrahidrofolato reductasa (MTHFR) en una poblaci��n Colombiana

Se realiz�� un estudio gen��tico ��� poblacional en dos grupos etarios de poblaci��n colombiana con la finalidad de evaluar las diferencias gen��ticas relacionadas con el polimorfismo MTHFR 677C���T en busca de eventos gen��ticos que soporten la persistencia de este polimorfismo en la especie humana debido que este ha sido asociado con m��ltiples enfermedades. De esta manera se genotipificaron los individuos, se analizaron los genotipos, frecuencias al��licas y se realizaron diferentes pruebas gen��ticas-poblacionales. Contrario a lo observado en poblaciones Colombianas revisadas se identific�� la ausencia del Equilibrio Hardy-Weinberg en el grupo de los ni��os y estructuras poblacionales entre los adultos lo que sugiere diferentes historias demogr��ficas y culturales entre estos dos grupos poblacionales al tiempo, lo que soporta la hip��tesis de un evento de selecci��n sobre el polimorfismo en nuestra poblaci��n. De igual manera nuestros datos fueron analizados junto con estudios previos a nivel nacional y mundial lo cual sustenta que el posible evento selectivo es debido a que el aporte de ��cido f��lico se ha incrementado durante las ��ltimas dos d��cadas como consecuencia de las campa��as de fortificaci��n de las harinas y suplementaci��n a las embarazadas con ��cido f��lico, por lo tanto aqu�� se propone un modelo de selecci��n que se ajusta a los datos encontrados en este trabajo se establece una relaci��n entre los patrones nutricionales de la especie humana a trav��s de la historia que explica las diferencias en frecuencias de este polimorfismo a nivel espacial y temporal. ���

Genetic testing with primary prevention and moral hazard

We develop a model where a free genetic test reveals whether the individual tested has a low or high probability of developing a disease. A costly prevention effort allows high-risk agents to decrease the probability of developing the disease. Agents are not obliged to take the test, but must disclose its results to insurers. Insurers offer separating contracts which take into account the individual risk, so that taking the test is associated to a discrimination risk. We study the individual decisions to take the test and to undertake the prevention effort as a function of the effort cost and of its e�� ciency. We obtain that, if effort is observable by insurers, agents undertake the test only if the effort cost is neither too large nor too low. If the effort cost is not observable by insurers, they face a moral hazard problem which induces them to under-provide insurance. We obtain the counterintuitive result that moral hazard increases the value of the test if the effort cost is low enough. Also, agents may perform the test for lower levels of prevention e�� ciency when effort is not observable