Access to continued-use medication among older adults, Brazil

OBJECTIVE To determine the prevalence and associated access factors for all continued-use prescription drugs and the ways in which they can be obtained.METHODS Data was obtained from the 2008 Household National Survey. The sample comprised 27,333 individuals above 60 years who reported that they used continued-use prescription drugs. A descriptive analysis and binary and multiple multinomial logistic regressions were performed.RESULTS 86.0% of the older adults had access to all the medication they needed, and among them, 50.7% purchased said medication. Those who obtained medication from the public health system were younger (60-64 years), did not have health insurance plans, and belonged to the lower income groups. It is remarkable that 14.0% of the subjects still had no access to any continued-use medication, and for those with more than four chronic diseases, this amount reached 22.0%. Those with a greater number of chronic diseases ran a higher risk of not having access to all the medication they needed.CONCLUSIONS There are some groups of older adults with an increased risk of not obtaining all the medication they need and of purchasing it. The results of this study are expected to contribute to guide programs and plans for access to medication in Brazil.

Financial support of graduate programs in Brazil: quo vadis?

Graduate programs provide the highest level of formal education and thus are crucial for the development of any country. However, official Brazilian data clearly show a dramatic decrease in the number and values of scholarships available to graduate programs in Brazil over the last few years, despite the importance and growth of such programs. Between 1995 and 2004, investment by the Coordenadoria de Aperfeiçoamento de Pessoal do Ensino Superior (CAPES, subordinate to the Ministry of Education and Culture) in funding scholarships, corrected for inflation in the period, actually decreased by 51%. In addition, during the period between 1994 and 2004, there was a loss of about 60% in the purchasing power of the graduate scholarships provided by CAPES and the National Council for Science and Technology (CNPq). To reverse this trend, we propose the development of sectorial funding for Brazilian graduate programs to guarantee the availability and continuity of financial support for this strategic activity.

Back pain in adults living in quilombola territories of Bahia, Northeastern Brazil

OBJECTIVE To analyze the factors associated with back pain in adults who live in quilombola territories. METHODS A population-based survey was performed on quilombola communities of Vitória da Conquista, state of Bahia, Northeastern Brazil. The sample (n = 750) was established via a raffle of residences. Semi-structured interviews were conducted to investigate sociodemographics and employment characteristics, lifestyle, and health conditions. The outcome was analyzed as a dichotomous variable (Poisson regression). RESULTS The prevalence of back pain was of 39.3%. Age ≥ 30 years and being a smoker were associated with the outcome. The employment status was not related to back pain. CONCLUSIONS The survey identified a high prevalence of back pain in adults. It is suggested to support the restructuring of the local public service in order to outline programs and access to healthy practices, assistance, diagnosis, and treatment of spine problems.

Jatobal virus antigenic characterization by ELISA and neutralization test using EIA as indicator, on tissue culture

A virus antigenic characterization methodology using an indirect method of antibody detection ELISA with virus-infected cultured cells as antigen and a micro virus neutralisation test using EIA (NT-EIA) as an aid to reading were used for antigenic characterization of Jatobal (BeAn 423380). Jatobal virus was characterized as a Bunyaviridae, Bunyavirus genus, Simbu serogroup virus. ELISA using infected cultured cells as antigen is a sensitive and reliable method for identification of viruses and has many advantages over conventional antibody capture ELISA's and other tests: it eliminates solid phase coating with virus and laborious antigen preparation; it permits screening of large numbers of virus antisera faster and more easily than by CF, HAI, or plaque reduction NT. ELISA and NT using EIA as an aid to reading can be applicable to viruses which do not produce cytopathogenic effect. Both techniques are applicable to identification of viruses which grow in mosquito cells.

O impacto do PADCT na química e engenharia química

Among all activities related to the management of science and technology in Brazil, program monitoring and evaluation is certainly one of the less developed and most needed. There are no universal methodologies that can be applied. In essence programs can be evaluated by relating their achievements to pre-established goals. A second strategy is to compare programs similar in nature, utilizing as reference common indicators. Finally programs can be evaluated by their socio-economic impact comparing investments to outcomes. All strategies mentioned require appropriate program design monitoring and expert independent evaluation. In Brazil as in many other countries including developed ones this activity is complicated by the fact that programs vary widely in their scope and goals. In Brazil program designs often do not specify clearly their purposes and output indicators, many are not monitored properly which makes evaluation difficult. Consequently science and technology programs are difficult to be compared to each other, and even evaluated on the basis of pre-established goals. In PADCT monitoring and evaluation proved to be the most challenging activities. Two lessons however were learnt. One is that the process of monitoring and evaluation has to be continuously exposed to criticism to be perfected; and the second is that the evaluation process must not be exhausted shortly after investments since translation of scientific knowledge into industrial applications may prove to be a lengthy process. In this exercise we certainly do not pretend to evaluate the QEQ subprogram but to organize some of the information produced by different sources related to this subject, including the PADCT administration. We use somewhat each strategy described: compare the outputs of the QEQ to predetermined proposed goals (particularly in PADCT II), compare the QEQ to other PADCT subprograms, and specify some outputs in terms of technological and industrial applications. Finally, we utilize this opportunity to discuss science and technology M&E in general and the complexity of developing this area in Brazil.

Avaliação dos programas de pós-graduação em química no Brasil: versão 2002

The graduate programs in Chemistry were evaluated and classified from the data collected for the period 1998-2000 by CAPES, the Minister of Education agency that is responsible for the regulation and support of this level of human resources formation. The next classification will be made in 2004, from the data of the period 2001-2003. The years in between, like the present year, are used for an evaluation without classification, from what comments are emitted to the programs to know how their data are improving or not, before the new ranking reporting. The progresses in the area of chemistry in Brazil are analysed from the confrontation of the present data with that of all previous evaluations, since 1983. The results confirm that the research and graduate formation in the area of Chemistry is continuously improving in Brazil, particularly during the last seven years.

Evaluation of the dioxin and furan formation thermodynamics in combustion processes of urban solid wastes

Specific combustion programs (Gaseq, Chemical equilibria in perfect gases, Chris Morley) are used to model dioxin and formation in the incineration processes of urban solid wastes. Thanks to these programs, it is possible to establish correlations with the formation mechanisms postulated in literature on the subject. It was found that minimum oxygen quantities are required to obtain a significant formation of these compounds and that more furans than dioxins are formed. Likewise, dioxin and furan formation is related to the presence of carbon monoxide, and dioxin and furan distribution among its different compounds depends on the chlorine and hydrogen relative composition. This is due to the fact that an increased chlorine availability leads to the formation of compounds bearing a higher chlorine concentration (penta-, hexa-, hepta-, and octachlorides), whereas an increased hydrogen availability leads to the formation of compounds bearing a lower chlorine number (mono, di-, tri-, and tetrachlorides).

Adherence and perceptions regarding simulation training in undergraduate health Sciences

BACKGROUND: Simulation techniques are spreading rapidly in medicine. Suc h resources are increasingly concentrated in Simulation Laboratories. The MSRP-USP is structuring such a laboratory and is interested in the prevalence of individual initiatives that could be centralized there. The MSRP-USP currently has five full-curriculum courses in the health sciences: Medicine, Speech Therapy, Physical Therapy, Nutrition, and Occupational Therapy, all consisting of core disciplines. GOAL: To determine the prevalence of simulation techniques in the regular courses at MSRP-USP. METHODS: Coordinators of disciplines in the various courses were interviewed using a specifically designed semi-structured questionnaire, and all the collected data were stored in a dedicated database. The disciplines were grouped according to whether they used (GI) or did not use (GII) simulation resources. RESULTS AND DISCUSSION: 256 disciplines were analyzed, of which only 18.3% used simulation techniques, varying according to course: Medicine (24.7.3%), Occupational Therapy (23.0%), Nutrition (15.9%), Physical Therapy (9.8%), and Speech Therapy (9.1%). Computer simulation programs predominated (42.5%) in all five courses. The resources were provided mainly by MSRP-USP (56.3%), with additional funding coming from other sources based on individual initiatives. The same pattern was observed for maintenance. There was great interest in centralizing the resources in the new Simulation Laboratory in order to facilitate maintenance, but there was concern about training and access to the material. CONCLUSIONS: 1) The MSRP-USP simulation resources show low complexity and are mainly limited to computer programs; 2) Use of simulation varies according to course, and is most prevalent in Medicine; 3) Resources are scattered across several locations, and their acquisition and maintenance depend on individual initiatives rather than central coordination or curricular guidelines

Bases políticas das transferências intergovernamentais no Brasil (1985-2004)

The politics of intergovernmental transfers in Brazil. This article examines the political economy of public resources distribution in Brazil's federal system in 1985-2004. We propose an empirical exercise to analyze how the country's federal governments deal with the tradeoff between the provision of material wellbeing to sub-national governments (the states in our study) and the pursuit of political support from the latter. To identify the determinants of the transfer of resources from the federal government to the states, a set of economic, political, and institutional variables is econometrically tested. Based upon instrumental variables estimation for panel-data models, our estimates indicate that in Brazil the pursuit of political goals prevails over social equity and economic efficiency criteria: higher levels of per capita transfers are associated with the political makeup of governing coalitions, while larger investments in infrastructure and development by the states are associated with a lower amount of per capita resources transferred to sub-national governments. Our findings also suggest a trend toward the freezing of interregional inequalities in Brazil, and show the relevance of fiscal discipline laws in discouraging the use of the administrative apparatus for electioneering.