Global Acceleration and Dispossesion: Regression in the Right to Life and Public Health during Ecuador’s Neoliberal Decades

The present essay’s central argument or hypothesis is, consequently, that the mechanisms accelerating a wealth concentrating and exclusionary economy centred on the benefit and overprotection of big business—with a corresponding plundering of resources that are vital for life—generated forms of loss and regression in the right to healthcare and the dismantling of institutional protections. These are all expressed in indicators from 1990-2005, which point not only to the deterioration of healthcare programs and services but also to the undermining of the general conditions of life (social reproduction) and, in contrast to the reports and predictions of the era’s governments, a stagnation or deterioration in health indicators, especially for those most sensitive to the crisis. The present study’s argument is linked together across distinct chapters. First, we undertake the necessary clarification of the categories central to the understanding of a complex issue; clarifying the concept of health itself and its determinants, emphasizing the necessity of taking on an integral understanding as a fundamental prerequisite to unravelling what documents and reports from this era either leave unsaid or distort. Based on that analysis, we will explain the harmful effects of global economic acceleration, the monopolization and pillaging of strategic healthcare goods; not only those which directly place obstacles on the access to health services, but also those like the destructuration of small economies, linked to the impoverishment and worsening of living modes. Thinking epidemiologically, we intend to show signs of the deterioration of broad collectivities’ ways of life as a result of the mechanisms of acceleration and pillage. We will then collect disparate evidence of the deterioration of human health and ecosystems to, finally, establish the most urgent conclusions about this unfortunate period of our social and medical history.

What do patients want to know about their medicines, and what do doctors want to tell them?: a comparative study

A two phase study is reported. In the first phase, we asked a number of doctors to rate a list of information categories (identified by Berry, Gillie and Banbury 1995) in terms of how important they felt it was for the items to be included in an explanation to a patient about a drug prescription. In the second phase, we presented a large sample of people with a scenario about visiting their doctor and being prescribed medication, together with an explanation about the prescription which was said to be provided by the doctor. Four different explanations were compared, which were either based on what people in our earlier study wanted to know about drug prescriptions or on what the doctors thought it was important lo tell them. We also manipulated whether or not the explanations conveyed negative information (e.g. about the possible side effects of the medication). The results showed that people 'preferred' the explanations based on what the participants in the earlier study wanted to know about their medicines, rather than those based on what the doctors thought they should be told. They also 'preferred' the explanations that did not convey negative information, rather than those that did convey some negative information. In addition, the inclusion of negative information affected ratings of likely compliance with the prescribed medication.

What do patients want to know? An empirical approach to explanation generation and validation

This article describes an empirical, user-centred approach to explanation design. It reports three studies that investigate what patients want to know when they have been prescribed medication. The question is asked in the context of the development of a drug prescription system called OPADE. The system is aimed primarily at improving the prescribing behaviour of physicians, but will also produce written explanations for indirect users such as patients. In the first study, a large number of people were presented with a scenario about a visit to the doctor, and were asked to list the questions that they would like to ask the doctor about the prescription. On the basis of the results of the study, a categorization of question types was developed in terms of how frequently particular questions were asked. In the second and third studies a number of different explanations were generated in accordance with this categorization, and a new sample of people were presented with another scenario and were asked to rate the explanations on a number of dimensions. The results showed significant differences between the different explanations. People preferred explanations that included items corresponding to frequently asked questions in study 1. For an explanation to be considered useful, it had to include information about side effects, what the medication does, and any lifestyle changes involved. The implications of the results of the three studies are discussed in terms of the development of OPADE's explanation facility.

Ensuring the right to the city: pro-poor housing, urban development and tenure legalization in São Paulo, Brazil

São Paulo is one of Latin America’s most modern and developed cities, yet around one-third of its 10 million inhabitants live in poor-quality housing in sub-standard settlements. This paper describes the response of the São Paulo municipal government that took office in 2001. Through its Secretariat of Housing and Urban Development, it designed a new policy framework with a strong emphasis on improving the quantity and quality of housing for low-income groups. Supported by new legislation, financial instruments and partnerships with the private sector, the mainstays of the new policy are integrated housing and urban development, modernization of the administrative system, and public participation in all decision-making and implementation processes. The programmes centre on upgrading and legalizing land tenure in informal settlements, and regeneration of the city centre. The new focus on valuing the investments that low-income groups have already made in their housing and settlements has proved to be more cost-effective than previous interventions, leading to improvements on an impressive scale.

Binaural prediction of speech intelligibility in reverberant rooms with multiple noise sources

When speech is in competition with interfering sources in rooms, monaural indicators of intelligibility fail to take account of the listener’s abilities to separate target speech from interfering sounds using the binaural system. In order to incorporate these segregation abilities and their susceptibility to reverberation, Lavandier and Culling [J. Acoust. Soc. Am. 127, 387–399 (2010)] proposed a model which combines effects of better-ear listening and binaural unmasking. A computationally efficient version of this model is evaluated here under more realistic conditions that include head shadow, multiple stationary noise sources, and real-room acoustics. Three experiments are presented in which speech reception thresholds were measured in the presence of one to three interferers using real-room listening over headphones, simulated by convolving anechoic stimuli with binaural room impulse-responses measured with dummy-head transducers in five rooms. Without fitting any parameter of the model, there was close correspondence between measured and predicted differences in threshold across all tested conditions. The model’s components of better-ear listening and binaural unmasking were validated both in isolation and in combination. The computational efficiency of this prediction method allows the generation of complex “intelligibility maps” from room designs. © 2012 Acoustical Society of America

What GPs need to know about palliative-care drugs: ketamine

This is the first in a short series of articles that focus on what GPs should consider when monitoring and prescribing specialist-initiated palliative-care drugs. This first article summarises the key issues for patients receiving ketamine.

What GPs need to know about palliative-care drugs : methadone

This is the second in a short series of articles that focus on what GPs should consider when monitoring and prescribing specialist‐initiated palliative‐care drugs. Here, the authors summarise the key issues around the use of methadone for pain management.

Platelet adhesion to podoplanin under flow is mediated by the receptor CLEC-2 and stabilised by Src/Syk-dependent platelet signalling

Platelet-specific deletion of CLEC-2, which signals through Src and Syk kinases, or global deletion of its ligand podoplanin results in blood-filled lymphatics during mouse development. Platelet-specific Syk deficiency phenocopies this defect, indicating that platelet activation is required for lymphatic development. In the present study, we investigated whether CLEC-2-podoplanin interactions could support platelet arrest from blood flow and whether platelet signalling is required for stable platelet adhesion to lymphatic endothelial cells (LECs) and recombinant podoplanin under flow. Perfusion of human or mouse blood over human LEC monolayers led to platelet adhesion and aggregation. Following αIIbβ3 blockade, individual platelets still adhered. Platelet binding occurred at venous but not arterial shear rates. There was no adhesion using CLEC-2-deficient blood or to vascular endothelial cells (which lack podoplanin). Perfusion of human blood over human Fc-podoplanin (hFcPDPN) in the presence of monoclonal antibody IV.3 to block FcγRIIA receptors led to platelet arrest at similar shear rates to those used on LECs. Src and Syk inhibitors significantly reduced global adhesion of human or mouse platelets to LECs and hFcPDPN. A similar result was seen using Syk-deficient mouse platelets. Reduced platelet adhesion was due to a decrease in the stability of binding. In conclusion, our data reveal that CLEC-2 is an adhesive receptor that supports platelet arrest to podoplanin under venous shear. Src/Syk-dependent signalling stabilises platelet adhesion to podoplanin, providing a possible molecular mechanism contributing to the lymphatic defects of Syk-deficient mice.

Brazil: challenges for freedom of speech online

Escola de Direito de São Paulo da Fundação Getulio Vargas

Liberdade de expressão artística: concepções filosóficas, fundamentalidade constitucional e política da pluralidade

The right to artistic expression, freedom granted in the western democratic constitutionalism, is a fundamental right that cyclically, compared to other cohesive rights of expression, has been forgotten and put in an irrelevant juridical-dogmatic position. The first reason for this behaviour that disesteems artistic freedom is the valorisation of rationalism and scientificism in the modern society, subordinating academic researches to utilitarianism, relegating the purpose of feelings and spirituality on men s elocution, therefore, we investigate, guided by philosophy, the attribution of art on human formation, due to its capacity in harmonising reason and emotion. After that, we affirm the fundamental right to artistic expression s autonomy in the 1988 valid constitutional order, after a comparative explanation of freedom in the Fundamental Laws of United States, Portugal, Spain and Germany; and the construction historic-constitutional of the same right in the Brazilian Constitutions. In this desiderate, the theoric mark chosen is the Liberal Theory of the fundamental rights, guiding the exam through jusfundamental dimensions: juridical-subjective and juridical-objective. Whilst the first, classical function of resistance, delimitates the protection area of the artistic expression right from its specific content, titularity and its constitutional and subconstitutional limits, the other one establishes it as cultural good of the Social Order, defining to the State its rendering duties of protection, formation and cultural promotion. We do not admit artistic communication, granted without legal reserve, to be transposed of restrictions that belong to other fundamental rights and, when its exercise collides with another fundamental right or juridical-constitutional good, the justification to a possible state intervention that tangentiates its protection area goes, necessarily, through the perquisition of the artist s animus, the used method, the many viable interpretations and, at last, the correct application of the proportionality criteria. The cultural public politics analysis, nevertheless, observes the pluralism principle of democratic substratum, developer of the cultural dialogue and opposed to patterns determined by the mass cultural industry. All powers are attached, on the scope of its typical attributions, to materialise public politics that have the cultural artistic good as its aim, due to the constant rule contained in §1, art. 5º of the Federal Constitution. However, the access and the incentive laws to culture must be constantly supervised by the constitutional parameter of fundamental right to equality

Right to health in Latin America: beyond universalization

Incluye bibliografía.

The right to an identity: birth registration in Latin America and the Caribbean

A disturbing token of child and adolescent vulnerability in Latin America and the Caribbean is that so many are deprived of any legal identity by failure to report their birth. This bars them from exercising basic citizen rights and can hinder their access to productive employment, social benefits and the justice system and deny them recognition as full citizens and the right to well-being, capacity development and political participation.