Fatores associados à vacinação contra a influenza em idosos

Objective. To investigate the epidemiologic profile of elderly persons who do or do not participate in influenza vaccination campaigns and to identify the variables that bear an influence on participation. Method. A cross-sectional population-based study was performed using data on individuals aged 60 years or older who were living in the municipalities of São Paulo, Itapecerica da Serra, Embu, Taboão da Serra, Campinas and Botucatu, Brazil, in 2001 and 2002. A stratified random sample of 1 908 elderly individuals was selected by means of two-stage cluster sampling. Exploratory data analysis was performed, including bivariate analysis and multiple logistic regression. Results. Sixty-six percent of the elderly subjects reported having received vaccination against influenza. After adjustment, the following factors were found to be associated with having received vaccination, based on self-report: age (OR = 1.47; 95% CI = 1.09 to 1.99), self-reported hypertension (OR = 1.39; 95% CI = 1.03 to 1.87) and educational level (OR = 0.64; 95% CI = 0.41 to 0.98). The highest number of vaccinated individuals was observed in the group = 70 years of age and in the hypertension group. Individuals with 9 or more years of schooling reported less adherence to influenza vaccination. Conclusions. The results suggest the need for campaigns to make information on the benefits of influenza vaccination more easily accessible to the elderly and health professionals.

The first Triassic lungfish from South America (Santa Maria Formation, Paraná Basin) and its bearing on geological correlations within Pangaea

The Triassic fish faunas of the Southern Hemisphere are only known from a few sedimentary basins and the most productive sites are those from the Karoo Supergroup, in South Africa and the Sydney Basin of Australia. A single lungfish tooth plate ascribed to Ptychoceratodus cf. philippsi was recovered from Late Triassic (Carnian) red beds of southern Brazil and is described herein. This find extends to South America the palaeogeographic distribution of the genus, which occurs in the Early Triassic of Australia and South Africa and the Middle/Late Triassic of Europe and Late Triassic of Madagascar and India. The presence of this dipnoan solely in the uppermost part of the Santa Maria Formation suggests that the migration of Ptychoceratodus towards the Paraná Basin began not before the late Induan/early Olenekian (late Early Triassic). At that time, more humid (monsoonal) conditions prevailed in what is now southern Brazil, compared to semi-arid/desert conditions that dominated the Late Permian and possibly the earliest Early Triassic (the latter presumably not represented in the Paraná Basin). © The Geological Society of London 2008.

A proposal for unitary taxes on the profits of transnational corporations

Includes bibliography

Global economic developments, 1999

Includes bibliography

Etnobotânica de plantas antimaláricas em Barcelos, Amazonas

Pós-graduação em Agronomia (Horticultura) - FCA

Conflitos no chifre da África: oportunidades e constrangimentos da difusão do poder

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The employment situation in Latin America and the Caribbean: Labour productivity and distribution issues

Although the economies of Latin America and the Caribbean grew more slowly in 2011 than in 2010, there were some improvements on the employment front. Workers benefited from the region’s satisfactory economic performance in an increasingly complex international setting. The unemployment rate fell from 7.3% in 2010 to 6.7% in 2011 thanks to a halfpercentage- point gain in the urban employment rate. Both rates are at levels that have not been seen for a long time. The proportion of formal jobs with social benefits rose as well, and underemployment declined. The average wage and the minimum wage both increased in real terms, albeit only moderately. Economic performance and the employment situation varied widely among the subregions. The unemployment rate dropped by 0.6 percentage points in South America but 0.4 percentage points in the countries of the northern part of Latin America. In the countries of the Caribbean, the employment rate was up by 0.2 percentage points. The data show that substantial labour market gaps and serious labour-market insertion issues remain. This is especially the case for women and young people, for whom unemployment rates and other labour indicators are still unfavourable. The second part of this report looks at whether the fruits of economic growth and rising productivity have been distributed equitably between workers and companies. Between 2002 and 2008 (the most recent expansionary economic cycle), wages as a percentage of GDP fell in 13 of the 21 countries of the region for which data are available and rose in just 8. This points to redistribution that is unfavourable to workers, which is worrying in a region which already has the most unequal distribution of income in the world. Underlying this trend is the fact that, worldwide, wages have grown less than productivity. Beyond the ethical dimension of this issue, it jeopardizes the social and economic sustainability of growth. For example, one of the root causes of the recent financial crisis was that households in the United States responded to declining wage income by borrowing more to pay for consumption and housing. This turned out to be unsustainable in the long run. Over time, it undermines the labour market’s contribution to the efficient allocation of resources and its distributive function, too, with negative consequences for democratic governance. Among the triggers of this distributive worsening most often cited in the global debate are market deregulation and its impact on financial globalization, technological change that favours capital over labour, and the weakening of labour institutions. What is needed here is a public policy effort to help keep wage increases from lagging behind increases in productivity. Some countries of the region, especially in South America, saw promising developments during the second half of the 2000s in the form of a positive trend reversal in wages as a percentage of GDP. One example is Brazil, where a minimum wage policy tailored to the dynamics of the domestic market is considered to be one of the factors behind an upturn in the wage share of GDP. The region needs to grow more and better. Productivity must grow at a steady pace, to serve as the basis for sustained improvements in the well-being of the populace and to narrow the gap between the economies of Latin America and the Caribbean and the more advanced economies. And inequality must be decreased; this could be achieved by closing the productivity gap between upgraded companies and the many firms whose productivity is low. As set out in this report, the region made some progress between 2002 and 2010, with labour productivity rising at the rate of 1.5% a year. But this progress falls short of that seen in other regions such as Sub-Saharan Africa (2.1%) and, above all, East Asia (8.3%, not counting Japan and the Republic of Korea). Moreover, in many of the countries of the region these gains have not been distributed equitably. Therein lies a dual challenge that must be addressed: continue to increase productivity while enhancing the mechanisms for distributing gains in a way that will encourage investment and boost worker and household income. The Economic Commission for Latin America and the Caribbean (ECLAC) and the International Labour Organization (ILO) estimate that the pace of economic growth in the region will be slightly slower in 2012 than in 2011, in a global economic scenario marked by the cooling of several of the main economic engines and a high degree of uncertainty concerning, above all, prospects for the euro zone. The region is expected to continue to hold up well to this worsening scenario, thanks to policies that leveraged more favourable conditions in the past. This will be felt in the labour markets, as well, so expectations are that unemployment will edge down by as much as two tenths of a decimal point.

Human immunodeficiency virus prevalence, incidence, and residual risk of transmission by transfusions at Retrovirus Epidemiology Donor Study-II blood centers in Brazil

BACKGROUND: In Brazil nationally representative donor data are limited on human immunodeficiency virus (HIV) prevalence, incidence, and residual transfusion risk. The objective of this study was to analyze HIV data obtained over 24 months by the Retrovirus Epidemiology Donor Study-II program in Brazil. STUDY DESIGN AND METHODS: Donations reactive to third-and fourth-generation immunoassays (IAs) were further confirmed by a less-sensitive (LS) IA algorithm and Western blot (WB). Incidence was calculated for first-time (FT) donors using the LS-EIA results and for repeat donors with a model developed to include all donors with a previous negative donation. Residual risk was projected by multiplying composite FT and repeat donor incidence rates by HIV marker-negative infectious window periods. RESULTS: HIV prevalence among FT donors was 92.2/ 105 donations. FT and repeat donor and composite incidences were 38.5 (95% confidence interval [CI], 25.651.4), 22.5 (95% CI, 17.6-28.0), and 27.5 (95% CI, 22.0-33.0) per 100,000 person-years, respectively. Male and community donors had higher prevalence and incidence rates than female and replacement donors. The estimated residual risk of HIV transfusion transmission was 11.3 per 106 donations (95% CI, 8.4-14.2), which could be reduced to 4.2 per 106 donations (95% CI, 3.2-5.2) by use of individual-donation nucleic acid testing (NAT). CONCLUSION: The incidence and residual transfusion risk of HIV infection are relatively high in Brazil. Implementation of NAT will not be sufficient to decrease transmission rates to levels seen in the United States or Europe; therefore, other measures focused on decreasing donations by at-risk individuals are also necessary.

Comparison of the Clinical Expression of Patients with Ankylosing Spondylitis from Europe and Latin America

Objective. To compare the clinical, demographic, and serologic characteristics and the treatment of patients diagnosed with ankylosing spondylitis (AS) from Europe (EU) and Latin America (LA). Methods. We included 3439 patients from national registries: the Spanish Registry of Spondyloarthritis (REGISPONSER), the Belgian registry (ASPECT), and the Latin American Registry of Spondyloarthropathies (RESPONDIA). We selected patients with diagnosis of AS who met the modified New York classification criteria. Demographic, clinical, disease activity, functional, and metrological measurement data were recorded. Current treatment was recorded. The population was classified into 2 groups: patients with disease duration < 10 years and those with disease duration >= 10 years. A descriptive and comparative analysis of variables of both groups was carried out. Results. There were 2356 patients in EU group and 1083 in LA group. Prevalence of HLA-B27 was 71% in LA group and 83% in EU group (p < 0.001). We found a greater frequency of peripheral arthritis and enthesitis (p < 0.001) in the LA population; prevalence of arthritis was 57% in LA and 42% in EU, and for enthesitis, 54% and 38%. Except for treatment with anti-tumor necrosis factor (anti-TNF), the use of nonsteroidal antiinflammatory drugs (NSAID), corticosteroids, and disease-modifying antirheumatic drugs (DMARD), and the association of anti-TNF and methotrexate use showed a significant difference (p < 0.001) in the 2 populations. Conclusion. The principal differences in the clinical manifestations of patients with AS from EU and LA were the greater frequency of peripheral arthritis and enthesitis in LA group, the higher percentage of HLA-B27 in EU group, and the form of treatment, with a greater use of NSAID, steroids, and DMARD in the LA group. (First Release Nov 15 2012; J Rheumatol 2012;39:2315-20; doi:10.3899/jrheum.110687)

Soil carbon balance in a tropical grassland: Estimation of soil respiration and its partitioning using a semi-empirical model

In savannah and tropical grasslands, which account for 60% of grasslands worldwide, a large share of ecosystem carbon is located below ground due to high root:shoot ratios. Temporal variations in soil CO2 efflux (R-S) were investigated in a grassland of coastal Congo over two years. The objectives were (1) to identify the main factors controlling seasonal variations in R-S and (2) to develop a semi-empirical model describing R-S and including a heterotrophic component (R-H) and an autotrophic component (R-A). Plant above-ground activity was found to exert strong control over soil respiration since 71% of seasonal R-S variability was explained by the quantity of photosynthetically active radiation absorbed (APAR) by the grass canopy. We tested an additive model including a parameter enabling R-S partitioning into R-A and R-H. Assumptions underlying this model were that R-A mainly depended on the amount of photosynthates allocated below ground and that microbial and root activity was mostly controlled by soil temperature and soil moisture. The model provided a reasonably good prediction of seasonal variations in R-S (R-2 = 0.85) which varied between 5.4 mu mol m(-2) s(-1) in the wet season and 0.9 mu mol m(-2) s(-1) at the end of the dry season. The model was subsequently used to obtain annual estimates of R-S, R-A and R-H. In accordance with results reported for other tropical grasslands, we estimated that R-H accounted for 44% of R-S, which represented a flux similar to the amount of carbon brought annually to the soil from below-ground litter production. Overall, this study opens up prospects for simulating the carbon budget of tropical grasslands on a large scale using remotely sensed data. (C) 2012 Elsevier B.V. All rights reserved.

Giustizia sanitaria e diseguaglianze globali in salute: il caso dell'aiuto allo sviluppo in sanità

Life expectancy at birth is the average number of years that a group of people born in the same year should live. The estimate for those born in 2010 is 80.2 years for Italy. On the other side of the chart are a number of countries in sub Saharan Africa. Haiti is in last place: children born in this country in 2010 have a life expectancy by an average of even 30 years, fifty in less than peers born in Italy. From a bioethical point of view, the first question that arises is: Is it right? Is it right that there is such inequality in health? The answer is simple: it is not right. But if we ask ourselves what are the best solution to remedy this situation, the answers become more than one. The differences in life expectancy depends on many factors, including no doubt the effectiveness of health systems. The scope of this work is precisely that of justice in health care and how the different general concepts related to it can be applied in health care settings with very limited financial and human resources. The first chapter describes the main inequalities in global health. The second discusses the main theories of justice. In the next chapter we reason on official development assistance and health cooperation. In the fourth we analyze the contribution of theories of justice through such issues as equity in health, the right of access to health services and right to health. In the fifth chapter the aim is to reason about global justice, the role of health in this context and how the official development assistance in health can contribute.

Studio della Peste dei Piccoli Ruminanti nei territori saharawi

La Peste dei Piccoli Ruminanti (PPR) è una patologia virale ed acuta che colpisce i piccoli ruminanti, diffusa in Africa Sub-Sahariana, in Medio Oriente ed in Asia Meridionale. Questo lavoro si propone di effettuare il primo studio epidemiologico sulla PPR nella Repubblica Araba Saharawi Democratica (RASD), che comprende i Campi Profughi Saharawi, in territorio algerino, ed i “Territori Liberati” del Sahara Occidentale, valutando la potenziale presenza, prevalenza e distribuzione del virus della PPR in questi territori. Lo studio si è basato su una metodica di campionamento “a cluster” secondo la tecnica “a due stadi”. Sono stati individuati 23 siti di campionamento dai quali sono stati raccolti un totale di 976 campioni di siero prelevati da pecore, capre e cammelli. I campioni sono stati prelevati in Marzo ed Aprile 2008. I risultati dei test Competitive-Elisa hanno evidenziato una sieroprevalenza nel 28,26% degli animali testati, benché durante la raccolta dei campioni nessun animale abbia presentato sintomi clinici riferibili alla PPR. Tra Gennaio e Maggio 2010, in seguito ad episodi di aumentata mortalità nella popolazione ovi-caprina presente nei Campi Profughi, le autorità veterinarie locali sospettarono un outbreak di PPR. Tra Maggio ed Ottobre 2010 è stato sviluppato un outbreak investigation nei Campi Profughi Saharawi con lo scopo di confermare la circolazione del PPRV. I risultati di laboratorio hanno confermato la presenza del virus nel 33,33% dei campioni. Il sequenziamento del genoma virale ha rivelato che il virus apparteneva al Lignaggio 4 e le analisi filogenetiche hanno indicato una stretta relazione (99.3%) con il PPRV isolato durante l'epidemia di PPR in Marocco del 2008.

Demokratie, good governance und Entwicklung: Eine quantitative Analyse für 191 Staaten im Zeitraum 1996 bis 2005

Das Jahr 1989 markiert nicht nur den Beginn entscheidender geopolitischer Veränderungen, sondern gleichzeitig den Ursprung eines bedeutsamen Wandels in der internationalen Entwicklungszusammenarbeit. Mit der viel beachteten Studie ‚Sub-Saharan Africa – From Crisis to Sustainable Growth’ initiierte die Weltbank eine Debatte über die Relevanz institutioneller Faktoren für wirtschaftliche Entwicklung, die in den folgenden Jahren unter dem Titel ‚Good Governance’ erhebliche Bedeutung erlangte. Nahezu alle zentralen Akteure begannen, entsprechende Aspekte in ihrer praktischen Arbeit zu berücksichtigen, und entwickelten eigene Konzepte zu dieser Thematik. Wenn auch mit der Konzentration auf Institutionen als Entwicklungsdeterminanten eine grundlegende Gemeinsamkeit der Ansätze festzustellen ist, unterscheiden sie sich jedoch erheblich im Hinblick auf die Einbeziehung politischer Faktoren, so dass von einem einheitlichen Verständnis von ‚Good Governance’ nicht gesprochen werden kann. Während die meisten bilateralen Akteure sowie DAC und UNDP Demokratie und Menschenrechte explizit als zentrale Bestandteile betrachten, identifiziert die Weltbank einen Kern von Good Governance, der unabhängig von der Herrschaftsform, also sowohl in Demokratien wie auch in Autokratien, verwirklicht werden kann. Die Implikationen dieser Feststellung sind weit reichend. Zunächst erlaubt erst diese Sichtweise der Bank überhaupt, entsprechende Aspekte aufzugreifen, da ihr eine Berücksichtigung politischer Faktoren durch ihre Statuten verboten ist. Bedeutsamer ist allerdings, dass die Behauptung der Trennbarkeit von Good Governance und der Form politischer Herrschaft die Möglichkeit eröffnet, Entwicklung zu erreichen ohne eine demokratische Ordnung zu etablieren, da folglich autokratische Systeme in gleicher Weise wie Demokratien in der Lage sind, die institutionellen Voraussetzungen zu verwirklichen, welche als zentrale Determinanten für wirtschaftlichen Fortschritt identifiziert wurden. Damit entfällt nicht nur ein bedeutsamer Rechtfertigungsgrund für demokratische Herrschaft als solche, sondern rekurrierend auf bestimmte, dieser zu attestierende, entwicklungshemmende Charakteristika können Autokratien nun möglicherweise als überlegene Herrschaftsform verstanden werden, da sie durch jene nicht gekennzeichnet sind. Die Schlussfolgerungen der Weltbank unterstützen somit auch die vor allem im Zusammenhang mit der Erfolgsgeschichte der ostasiatischen Tigerstaaten vertretene Idee der Entwicklungsdiktatur, die heute mit dem Aufstieg der Volksrepublik China eine Renaissance erlebt. Der wirtschaftliche Erfolg dieser Staaten ist danach auf die überlegene Handlungsfähigkeit autokratischer Systeme zurückzuführen, während Demokratien aufgrund der Verantwortlichkeitsbeziehungen zwischen Regierenden und Regierten nicht in der Lage sind, die notwendigen Entscheidungen zu treffen und durchzusetzen. Die dargestellte Sichtweise der Weltbank ist allerdings von verschiedenen Autoren in Zweifel gezogen worden, die auch für ein im Wesentlichen auf technische Elemente beschränktes Good Governance-Konzept einen Zusammenhang mit der Form politischer Herrschaft erkennen. So wird beispielsweise vertreten, das Konzept der Bank bewege sich ausdrücklich nicht in einem systemneutralen Vakuum, sondern propagiere zumindest implizit die Etablierung demokratischer Regierungsformen. Im Übrigen steht die aus den Annahmen der Weltbank neuerlich abgeleitete Idee der Entwicklungsdiktatur in einem erheblichen Widerspruch zu der von multilateralen wie bilateralen Akteuren verstärkt verfolgten Förderung demokratischer Herrschaft als Mittel für wirtschaftliche Entwicklung sowie der fortschreitenden Verbreitung der Demokratie. Besteht nun doch ein Einfluss der Herrschaftsform auf die Verwirklichung von Good Governance als zentraler Entwicklungsdeterminante und kann zudem davon ausgegangen werden, dass Demokratien diesbezüglich Vorteile besitzen, dann ist eine Entwicklungsdiktatur keine denkbare Möglichkeit, sondern im Gegenteil demokratische Herrschaft der gebotene Weg zu wirtschaftlichem Wachstum bzw. einer Verbesserung der Lebensverhältnisse. Aufgrund der mit den Schlussfolgerungen der Weltbank verbundenen bedeutsamen Implikationen und der bisher weitestgehend fehlenden ausführlichen Thematisierung dieses Gegenstands in der Literatur ist eine detaillierte theoretische Betrachtung der Zusammenhänge zwischen den zentralen Elementen von Good Governance und demokratischer Herrschaft notwendig. Darüber hinaus sollen die angesprochenen Beziehungen auch einer empirischen Analyse unterzogen werden. Gegenstand dieser Arbeit ist deshalb die Fragestellung, ob Good Governance eine von demokratischer Herrschaft theoretisch und empirisch unabhängige Entwicklungsstrategie darstellt.

The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients' views

PURPOSE: Stigma is a frequent accompaniment of mental illness leading to a number of detrimental consequences. Most research into the stigma connected to mental illness was conducted in the developed world. So far, few data exist on countries in sub-Saharan Africa and no data have been published on population attitudes towards mental illness in Ghana. Even less is known about the stigma actually perceived by the mentally ill persons themselves. METHOD: A convenience sample of 403 participants (210 men, mean age 32.4 ± 12.3 years) from urban regions in Accra, Cape Coast and Pantang filled in the Community Attitudes towards the Mentally Ill (CAMI) questionnaire. In addition, 105 patients (75 men, mean age 35.9 ± 11.0 years) of Ghana's three psychiatric hospitals (Accra Psychiatry Hospital, Ankaful Hospital, Pantang Hospital) answered the Perceived Stigma and Discrimination Scale. RESULTS: High levels of stigma prevailed in the population as shown by high proportions of assent to items expressing authoritarian and socially restrictive views, coexisting with agreement with more benevolent attitudes. A higher level of education was associated with more positive attitudes on all subscales (Authoritarianism, Social Restrictiveness, Benevolence and Acceptance of Community Based Mental Health Services). The patients reported a high degree of experienced stigma with secrecy concerning the illness as a widespread coping strategy. Perceived stigma was not associated with sex or age. DISCUSSION: The extent of stigmatising attitudes within the urban population of Southern Ghana is in line with the scant research in other countries in sub-Saharan Africa and mirrored by the experienced stigma reported by the patients. These results have to be seen in the context of the extreme scarcity of resources within the Ghanaian psychiatric system. Anti-stigma efforts should include interventions for mentally ill persons themselves and not exclusively focus on public attitudes.

Worldwide Diaspora of Aethina tumida (Coleoptera: Nitidulidae), a Nest Parasite of Honey Bees

Native to sub-Saharan Africa, Aethina tumida Murray (Coleoptera: Nitidulidae) is now an invasive pest of honey bee, Apis mellifera L., colonies in Australia and North America. Knowledge about the introduction (s) of this beetle from Africa into and among the current ranges will elucidate pest populations and invasion pathways and contribute to knowledge of how a parasite expands in new populations. We examined genetic variation in adult beetle samples from the United States, Australia, Canada, and Africa by sequencing a 912-base pair region of the mitochondrial DNA cytochrome c oxidase subunit I gene and screening 10 informative microsatellite loci. One Canadian introduction of small hive beetles can be traced to Australia, whereas the second introduction seems to have come from the United States. Beetles now resident in Australia were of a different African origin than were beetles in North America. North American beetles did not show covariance between two mitochondrial haplotypes and their microsatellite frequencies, suggesting that these beetles have a shared source despite having initial genetic structure within their introduced range. Excellent dispersal of beetles, aided in some cases by migratory beekeeping and the bee trade, seems to lead to panmixis in the introduced populations as well as in Africa.