953 resultados para pharmacy services on the wards
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This issue of the FAL bulletin reflects on the need to place a new discourse at the centre of the academic, social and political debate, in relation to developing infrastructure services in a sustainable way.
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Statistical organizations of the Caribbean countries continue to face serious challenges posed by the increased demand for more relevant, accurate and timely statistical data. Tangible progress has been made in delivering key products in the area of economic statistics. The central banks of the subregion have assisted greatly in this respect. However, even in this branch of statistics there are still several glaring gaps. The situation is even worse in other areas of statistics including social and environmental statistics. Even though all countries of the subregion have committed to the Millennium Development Goals (MDGs) as well as to other internationally agreed development goals serious challenges remain with respect to the compilation of the agreed indicators to assist in assessing progress towards the goals. It is acknowledged that appreciable assistance has been provided by the various donor agencies to develop statistical competence. This assistance has translated into the many gains that have been made. However, the national statistical organizations require much more help if they are to reach the plateau of self reliance in the production of the necessary statistical services. The governments of the subregion have also committed to invest more in statistical development and in promoting a statistics culture in the Caribbean. The training institutions of the subregion have also started to address this urgent need by broadening and deepening their teaching curricula. Funding support is urgently required to develop the appropriate cadre of statistical professionals to deliver the required outputs. However, this training must be continuous and must be sustained over an appropriate period since the current turnover of trained staff is high. This programme of training will need to be intensive for a period of at least five years after which it may be reduced. The modalities of training will also have to be more focused and in addition to formal training at educational institutions there is much room for on-the-job training, group training at the national level and much more south-south capacity building. There is also an urgent need to strengthen cooperation and collaboration among the donor community in the delivery of assistance for statistical development. Several development agencies with very good intentions are currently operating in the Caribbean. There is a danger however, that efforts can be duplicated if agencies do not collaborate adequately. Development agencies therefore need to consult with each other much more and share there development agenda more freely if duplication is to be averted. Moreover, the pooling of resources can surely maximize the benefits to the countries of the subregion.
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Given the asymmetry in the levels of development and capacity which exist between the EU and CARIFORUM States, the architects of the CARIFORUM-European Union (EU) Economic Partnership Agreement (EPA)1 anticipated the need for review and monitoring of the impacts of implementation. Article 5 and other provisions in the Agreement therefore specifically mandate that monitoring be undertaken to ensure that the Agreement benefits a wide cross-section of the population in member countries. The paper seeks to provide a preliminary assessment of the impact of the EPA on CARIFORUM countries. In so doing, it highlights some critical information and implementation gaps and challenges that have emerged during the implementation process. The analysis however, is restricted to goods trade. The services sector will be the subject of a separate report. The paper draws on a combination of quantitative and qualitative analyses. While the paper undertakes a CARIFORUM-wide analysis for the most part, five CARIFORUM member states including Barbados, Dominican Republic, Guyana, Saint Kitts and Nevis and Saint Lucia are examined more closely in some instances. These economies were selected by virtue of economic structure and development constraints, as a representative subset of CARIFORUM, which comprises the CARICOM membership as well as the Dominican Republic.
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Owing to their high vulnerability and low adaptive capacity, Caribbean islands have legitimate concerns about their future, based on observational records, experience with current patterns and consequences of climate variability, and climate model projections. Although emitting less than 1% of global greenhouse gases, islands from the region have already perceived a need to reallocate scarce resources away from economic development and poverty alleviation, and towards the implementation of strategies to adapt to the growing threats posed by global warming (Nurse and Moore, 2005). The objectives of this Report are to conduct economic analyses of the projected impacts of climate change to 2050, within the context of the IPCC A2 and B2 scenarios, on the coastal and marine resources of St. Kitts and Nevis (SKN). The Report presents a valuation of coastal and marine services; quantitative and qualitative estimates of climate change impacts on the coastal zone; and recommendations for possible adaptation strategies and costs and benefits of adaptation.
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Owing to their high vulnerability and low adaptive capacity, Caribbean islands have legitimate concerns about their future, based on observational records, experience with current patterns and consequences of climate variability, and climate model projections. Although emitting less than 1% of global greenhouse gases, islands from the region have already perceived a need to reallocate scarce resources away from economic development and poverty reduction, and towards the implementation of strategies to adapt to the growing threats posed by global warming (Nurse and Moore, 2005). The objectives of this Report are to conduct economic analyses of the projected impacts of climate change to 2050, within the context of the IPCC A2 and B2 scenarios, on the coastal and marine resources of the British Virgin Islands (BVI). The Report presents a valuation of coastal and marine services; quantitative and qualitative estimates of climate change impacts on the coastal zone; and recommendations of possible adaptation strategies and costs and benefits of adaptation. A multi-pronged approach is employed in valuing the marine and coastal sector. Direct use and indirect use values are estimated. The amount of economic activity an ecosystem service generates in the local economy underpins estimation of direct use values. Tourism and fisheries are valued using the framework developed by the World Resources Institute. Biodiversity is valued in terms of the ecological functions it provides, such as climate regulation, shoreline protection, water supply erosion control and sediment retention, and biological control, among others. Estimates of future losses to the coastal zone from climate change are determined by considering: (1) the effect of sea level rise on coastal lands; and (2) the effect of a rise in sea surface temperature (SST) on coastal waters. Discount rates of 1%, 2% and 4% are employed to analyse all loss estimates in present value terms. The overall value for the coastal and marine sector is USD $1,606 million (mn). This is almost 2% larger than BVI’s 2008 GDP. Tourism and recreation comprise almost two-thirds of the value of the sector. By 2100, the effects of climate change on coastal lands are projected to be $3,988.6 mn, and $2,832.9 mn under the A2 and B2 scenarios respectively. In present value terms, if A2 occurs, losses range from $108.1-$1,596.8 mn and if B2 occurs, losses range from $74.1-$1,094.1 mn, depending on the discount rate used. Estimated costs of a rise in SST in 2050 indicate that they vary between $1,178.0 and $1,884.8 mn. Assuming a discount rate of 4%, losses range from $226.6 mn for the B2 scenario to $363.0 mn for the A2 scenario. If a discount rate of 1% is assumed, estimated losses are much greater, ranging from $775.6-$1,241.0 mn. Factoring in projected climate change impacts, the net value of the coastal and marine sector suggests that the costs of climate change significantly reduce the value of the sector, particularly under the A2 and B2 climate change scenarios for discount rates of 1% and 2%. In contrast, the sector has a large, positive, though declining trajectory, for all years when a 4% discount rate is employed. Since the BVI emits minimal greenhouse gases, but will be greatly affected by climate change, the report focuses on adaptation as opposed to mitigation strategies. The options shortlisted are: (1) enhancing monitoring of all coastal waters to provide early warning alerts of bleaching and other marine events; (2) introducing artificial reefs or fish-aggregating devices; (3) introducing alternative tourist attractions; (4) providing retraining for displaced tourism workers; and (5) revising policies related to financing national tourism offices to accommodate the new climatic realities. All adaptation options considered are quite justifiable in national terms; each had benefit-cost ratios greater than 1.
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This report provides an analysis and evaluation of the likely effects of climate change on the tourism sector in Montserrat. Clayton (2009) identifies three reasons why the Caribbean should be concerned about the potential effects of climate change on tourism: (a) the relatively high dependence on tourism as a source of foreign exchange and employment; (b) the intrinsic vulnerability of small islands and their infrastructure (e.g. hotels and resorts) to sea level rise and extreme climatic events (e.g. hurricanes and floods); and, (c) the high dependence of the regional tourist industry on carbon-based fuels (both to bring tourist to the region as well as to provide support services in the region). The effects of climate change are already being felt on the island. Between 1970 and 2009, there was a rise in the number of relatively hot days experienced on the island. Added to this, there was also a decline in mean precipitation over the period. Besides temperature, there is also the threat of wind speeds. Since the early 20th century, the number of hurricanes passing through the Caribbean has risen from about 5-6 per year to more than 25 in some years of the twenty-first century. In Montserrat, the estimated damage from four windstorms (including hurricanes) affecting the island was US$260 million or almost five times 2009 gross domestic product (GDP). Climate change is also likely to significantly affect coral reefs. Hoegh-Guldberg (2007) estimates that should current concentrations of carbon dioxide in the Earth’s atmosphere rise from 380ppm to 560ppm, decreases in coral calcification and growth by 40% are likely. The report attempted to quantify the likely effects of the changes in the climatic factors mentioned above. As it relates to temperature and other climatic variables, a tourism climatic index that captures the elements of climate that impact on a destination’s experience was constructed. The index was calculated using historical observations as well as those under two likely climate scenarios: A2 and B2. The results suggest that under both scenarios, the island’s key tourism climatic features will likely decline and therefore negatively impact on the destination experience of visitors. Including this tourism climatic index in a tourism demand model suggests that this would translate into losses of around 145% of GDP. As it relates to coral reefs, the value of the damage due to the loss of coral reefs was estimated at 7.6 times GDP, while the damage due to land loss for the tourism industry was 45% of GDP. The total cost of climate change for the tourism industry was therefore projected to be 9.6 times 2009 GDP over a 40-year horizon. Given the potential for significant damage to the industry, a large number of potential adaptation measures were considered. Out of these, a short-list of 9 potential options was selected using 10 evaluation criteria. These included: (a) Increasing recommended design wind speeds for new tourism-related structures; (b) Construction of water storage tanks; (c) Irrigation network that allows for the recycling of waste water; (d) Enhanced reef monitoring systems to provide early warning alerts of bleaching events; (e) Deployment of artificial reefs and fish-aggregating devices; (f) Developing national evacuation and rescue plans; (g) Introduction of alternative attractions; (h) Providing re-training for displaced tourism workers, and; (i) Revised policies related to financing national tourism offices to accommodate the new climatic realities Using cost-benefit analysis, three options were put forward as being financially viable and ready for immediate implementation: (a) Increase recommended design speeds for new tourism-related structures; (b) Enhance reef monitoring systems to provide early warning alerts of bleaching events, and; (c) Deploy artificial reefs or fish-aggregating devices. While these options had positive benefit cost ratios, other options were also recommended based on their non-tangible benefits: an irrigation network that allows for the recycling of waste water, development of national evacuation and rescue plans, providing retraining for displaced tourism workers and the revision of policies related to financing national tourism offices to accommodate the new climatic realities.
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This report provides an analysis and evaluation of the likely effects of climate change on the tourism sector in Saint Lucia. Clayton (2009) identifies three reasons why the Caribbean should be concerned about the potential effects of climate change on tourism: (a) the relatively high dependence on tourism as a source of foreign exchange and employment; (b) the intrinsic vulnerability of small islands and their infrastructure (e.g. hotels and resorts) to sea level rise and extreme climatic events (e.g. hurricanes and floods); and, (c) the high dependence of the regional tourist industry on carbon-based fuels (both to bring tourist to the region as well as to provide support services in the region). The effects of climate change are already being felt on the island. Between 1970 and 2009 there was a rise in the number of relatively hot days experienced on the island. Added to this, there was also a decline in mean precipitation over the period. In addition to temperature, there is also the threat of increased wind speeds. Since the early twentieth century, the number of hurricanes passing through the Caribbean has risen from about 5-6 per year to more than 25 in some years of the twenty-first century. In Saint Lucia, the estimated damage from 12 windstorms (including hurricanes) affecting the island was US$1 billion or about 106% of 2009 GDP. Climate change is also likely to significantly affect coral reefs. Hoegh-Guldberg (2007) estimates that should current concentrations of carbon dioxide in the Earth’s atmosphere rise from 380ppm to 560ppm, decreases in coral calcification and growth by 40% are likely. This report attempted to quantify the likely effects of the changes in the climatic factors mentioned above on the economy of Saint Lucia. As it relates to temperature and other climatic variables, a tourism climatic index that captures the elements of climate that impact on a destination’s experience was constructed. The index was calculated using historical observations, as well as those under two, likely, Special Report on Emissions Scenarios (SRES) climate scenarios: A2 and B2.
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The focus of the activities of the Economic Commission for Latin America and the Caribbean/Caribbean Development and Cooperation Committee (ECLAC/CDCC) secretariat during the 2006-2007 biennium continued to be on assistance to member governments of the subregion with policy-making and development strategies, especially on issues relevant to the promotion of the economic, social, and environmental dimensions of development in the Caribbean. The Subregional Headquarters for the Caribbean worked closely with member countries of the CDCC in an effort to ensure the relevance of outputs which would inform policy options. This involved the strengthening of partnerships with both regional and subregional institutions and relevant agencies of the United Nations system working in the Caribbean. A major decision was taken to refocus the operational aspects of the secretariat to ensure that they were relevant to the development goals of its members. This involved the introduction of a thematic approach to the work of the office. One of the changes resulting from this was the restructuring and renaming of the Caribbean Documentation Centre. The Caribbean Knowledge Management Centre (CKMC), as it is now known, has changed its emphasis from organizing and disseminating documents, and is now a more proactive partner in the research undertaken by staff and other users of the service. The CKMC manages the ECLAC website, the public face of the organization. Newsletters and all other documents, including Information and Communications Technology (ICT) profiles of selected countries, prepared by the secretariat, are now available online at the ECLAC/CDCC website www.eclacpos.org . The Caribbean Knowledge Management Portal was launched at a meeting of information specialists in St. Vincent and the Grenadines in 2007. In addition to reaching a wider public, this measure was introduced as a means of reducing the cost of printing or disseminating publications. In spite of the unusually high vacancy rate, at both the international and local levels, during the biennium, the subregional headquarters accomplished 98 per cent of the 119 outputs earmarked for the period. Using vacant positions to carry out the assignments was not an easy task, given the complexity in recruiting qualified and experienced persons for short periods. Nevertheless, consultancy services and short-term replacement staff greatly aided the delivery of these outputs. All the same, 35 work months remained unused during the biennium, leaving 301 work months to complete the outputs. In addition to the unoccupied positions, the work of the subprogramme was severely affected by the rising cost of regional and subregional travel which limited the ability of staff to network and interact with colleagues of member countries. This also hampered the outreach programme carried out mainly through ad hoc expert group meetings. In spite of these shortcomings, the period proved to be successful for the subprogramme as it engaged the attention of member countries in its work either through direct or indirect participation. Staff members completed 36 technical papers plus the reports of the meetings and workshops. A total of 523 persons, representing member countries, participated in the 18 intergovernmental and expert meetings convened by the secretariat in the 24-month period. In its effort to build technical capacity, the subprogramme convened 15 workshops/seminars which offered training for 446 persons.
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China is now facing a sudden change of redistribution of population in space as her urban population exceeds rural population. It seems necessary to learn others’ lessons by analyzing the urbanization of other developing countries, especially Brazil’s. To an extent, Brazil and some other developing countries have been unsuccessful in coordination for urbanization and improving living quality. The megacities in Latin America are the examples of swollen cities, and large groups excluded from the system of public services. It reflects in both short of infrastructures in many areas and high-levels of violence unique in the big cities in Latin America. Then the author summarizes Brazil’s lessons. Firstly, he describes the determinants in Brazil’s urbanization, especially the industrialization between 1930 and 1980. Secondly, the incentives for internal migration are analyzed, especially the industrial centralization in the southeast and the recessions in other areas. Finally, the characteristics of the present round of absorption of labor and the roots for the severe social inequality are discussed.
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The aim of this study was to analyze the relationship between oral diseases and their impact on the daily performance of adult and elderly Brazilians, verify the association of oral diseases with socioeconomic and demographic features, and compare the standard estimate of need with the sociodental assessment of these same needs. The authors evaluated data from 17,398 Brazilians aged between 35-44 years and 65-74 years, taken from the cross-sectional Brazilian Oral Health Survey (Saúde Bucal Brasil - SBBrasil). Regression models were applied to assess associations among impacts on daily performance and income, schooling, gender, region, use of dental services, health perception and dental disease status. McNemar’s test was applied to compare standard versus impact-related estimates of need. The prevalence ratio of these impacts was associated with the sociodemographic versus health perceptions (p < 0.001) of adults and the elderly. Adults also had impacts associated with loss of periodontal attachment (p < 0.001). The prevalence of normative needs was 95.39% for adults and 99.76% for the elderly, whereas the impact-related estimate of need was 50.92% and 43.71%, respectively. The impacted-related approach had a statistically significant association with the normative estimate of need (p < 0.001). This study showed a relationship between oral impact on daily performance of adults and educational level. Sociodemographic features were also related to the impacts on both adults and the elderly, and to health perception. The impacts among the adults were related to the loss of periodontal attachment. In addition, the authors found a sizable difference between the standard versus the sociodental approach, in that the sociodental assessment needs were lower than the needs identified by the standard estimate of need.
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In this article we present the plants used for the treatment of malaria and associated symptoms in Santa Isabel do Rio Negro in the Brazilian Amazon. The region has important biological and cultural diversities including more than twenty indigenous ethnic groups and a strong history in traditional medicine. The aims of this study are to survey information in the Baniwa, Baré, Desana, Piratapuia, Tariana, Tukano, Tuyuca, Yanomami ethnic communities and among caboclos (mixed-ethnicity) on: a) plant species used for the treatment of malaria and associated symptoms; b) dosage forms and c) distribution of these anti-malarial plants in the Amazon. Information was obtained through classical ethnobotanical and ethnopharmacological methods from interviews with 146 informants in Santa Isabel municipality on the upper Negro River, Brazil. Fifty-five mainly native neotropical plant species from 34 families were in use. The detailed uses of these plants were documented. The result was 187 records (64.4%) of plants for the specific treatment of malaria, 51 records (17.5%) of plants used in the treatment of liver problems and 28 records (9.6%) of plants used in the control of fevers associated with malaria. Other uses described were blood fortification ('dar sangue'), headache and prophylaxis. Most of the therapeutic preparations were decoctions and infusions based on stem bark, root bark and leaves. These were administered by mouth. In some cases, remedies were prepared with up to three different plant species. Also, plants were used together with other ingredients such as insects, mammals, gunpowder and milk. This is the first study on the anti-malarial plants from this region of the Amazon. Aspidosperma spp. and Ampelozizyphus amazonicus Ducke were the most cited species in the communities surveyed. These species have experimental proof supporting their anti-malarial efficacy. The dosage of the therapeutic preparations depends on the kind of plant, quantity of plant material available, the patient's age (children and adults) and the local expert. The treatment time varies from a single dose to up to several weeks. Most anti-malarial plants are domesticated or grow spontaneously. They are grown in home gardens, open areas near the communities, clearings and secondary forests, and wild species grow in areas of seasonally flooded wetlands and terra firme (solid ground) forest, in some cases in locations that are hard to access. Traditional knowledge of plants was found to be falling into disuse presumably as a consequence of the local official health services that treat malaria in the communities using commercial drugs. Despite this, some species are used in the prevention of this disease and also in the recovery after using conventional anti-malarial drugs.
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The aim of this study was to investigate the rheological properties and antibacterial efficacy of chitosan/ alpha-hydroxy acids (lactic acid and glycolic acid) and cellulose polymers, both in hydrogels, in order to produce a formulation with improved activity against Propionibacterium acnes and Staphylococcus aureus, which can potentially be used in the treatment of acne. The rheological characterisation of the hydrogels was examined using continuous shear and viscoelastic creep. The antibacterial activities of formulations were performed by the well diffusion and broth microdilution. The hydrogels formulated with only chitosan showed pseudoplastic behavior while the chitosan hydrogels with cellulose polymers presented viscoelastic properties. The antibacterial activity was proportional to AHA and chitosan concentration. It was enhanced at low pH values and with high molecular weight chitosan and did not change with the incorporation of two cellulose polymers. The antibacterial mechanism of chitosan has currently been hypothesized as being related to surface interference. The results show that chitosan - based hydrogels containing AHA and cellulose polymers are viscoelastic,indicating good applicability onto the skin, and they present bacterial activity under various experimental conditions.
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The social networks on the internet have experienced rapid growth and joined millions of users in Brazil and throughout the world. Such networks allow groups of people to communicate and exchange information. Sharing information in files is also a growing activity on the internet and is done in various ways. However, applications are not yet available to enable file sharing on Facebook, the premier social network today. This study aims to investigate how users use Facebook, and their practices for file sharing. Due to the experimental nature of this research, we opted for a data collection survey, applied over the web. From the data analysis, we have found a frequent use of file sharing, but no interest in paid services. As for Facebook, there was an extensive use of applications. The set of results shows a favourable scenario for applications that allow file sharing on Facebook.
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Adolescents are seeking new references and experiences, which may involve attitudes of risk and exposure to accidents and violence from external causes. These events constitute a serious Public Health problem. The scope of this study was to analyze the occurrence of accidents by external causes in adolescents from 10 to 19 years of age attended at sentinel urgency and emergency services in Brazil. Data from the 2009 Surveillance System for Violence and Accidents (VIVA 2009) was analyzed in 74 emergency units in 23 state capitals and the Federal District. The findings revealed that 6,434 adolescents (89.8%) were victims of accidents and 730 (10.2 %) were victims of violence. The main causes of the accidents were falls and traffic accidents, and assaults were predominant in violence. For both accidents and violence, non-white male adolescents were predominant and the events occurred most frequently on the public highways. A marked increase was detected, with hospitalization of victims of violence between 15 and 19 years of age. Understanding the epidemiological reality of external causes among adolescents represents an important tool for health prevention and promotion policies and the culture of peace seeking to reduce morbidity and mortality.
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Abamectin is used as an acaricide and insecticide for fruits, vegetables and ornamental plants, as well as a parasiticide for animals. One of the major problems of applying pesticides to crops is the likelihood of contaminating aquatic ecosystems by drift or runoff. Therefore, toxicity tests in the laboratory are important tools to predict the effects of chemical substances in aquatic ecosystems. The aim of this study was to assess the potential hazards of abamectin to the freshwater biota and consequently the possible losses of ecological services in contaminated water bodies. For this purpose, we identified the toxicity of abamectin on daphnids, insects and fish. Abamectin was highly toxic, with an EC50 48 h for Daphnia similis of 5.1 ng L-1, LC50 96 h for Chironomus xanthus of 2.67 mu g L-1 and LC50 48 h for Danio rerio of 33 mu g L-1. (C) 2011 Elsevier Ltd. All rights reserved.