Economic and environmental impacts of pollution control in a system of environment and economic interdependence

The importance of the rate of change of the pollution stock in determining the damage to the environment has been an issue of increasing concern in the literature. This paper uses a three-sector (economy, population and environment), non-linear, discrete time, calibrated model to examine pollution control. The model explicitly links economic growth to the health of the environment. The stock of natural resources is affected by the rate of pollution flows, through their impact on the regenerative capacity of the natural resource stock. This can shed useful insights into pollution control strategies, particularly in developing countries where environmental resources are crucial for production in many sectors of the economy. Simulation exercises suggested that, under plausible assumptions, it is possible to reverse undesirable transient dynamics through pollution control expenditure, but this is dependent upon the strategies used for control. The best strategy is to spend money fostering the development of production technologies that reduce pollution rather than spending money dealing with the effects of the pollution flow into the environment. (C) 2001 Elsevier Science Ltd. All rights reserved.

GH treatment in adults with chronic liver disease: A randomized, double-blind, placebo-controlled, cross-over study

Patients with chronic liver disease (CLD) are catabolic and GH-resistant. The effects of supraphysiological recombinant human GH (rhGH; 0.2 IU.kg(-1).d(-1)) treatment in adults with CLD were assessed in a randomized, double-blind, placebo-controlled cross-over trial (4-wk dietary run-in, 4-wk treatment, and 2-wk wash-out phases). Nine adults with mild- to moderate-severity CLD participated (median age, 49 yr; three males and six females; Child's classification A in six and B in three). Biopsy-proven etiologies were: alcohol (four patients), primary biliary cirrhosis (three patients), non-A, non-B, non-C hepatitis (one patient), and cryptogenic (one patient). Treatment with rhGH increased serum IGF-I (median increase over placebo, +93 mug.liter(-1); P = 0.004), IGF-binding protein-3 (+0.9 mg.liter(-1): P = 0.004), and acid labile subunit (+10.7 nM; P = 0.004). Total body potassium (+8.0 g; P = 0.023), body weight (+1.6 kg; P = 0.008), and total body water (by bioelectrical impedance; +4.9 kg; P = 0.004) increased. Resting metabolic rate (+313 ml.kg(-1).min(-1); P = 0.004) and lipid oxidation (+1072.0 kcal.d(-1); P = 0.032) increased. Metabolic changes included increased fasting plasma glucose (+1.2 mm; P = 0.008), insulin (+33.8 mU.liter(-1); P = 0.004), C-peptide (+0.7 nM; P = 0.004), and free-fatty acids (+0.1 mEq.liter(-1); P = 0.04). Clinical side effects included worsening edema and ascites. Hepatocellular function did not change. Therefore, rbGH treatment in CLD: 1) overcame hepatic GH resistance; 2) may have improved whole-body protein catabolism; 3) increased lipolysis and lipid oxidation; 4) increased insulin resistance; and 5) had potent antinatriuretic effects. Long-term safety and efficacy require further assessment.

Food Cent$: Educating mothers with a mental illness about nutrition

People with a mental illness can have deficits in a range of areas, including food skills. Mothers who have a mental illness and have residential care of their children are particularly vulnerable to experiencing food insecurity. The food skills programme known as Food Cent$ is a new way of spending money on food using the 10-plan, so that people can learn to balance their diet and their food budget. Occupational therapists in a mental health rehabilitation service incorporated the use of Food Cent$ into a parenting programme for mothers with a mental illness. A pilot study was conducted to identify whether the Food Cent$ programme influenced behaviours and attitudes towards food and food selection and preparation and reduced grocery expenditure. The participants were six mothers with a mental illness who had children under 5 years of age in their care. A focus group was conducted to gain insight into the experiences of mothers who had attended the programme. Supermarket receipts were collected before and after the project to determine changes in dietary practices. The results indicated that attending Food Cent$ contributed to an improvement in dietary intake, food selection and preparation, and grocery expenditure. Further research is required into the effectiveness of this programme with other target groups likely to experience food insecurity.

Evaluation of cyclooxygenase 2 inhibitor use in patients admitted to a large teaching hospital

Background: The heavy usage of coxibs in Australia far outstrips the predicted usage that was based on the treatment of patients with risk factors for upper gastro-intestinal adverse events from conventional anti--inflammatory agents. This raises questions regarding the appropriateness of prescribing. Aims: To determine: (i) the relationship between prescriptions for cyclooxygenase 2 (COX-2) inhibitors and objective evidence of inflammatory arthritis, (ii) prior experience with paracetamol and/or conventional non-steroidal anti-inflammatory drugs (NSAIDs), and (iii) contraindications to the use of NSAIDs. Methods: Drug utilization evaluation and rheumato-logical assessment was conducted on 70 consecutive patients admitted on COX-2 inhibitors to a 480-bed metropolitan hospital. The main outcome measures were: the indication for COX-2 inhibitor; objective -evidence of inflammatory arthritis; previous trial of -paracetamol or conventional NSAIDs; and patient -satisfaction. Results: Only 11 patients (16%) had symptoms or signs of an inflammatory arthropathy, and met Pharmaceut-ical Benefits Schedule criteria for prescribing a COX-2 inhibitor. Fifty-nine patients (84%) had chronic osteo-arthritis, degenerative spinal disease, injury or malignancy, without overt active inflammation. Fourteen patients (20%) had trialled regular paracetamol prior to using any NSAID treatment. Conventional NSAIDs had been previously used by 51 patients (73%). Eleven patients (16%) reported previous adverse gastrointestinal effects from conventional NSAIDs. On the basis of significant renal impairment (creatinine clearance 5/10). Conclusions: Drug utilization data indicate that COX-2 inhibitors are frequently used first line for degenerative osteoarthritis in the absence of overt inflammation, without prior adequate trial of paracetamol and with disregard for the cautions and contraindications of these agents. These findings may explain the unprecedented Pharmaceutical Benefits Schedule expenditure on COX-2 inhibitors in Australia.

The peroxisome proliferator-activated receptor beta/delta agonist, GW501516, regulates the expression of genes involved in lipid catabolism and energy uncoupling in skeletal muscle cells

Lipid homeostasis is controlled by the peroxisome proliferator-activated receptors (PPARalpha, -beta/delta, and -gamma) that function as fatty acid-dependent DNA-binding proteins that regulate lipid metabolism. In vitro and in vivo genetic and pharmacological studies have demonstrated PPARalpha regulates lipid catabolism. In contrast, PPARgamma regulates the conflicting process of lipid storage. However, relatively little is known about PPARbeta/delta in the context of target tissues, target genes, lipid homeostasis, and functional overlap with PPARalpha and -gamma. PPARbeta/delta, a very low-density lipoprotein sensor, is abundantly expressed in skeletal muscle, a major mass peripheral tissue that accounts for approximately 40% of total body weight. Skeletal muscle is a metabolically active tissue, and a primary site of glucose metabolism, fatty acid oxidation, and cholesterol efflux. Consequently, it has a significant role in insulin sensitivity, the blood-lipid profile, and lipid homeostasis. Surprisingly, the role of PPARbeta/delta in skeletal muscle has not been investigated. We utilize selective PPARalpha, -beta/delta, -gamma, and liver X receptor agonists in skeletal muscle cells to understand the functional role of PPARbeta/delta, and the complementary and/or contrasting roles of PPARs in this major mass peripheral tissue. Activation of PPARbeta/delta by GW501516 in skeletal muscle cells induces the expression of genes involved in preferential lipid utilization, beta-oxidation, cholesterol efflux, and energy uncoupling. Furthermore, we show that treatment of muscle cells with GW501516 increases apolipoprotein-A1 specific efflux of intracellular cholesterol, thus identifying this tissue as an important target of PPARbeta/delta agonists. Interestingly, fenofibrate induces genes involved in fructose uptake, and glycogen formation. In contrast, rosiglitazone-mediated activation of PPARgamma induces gene expression associated with glucose uptake, fatty acid synthesis, and lipid storage. Furthermore, we show that the PPAR-dependent reporter in the muscle carnitine palmitoyltransferase-1 promoter is directly regulated by PPARbeta/delta, and not PPARalpha in skeletal muscle cells in a PPARgamma coactivator-1-dependent manner. This study demonstrates that PPARs have distinct roles in skeletal muscle cells with respect to the regulation of lipid, carbohydrate, and energy homeostasis. Moreover, we surmise that PPARgamma/delta agonists would increase fatty acid catabolism, cholesterol efflux, and energy expenditure in muscle, and speculate selective activators of PPARbeta/delta may have therapeutic utility in the treatment of hyperlipidemia, atherosclerosis, and obesity.

Los desaf??os de las pol??ticas y la gesti??n social en Am??rica Latina

La pobreza est?? aumentando en t??rminos absolutos de manera sistem??tica desde 1990 y, desde comienzos del nuevo siglo, tambi??n en valores relativos. Hay, sin embargo, una buena nueva: el gasto p??blico social ha aumentado tambi??n de manera sistem??tica desde entonces. ??Qu?? se ha hecho con la enorme magnitud de recursos destinada a financiar las pol??ticas sociales? Hay, por un lado, limitaciones que surgen de la forma en que ellas se dise??an e implementan. La gesti??n social tradicional asume que el impacto perseguido se producir?? autom??ticamente como resultado de la mera entrega de los bienes o servicios a la poblaci??n destinataria. Aparece, adem??s, la masiva introducci??n de mecanismos de mercado en las pol??ticas sociales, bajo el supuesto que permitir??an mejorar su eficiencia e impacto. Teniendo en cuenta las limitaciones precedentes, se sugieren en este art??culo tres senderos, estos son: la superaci??n del estilo tradicional de gestionar los programas y proyectos sociales; el aprendizaje por medio de la experiencia de la evaluaci??n de impacto y del monitoreo; y la generaci??n de un estilo m??s participativo en el proceso de dise??o, gesti??n y evaluaci??n de las pol??ticas sociales.

A qualidade do gasto p??blico e a avalia????o das pol??ticas sociais: o or??amento do Minist??rio do Trabalho no per??odo 2000-2006

Nos ??ltimos anos, o debate sobre a melhoria da qualidade do gasto p??blico tem ganhado espa??o crescente. As quest??es mais gerais do tema s??o relevantes, mas n??o substituem o exame espec??fico dos gastos sociais dos diversos minist??rios ??? raz??o pela qual a avalia????o das pol??ticas p??blicas ?? instrumento fundamental para melhoria do gasto. O trabalho corrente faz uma avalia????o da din??mica or??ament??ria das pol??ticas do Minist??rio do Trabalho e Emprego. Essa an??lise revela um crescente desequil??brio: enquanto o valor destinado ??s pol??ticas passivas de emprego aumentou brutalmente, os valores destinados ??s pol??ticas ativas de emprego ca??ram significativamente. Esse cen??rio ??? oposto ao que seria desej??vel ??? ?? ainda mais preocupante na medida em que as pol??ticas passivas de emprego n??o beneficiam os mais pobres. Neste contexto, o trabalho avalia a possibilidade de que parte dos recursos reservados para pol??ticas passivas seja dirigido ??s pol??ticas ativas de emprego.

Vantagens e desvantagens do preg??o na gest??o de compras no setor p??blico: o caso da Funasa/PB

O presente artigo ?? parte de um estudo explorat??rio cujo objetivo foi analisar as vantagens e desvantagens na aquisi????o de bens e servi??os por meio das modalidades de licita????o preg??o presencial e eletr??nico no servi??o p??blico. Para isso, foi realizado um estudo de caso na Funda????o Nacional de Sa??de da Para??ba. A parte da pesquisa divulgada neste artigo, al??m de uma s??ntese sobre o referencial te??rico, apresenta as caracter??sticas investigadas da modalidade de licita????o preg??o, comparando suas formas presencial e eletr??nica na institui????o estudada. Os resultados apontam aspectos relevantes quanto ??s quest??es: vantagens e desvantagens do preg??o eletr??nico em rela????o ao preg??o presencial e vice-versa; recursos para atendimento de despesas; planejamento anual da FUNASA/PB; economia de pre??o; economia e repasse de recursos para outras necessidades; prazos de fornecimento; treinamento e capacita????o de pessoal. Conclui a exposi????o destacando alguns pontos fortes e fracos do processo, sugerindo medidas a serem avaliadas no que tange a capacita????o de pessoal e planejamento anual na FUNASA/PB.

Temas e quest??es sobre a gest??o da despesa p??blica

O presente texto tem por escopo a avalia????o da gest??o da despesa p??blica, num contexto de mudan??as inseridas por novas t??cnicas gerenciais, provocando uma amplia????o do conceito de gest??o da despesa, que, al??m de se preocupar com sistemas e t??cnicas operacionais, teria tamb??m sua aten????o voltada para os resultados e a satisfa????o do cliente. A transforma????o gerada pelo pacote emplementador da reforma ?? avaliada, partindo de uma simula????o em que as reformas seriam consideradas completamente instaladas, com o objetivo de ressaltar suas totais implica????es num contexto futuro. Elege-se o ano de 2020, como um marco, para levantar quest??es cruciais do referido pacote, abordando elementos que poderiam favorecer melhores resultados.

Or??amento orientado a resultados: instrumento de fortalecimento democr??tico na Am??rica Latina?

O presente artigo discute a rela????o entre or??amento e democracia, argumentando que as transforma????es propugnadas pela or??amenta????o por resultados possuem n??o somente benef??cios gerenciais para a administra????o p??blica, mas tamb??m efeitos positivos sobre o sistema pol??tico e suas institui????es. Dados emp??ricos demonstram que os padr??es de confian??a institucional na Am??rica Latina s??o baixos, apesar de a confian??a no regime democr??tico ser significativamente maior. A implanta????o do modelo de or??amento orientado a resultados (OOR) representa ruptura com o paradigma tradicional de gest??o p??blica, propondo a substitui????o do foco nos insumos, controles, regulamentos e conformidade pela ??nfase na a????o estrat??gica, efetividade do gasto p??blico, flexibilidade gerencial, accountability e participa????o da sociedade. A formula????o de pol??ticas p??blicas orientadas para as necessidades dos cidad??os fomenta o capital social da comunidade, alavancando rela????es sin??rgicas entre governo e sociedade. Esse estreitamento fortalece as institui????es democr??ticas na medida em que favorece o monitoramento do desempenho do governante pela sua comunidade e, especialmente, contribui para aprimorar os mecanismos de representa????o pol??tica.

An outline of military technological dynamics as restraints for acquisition, international cooperation and domestic technological development

The expectation that technological returns from defense expenditure through acquisition, international cooperation and domestic research would further national development underappreciates the different technological dynamic of the armed services. This paper outlines the technological dynamic the stems from fighting in the air, at sea and on land, exemplifying consequences for the case of acquisition.

Inv(f)erno da Universidade de Verão

Despesa em educação é investimento constitucional: art.s 75º e 76º da Constituição. Como referiu o director da Revista Ensino Superior, nº 53, pp. 4-5, ex-presidente do Sindicato Nacional do Ensino Superior, Professor da Faculdade de Economia da Universidade de Coimbra, Doutor Paulo Peixoto, o ensino superior tornou-se em grande parte uma “máquina de triturar intelectuais”. A tentativa de impor uma mentalidade única pode provocar a destruição da génese da própria universalidade. § Spending on education is constitutional investment: Articles 75 and 76 of the Constitution. As the director of the Journal of Higher Education, # 53, pp. 4-5, former president of the National Union of Higher Education, Professor of Economics, University of Coimbra, Dr. Paulo Peixoto, higher education has become largely an 'intellectual grinding machine. "The attempt to impose a single mindset may cause the destruction of the very universality genesis.

Consumo energético e eficiência da marcha com dois modelos de joelhos protésicos: estudo de caso

Introdução – Os componentes protésicos têm um papel fundamental na eficiência energética da marcha dos indivíduos amputados. Esta é uma área de conhecimento ainda em desenvolvimento, onde a investigação desempenha um papel central. Objectivos – Comparar e analisar o efeito de dois joelhos protésicos, 3R34, monocêntrico modular, de fricção constante, com auxiliar de extensão incorporado (A) e 3R92, monocêntrico modular, com travão de fricção e controlo pneumático da fase de balanço (B) no consumo energético e eficiência da marcha. Metodologia – Um indivíduo do sexo masculino de 27 anos, com amputação transfemural longa, foi sujeito a um protocolo submáximo de avaliação da resposta ao exercício em passadeira rolante (H/P/Cosmos(R) Mercury), através de um sistema de análise de gases breath‑by‑breath (Cosmed Quark PFT Ergo). Foi efetuado o mesmo protocolo com intervalo de dois dias, primeiro utilizando o joelho A e depois o B. As variáveis analisadas foram o consumo de O2 (VO2), o equivalente metabólico (MET) e a eficiência energética da marcha (Quociente de VO2 esperado de um individuo saudável e o VO2 do individuo em estudo). O esforço percecionado foi medido com a escala RPE de Borg. Resultados – O consumo energético com o joelho A (24,2 ml O2/kg/min; 6,9 MET) foi inferior ao obtido com o joelho B (28,68 ml O2/kg/min; 8,2 MET). A eficiência energética da marcha foi mais elevada para o joelho A (43%) do que para o joelho B (39%). Conclusão – A utilização do joelho A na prótese do indivíduo em estudo resulta numa marcha de menor consumo energético e maior eficiência. No entanto, este valor poderá estar influenciado pelo curto período de adaptação ao joelho B, sendo necessários mais estudos para confirmar os resultados do estudo e a influência deste fator. ABSTRACT - Background – Prosthetic components have a crucial role in the energy efficiency of amputee’s gait. This is an area of knowledge still in development, where research plays a central role. Objective – The purpose of this case study is to compare the impact in energy consumption of two prosthetic knees, titanium single‑axis constant friction knee joint with internal extension assist, 3R34 (A) and a single‑axis pneumatic swing phase control, 3R92 (B). Methodology – The participant was a transtibial amputee, male, with 27 years old, with no other clinical or functional impairments. To measure the energy expenditure a submaximal treadmill (H/P/Cosmos(R) Mercury) exercise stress test combined with a breath‑by‑breath analysis system (Cosmed Quark PFT Ergo) was used. The same test was applied to both knees, separated by two days. The analyzed variables were O2 consumption (VO2), metabolic equivalent (MET) and gait efficiency (VO2 ratio expected from a healthy individual and the studied individual). A rate of perceived exertion (Borg’s Scale) was used. Results – The results were favorable to knee A (24.2 ml O2/kg/min; 6.9 MET, 43% efficiency) compared with knee B (28.68 ml O2/kg/min; 8.2 MET, 39% efficiency). Conclusion – In this case, a less energy consumption gait corresponds to the prosthesis with knee A. These values may be influenced by the short adaptation period with knee B, so it’s necessary to perform more studies to confirm the previous results and to understand the truly impact of correct adaptation factor to the best prosthetics components for different patients.

O modelo transteórico de mudança de comportamentos na promoção da actividade física nas grávidas

Os hábitos de actividade física (AF) podem-se alterar consideravelmente durante a gravidez. O sucesso das estratégias que visam promover a AF das gestantes depende do modelo motivacional implementado. Objectivo: Determinar se o Modelo Transteórico de Mudança de Comportamento (MTMC) utilizado no Projecto “Mães em Movimento” é eficaz na promoção de mudança de comportamentos nas grávidas no sentido de aumentar os níveis de AF. Metodologia: Foi realizado um estudo, experimental do tipo Intervenção Comunitária, numa amostra consecutiva constituída por 20 grávidas que faziam Preparação para a Parentalidade (PP) em dois Centros de Saúde. O grupo experimental, constituído por 10 grávidas, além da preparação, participou no projecto “Mães em Movimento” baseado no MTMC. O grupo de controlo seguiu o programa de PP. Os instrumentos utilizados para 1ª avaliação foram: o Questionário de Actividade Física para Gestantes, a Escala de Estados de Mudança de Comportamento para o Exercício, o Questionário de Auto-Eficácia, o Behavioural Regulation in Exercise Questionnaire-2 e um Questionário de Hábitos e Conhecimentos. Resultados: Após a implementação do projecto “Mães em Movimento” no grupo experimental, 100% das mulheres referiram praticar AF regular. O gasto energético semanal em actividades desportivas/exercício aumentou aproximadamente 4 vezes (p=0,002) desde a 1ª avaliação até à 2ª avaliação. Verificou-se uma tendência de deslocação dos estadios de mudança de comportamento inactivos para os activos (p=0,007) e a motivação intrínseca aumentou significativamente (p=0,018). Observou-se, também, um aumento dos conhecimentos relativos a diversas dimensões da AF na gravidez (p=0,002). Conclusão: Neste estudo, o MTMC revelou-se um modelo eficaz na promoção de hábitos de AF em grávidas, realçando que o sucesso da mudança de comportamento é influenciado pela motivação individual, pelo empowerment (transferência de conhecimentos e competências) e pelas oportunidades criadas.

Analysis of ground reaction force and electromyographic activity of the gastrocnemius muscle during double support

O documento em anexo encontra-se na versão post-print (versão corrigida pelo editor).