Impact of early fructose intake on metabolic profile and aerobic capacity of rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Brazilian health regions and scales: A geographical perspective

This paper offers a geographical perspective on the way in which health regions have been defined and established in São Paulo as part of overall Brazilian health policy. To accomplish this, I first situate the Brazilian case in the international debate over the regionalization of health services. Second, I examine health regionalization in the case of São Paulo and show how the process is dynamic and complex, involving geographical scales that go well beyond the administrative boundaries of Brazilian municipalities.

Gender differences in predictors of health status in patients with COPD

Objective: To evaluate the health status (HS) of COPD patients and to identify the main predictors of HS in these patients according to gender. Methods: The study included 90 COPD patients (60 males and 30 females; mean age = 64 +/- 9 years) with a wide range of airway obstruction disorders (mean FEV(1) = 56 +/- 19% of predicted). The men were individually matched to the women by % of predicted FEV(1) (ratio: 2:1). The patients were assessed regarding body composition; six-minute walk distance; perception of dyspnea using the Modified Medical Research Council Dyspnea Scale; Saint George's Respiratory Questionnaire (SGRQ); Charlson comorbidity index; and the multidimensional Body mass index, airway Obstruction, Dyspnea, and Exercise capacity (BODE) index. Multiple linear regression analysis was performed to identify the predictors of HS by gender. Results: Impairment of HS was greater among the women than among the men for SGRQ total score and for all SGRQ domains (total: 51 +/- 18% vs. 38 19%; p = 0.002; symptoms: 61 +/- 22% vs. 42 +/- 21%; p < 0.001; activity: 62 +/- 18% vs. 49 +/- 21%; p = 0.004; and impact: 41 +/- 19% vs. 27 +/- 18%; p = 0.001). The multiple linear regression showed that age and perception of dyspnea correlated with SGRQ total score for both genders (males, r(2) = 0.42; females, r(2) = 0.70; p < 0.05). Conclusions: Our results showed an association between gender and HS in COPD patients. Age and dyspnea are determinants of HS in both genders.

Fish Migration, Dams, and Loss of Ecosystem Services in the Mekong Basin

The past decade has seen increased international recognition of the importance of the services provided by natural ecosystems. It is unclear however whether such international awareness will lead to improved environmental management in many regions. We explore this issue by examining the specific case of fish migration and dams on the Mekong river. We determine that dams on the Mekong mainstem and major tributaries will have a major impact on the basin's fisheries and the people who depend upon them for food and income. We find no evidence that current moves towards dam construction will stop, and consider two scenarios for the future of the fisheries and other ecosystems of the basin. We conclude that major investment is required in innovative technology to reduce the loss of ecosystem services, and alternative livelihood strategies to cope with the losses that do occur.

Methodological contributions towards the study of health care production: lessons from a research study on barriers and access in mental health

This article presents methodological contributions and a conceptual innovation for thinking about the production of health care, stemming from a study on access and barriers in mental health carried out in the municipality of Campinas (São Paulo, Brazil). The study used a cartographic approach and, after an initial identification of the most complex cases (on the part of the teams of workers), adopted the users as guides to explore the different levels of production of their lives and to evaluate the possibility of forming a network of existential connections that produce life as a fundamental analyzer of access or barriers to care.

Testing the resolving power of two-dimensional K+K+ interferometry

We show results from an analysis performed to test the resolving power of a two-dimensional χ2 method proposed previously when applied to the case of kaon interferometry, where no significant contribution from long-lived resonances is expected. For that purpose, use is made of the preliminary E859 K+K+ interferometry data from Si+Au collisions at 14.6/4 GeV/c. Although less sensitivity is achieved in the present case, this analysis seems to favor scenarios with no resonance formation at the AGS energy range. The possible compatibility of data with zero decoupling proper time interval, conjectured by the three-dimensional experimental analysis, is also investigated and is ruled out when considering more realistic dynamical models with expanding sources. Furthermore, these results strongly emphasize that the static Gaussian parametrization cannot be trusted under more realistic conditions, leading to a distorted or even wrong interpretation of the source parameters.

Contribution of energy services to the Millennium Development Goals and to poverty alleviation in Latin America and the Caribbean: executive summary

Includes bibliography

Contribution of energy services to the millennium development goals and to poverty alleviation in Latin America and the Caribbean

Includes bibliography

A comparative study of health care policy in the United States and Canada: what policymakers in Latin America might and might not learn from their neighbors to the North

Includes bibliography

Potential and limits of health management reform in Chile

Includes bibliography

Production structure of the services sector in countries at different development levels

Includes bibliography

Population, ageing and development

Includes bibliography

A study on the capacity of statistical offices of the Caribbean to produce Environment, Social, Economic and Gender Statistics

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.

eHealth handbook for managers of healthcare services and systems

Prefacio de Alicia Bárcena y Luciano Sáez