Chagas disease-related mortality trends, state of Sao Paulo, Brazil, 1985 to 2006: a study using multiple causes of death

Objectives. To study mortality trends related to Chagas disease taking into account all mentions of this cause listed on any line or part of the death certificate. Methods. Mortality data for 1985-2006 were obtained from the multiple cause-of-death database maintained by the Sao Paulo State Data Analysis System (SEADE). Chagas disease was classified as the underlying cause-of-death or as an associated cause-of-death (non-underlying). The total number of times Chagas disease was mentioned on the death certificates was also considered. Results. During this 22-year period, there were 40 002 deaths related to Chagas disease: 34 917 (87.29%) classified as the underlying cause-of-death and 5 085 (12.71%) as an associated cause-of-death. The results show a 56.07% decline in the death rate due to Chagas disease as the underlying cause and a stabilized rate as associated cause. The number of deaths was 44.5% higher among men. The fact that 83.5% of the deaths occurred after 45 years of age reflects a cohort effect. The main causes associated with Chagas disease as the underlying cause-of-death were direct complications due to cardiac involvement, such as conduction disorders, arrhythmias and heart failure. Ischemic heart disease, cerebrovascular disorders and neoplasms were the main underlying causes when Chagas was an associated cause-of-death. Conclusions. For the total mentions to Chagas disease, a 51.34% decline in the death rate was observed, whereas the decline in the number of deaths was only 5.91%, being lower among women and showing a shift of deaths to older age brackets. Using the multiple cause-of-death method contributed to the understanding of the natural history of Chagas disease.

Recent Trends in Maternal, Newborn, and Child Health in Brazil: Progress Toward Millennium Development Goals 4 and 5

We analyzed Brazil`s efforts in reducing child mortality, improving maternal and child health, and reducing socioeconomic and regional inequalities from 1990 through 2007. We compiled and reanalyzed data from several sources, including vital statistics and population-based surveys. We also explored the roles of broad socioeconomic and demographic changes and the introduction of health sector and other reform measures in explaining the improvements observed. Our findings provide compelling evidence that pro-active measures to reduce health disparities accompanied by socioeconomic progress can result in measurable improvements in the health of children and mothers in a relatively short interval. Our analysis of Brazil`s successes and remaining challenges to reach and surpass Millennium Development Goals 4 and 5 can provide important lessons for other low- and middle-income countries. (Am J Public Health. 2010;100:1877-1889. doi:10.2105/AJPH.2010.196816)

Trends in Morbid Obesity and in Bariatric Surgeries Covered by the Brazilian Public Health System

Obesity is an increasingly serious public health problem on a global level. Morbid obesity, defined as a body mass index greater than 40 kg/m(2), is associated with increased mortality and a high burden of obesity-related morbidities. To study the prevalence of morbid obesity in Brazil, three national anthropometric surveys were reanalyzed. Data about bariatric surgeries were obtained from the Ministry of Health Hospital Information System, which is available online. A 255% rise in the prevalence of morbid obesity was observed, starting at 0.18% in 1975-1976 and growing to 0.33% in 1989 and 0.64% in 2002-2003. There was a higher rate in the South in the first two surveys, but the prevalence in the Southeast rose steadily, reaching 0.77% in 2002-2003 and overtaking the South. Since 1999, the Brazilian Unified Health System has covered surgical treatment for morbid obesity. From 2000 to 2006, there was a sixfold increase in the number of surgeries, which topped the 2,500 mark in 2006. The geographic distribution of these surgeries is heavily concentrated in the Southeast, the most developed region of Brazil, where there is also the highest prevalence of morbid obesity. This was followed by the Southern region. The figures for the rise in morbid obesity in Brazil are startling, especially the increase among men. This is a situation that calls for further study, alongside measures to encourage the adoption of healthy lifestyles. Preventive measures aimed at slowing down or reversing the obesity epidemic are urgently required.

Scientific output trends in oral health in Brazil

Objective. To describe dental research trends in Brazil (especially population-based oral health) in the early Twenty-first Century. Methods. The abstracts of studies presented at meetings of the Brazilian Society for Dental Medicine Research (Sociedade Brasileira de Pesquisa Odontologica) from 2001-2006 were assessed in terms of methodological design (aggregate or population-based and individual-based studies, observational and intervention studies, cross-sectional and longitudinal studies); general type (literature review, studies with human subjects, and laboratory studies); and classification into one of the 19 specialty categories recognized by the Brazilian Federal Dentistry Council. Of the 10 406 abstracts presented in this period, 5 203 (50%) were reviewed. Results. Concerning methodological design, 87.5% of the abstracts referred to individual-based studies, whereas 12.5% were of aggregate studies. Concerning the general category, 41.7% referred to studies with human subjects. The remaining abstracts (58.3%) described in vitro (31.1%) or in vivo (23.6%) laboratory research and literature reviews (3.6%). Concerning the Council`s specialty categories, only five had a frequency higher than 10.0%: esthetic dentistry, periodontics, endodontics, pediatric dentistry, and population-based oral health. Conclusions. Brazil`s scientific output in the field of oral health for the period 2001-2006 was balanced, with increasing interest in the area of population-based oral health.

Modelling the secular evolution of migrating planet pairs

The subject of this paper is the secular behaviour of a pair of planets evolving under dissipative forces. In particular, we investigate the case when dissipative forces affect the planetary semimajor axes and the planets move inwards/outwards the central star, in a process known as planet migration. To perform this investigation, we introduce fundamental concepts of conservative and dissipative dynamics of the three-body problem. Based on these concepts, we develop a qualitative model of the secular evolution of the migrating planetary pair. Our approach is based on the analysis of the energy and the orbital angular momentum exchange between the two-planet system and an external medium; thus no specific kind of dissipative forces is invoked. We show that, under the assumption that dissipation is weak and slow, the evolutionary routes of the migrating planets are traced by the Mode I and Mode II stationary solutions of the conservative secular problem. The ultimate convergence and the evolution of the system along one of these secular modes of motion are determined uniquely by the condition that the dissipation rate is sufficiently smaller than the proper secular frequency of the system. We show that it is possible to reassemble the starting configurations and the migration history of the systems on the basis of their final states and consequently to constrain the parameters of the physical processes involved.

Trends on 3d transition metal impurities in diamond

We carried out a first principles investigation on the electronic properties and chemical trends of 3d transition metal related impurities in diamond. In terms of formation energy, the interstitial site is considerably more unfavorable than the substitutional or divacancy ones. Going from Ti to Ni, the 3d-related energy levels in the gap become deeper toward the valence band in all three sites. However, in the divacancy one, those levels cross with the divacancy-related ones, such that the electronic property of the center depends on the character of the highest occupied level. (C) 2009 Elsevier B.A. All rights reserved.

Global perturbation of the marine Ca isotopic composition in the aftermath of the Marinoan global glaciation

Ca isotopic compositions of Marinoan post-glacial carbonate successions in Brazil and NW Canada were measured Both basal dolostones display delta(44/40)Ca values between 1 and 0 7 parts per thousand overlying limestones show a negative Ca isotope excursion to values around 0 1 parts per thousand and delta(44/40)Ca values rapidly increase up-section to near 2 0 parts per thousand In the Brazilian successions those high delta(44/40)Ca values rapidly decrease and stabilize to values between 0 6 and 0 9 parts per thousand These Ca isotope secular variation trends are unlike those of Sturtian post-glacial carbonate successions but similar to those of Marinoan post-glacial carbonate successions in Namibia suggesting that the perturbation of the marine Ca cycle was global This recommends Ca isotope stratigraphy as a tool to correlate Neoproterozoic post-glacial carbonate successions worldwide While the lowermost and uppermost strata have delta(44/40)Ca values typical of Phanerozoic carbonates the extremes 0 1 and 2 0 parts per thousand have not been thus far reported for other marine carbonates These extreme values suggest a short-lived non-actualistic perturbation in the marine Ca cycle Simple box modelling of the Marinoan post-glacial marine Ca cycle can reproduce the extreme values only by postulating a two-step process with Ca input initially exceeding Ca removal trough carbonate precipitation followed by precipitation overtaking a decreased Ca Input (C) 2010 Elsevier B V All rights reserved

A SPATIAL COMPARISON OF SHORT AND LONG TERM MIGRATION TRENDS IN CHINA

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A Spatial Comparison of Short and Long Term Migration Trends in China

China’s floating population, those individuals who have migrated between counties or provinces for a period of longer than 6 months, account for 79 million individuals. If intracounty migration is also included, the number jumps to 145 million individuals or over 11% of the total population. This study examines the geographical differences in short and long term migration using ArcGIS to manipulate the spatial GIS data. The study shows that both short and long term migration (in absolute numbers) occurs more frequently near cities and in coastal regions. However, by normalizing the data by population size, the study eliminates the problems of population size on the size of the migrants. Using this normalized data, the study finds that western and northern counties have a large number of migrants present relative to the size of the population. Determining where this floating population migrates helps explain regional inequalities in employment opportunities.

O processo de formulação do 2. Plano Diretor de Desenvolvimento Urbano Ambiental de Porto Alegre : ruptura, reunião de fragmentos, inovação ou manutenção de uma tradição secular?

O presente estudo descreve o processo de formulação do 2º Plano Diretor de Desenvolvimento Urbano Ambiental de Porto Alegre, mostrando de que maneira, através de conteúdo e método, foram se consolidando as idéias que definem “a cidade do desejo mediada pela cidade do possível”, considerando os discursos e as atividades desenvolvidas, desde o lançamento, em 1993, do Projeto Porto Alegre Mais-Cidade Constituinte, até a entrega à Câmara Municipal, da proposta de plano diretor formalizada pelo Executivo Municipal, em 1997, como resultado de um amplo trabalho participativo, que teve como desafio a construção, de forma compartilhada, de um projeto para o futuro da cidade. As conclusões apresentam através de aspectos selecionados, uma comparação entre o 1º Plano Diretor de Desenvolvimento Urbano, aprovado em 1979 e o novo plano, mostrando as principais diferenças - enfoque e linguagem - entre os discursos de uma e de outra proposta, considerando-se a “Noção de Projeto de Cidade” e a de “Aspectos de Gestão”. Da mesma maneira, respondem, de acordo com o referencial conceitual adotado, se o novo plano faz rupturas, reúne fragmentos, traz inovações ou repete a tradição do último século.