Mortalidade fetal e infantil na cidade de Surubim, Pernambuco

Enquadramento: Com a redução global da mortalidade infantil no Brasil, o componente perinatal passou a exercer maior influência neste indicador, sendo necessário, portanto, um maior enfoque nas análises dessa componente. Objectivo: Levantar o perfil da mortalidade infantil e fetal e a evitabilidade destes óbitos, no município de Surubim, Pernambuco, no período de Junho de 2011 a Dezembro de 2014. Métodos: Estudo retrospectivo com enfoque descritivo, cuja a amostra foi de 56 óbitos investigados com base em 53 Fichas de Investigação da Secretaria de Saúde de Surubim. Este número corresponde a 66,66% dos casos entre 2011 e 2014 em fetos e menores de um ano, residentes de Surubim, Pernambuco. Utilizados como fontes de dados, os Bancos do Sistema de Informações sobre Mortalidade (SIM) e o Sistema de Informações sobre Nascidos Vivos (SINASC) do Ministério da Saúde (DATASUS), ambos com boa cobertura e qualidade satisfatória das informações, e Fichas usadas pelo Grupo Técnico de Investigação do Óbito do Município. Resultados: Em 2011, 23 óbitos (11 fetais e 12 infantis), 07 investigados, 1 fetal e 6 infantis; em 2012, 26 óbitos (12 fetais e 14 infantis), 23 investigados, 9 fetais e 14 infantis; em 2013, 17 óbitos (11 fetais e 6 infantis), 14 investigados, 9 fetais e 5 infantis; e em 2014, 19 óbitos (7 fetais e 12 infantis), 12 investigados, 4 fetais e 8 infantis. A Taxa de Mortalidade Infantil e Fetal para o período foi de 13,8/1000nv e 12,6/1000nv(2011), 15/1000nv e 13/1000nv(2012), 7/1000nv e 12,7/1000nv(2013),13/1000nv e 8/1000nv(2014)nv. 60,61% dos óbitos fetais e 91,3% dos óbitos infantis foram por causas evitáveis. Inconclusivos 06, não evitáveis 02 fetais e 07 Infantis. Conclusão:Consideram-se necessárias mudanças no processo de trabalho da equipe de saúde, capacitação da equipe multidisciplinar na perspectiva de trabalho colaborativo de maior equidade e efetividade clínica de forma a dotar a assistência à mulher fértil, à mulher grávida, à puérpera,ao feto e ao recém-nascido,com vistas à redução da mortalidade infantil e neonatal precoce por causas evitáveis. Palavras-chave: mortalidade infantil, mortalidade neonatal precoce, evitabilidade.

HIV infection, viral hepatitis and liver fibrosis among prison inmates in West Africa.

BACKGROUND Prisoners represent a vulnerable population for blood-borne and sexually transmitted infections which can potentially lead to liver fibrosis and ultimately cirrhosis. However, little is known about the prevalence of liver fibrosis and associated risk factors among inmates in sub-Saharan Africa. METHODS Screening of liver fibrosis was undertaken in a randomly selected sample of male inmates incarcerated in Lome, Togo and in Dakar, Senegal using transient elastography. A liver stiffness measurement ≥9.5 KPa was retained to define the presence of a severe liver fibrosis. All included inmates were also screened for HIV, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infection. Substances abuse including alcohol, tobacco and cannabis use were assessed during face-to-face interviews. Odds Ratio (OR) estimates were computed with their 95 % Confidence Interval (CI) to identify factors associated with severe liver fibrosis. RESULTS Overall, 680 inmates were included with a median age of 30 years [interquartile range: 24-35]. The prevalence of severe fibrosis was 3.1 % (4.9 % in Lome and 1.2 % in Dakar). Infections with HIV, HBV and HCV were identified in 2.6 %, 12.5 % and 0.5 % of inmates, respectively. Factors associated with a severe liver fibrosis were HIV infection (OR = 7.6; CI 1.8-32.1), HBV infection (OR = 4.8; CI 1.8-12.8), HCV infection (OR = 52.6; CI 4.1-673.8), use of traditional medicines (OR = 3.7; CI 1.4-10.1) and being incarcerated in Lome (OR = 3.3; CI 1.1-9.8) compared to Dakar. CONCLUSIONS HIV infection and viral hepatitis infections were identified as important and independent determinants of severe liver fibrosis. While access to active antiviral therapies against HIV and viral hepatitis expands in Africa, adapted strategies for the monitoring of liver disease need to be explored, especially in vulnerable populations such as inmates.

Innovation and Development in the Age of Climate Change Adaptation: Open or Closed?

Change Adaptation: Open or Closed? Paper read at the Second African International Economic Law Network Conference, 7-8 March 2013, Wits School of Law, Johannesburg, South Africa. In a time of rapid convergence of technologies, goods, services, hardware, software, the traditional classifications that informed past treaties fail to remove legal uncertainty, or advance welfare and innovation. As a result, we turn our attention to the role and needs of the public domain at the interface of existing intellectual property rights and new modes of creation, production and distribution of goods and services. The concept of open culture would have it that knowledge should be spread freely and its growth should come from further developing existing works on the basis of sharing and collaboration without the shackles of intellectual property. Intellectual property clauses find their way into regional, multilateral, bilateral and free trade agreements more often than not, and can cause public discontent and incite unrest. Many of these intellectual property clauses raise the bar on protection beyond the clauses found in the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). In this paper we address the question of the protection and development of the public domain in service of open innovation in accord with Article 15 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) in light of the Objectives (Article 7) and Principles (Article 8) set forth in TRIPS. Once areas of divergence and reinforcement between the intellectual property regime and human rights have been discussed, we will enter into options that allow for innovation and prosperity in the global south. We then conclude by discussing possible policy developments.

Magnetic charachterization of surface sediments in the South Atlantic

Surface sediment samples representative for the tropical and subtropical South Atlantic (15°N to 40°S) were investigated by isothermal magnetic methods to delineate magnetic mineral distribution patterns and to identify their predominant Holocene climatic and oceanographic controls. Individual parameters reveal distinct, yet frequently overlapping, regional sedimentation characteristics. A probabilistic ('fuzzy c-means') cluster analysis was applied to five concentration independent magnetic properties assessing magnetite to hematite ratios and diagnostic of bulk and fine-particle magnetite grain size and coercivity spectra. The resultant 10 cluster structures establish an oceanwide magnetic sediment classification scheme tracing the major terrigenous eolian and fluvial fluxes, authigenic biogenic magnetite accumulation in high-productivity areas, transport by ocean current systems, and effects of bottom water velocity on depositional regimes. Distinct dissimilarities in magnetic mineral inventories between the eastern and western basins of the South Atlantic reflect prominent contrasts of both oceanic and continental influences.

Organic geochemistry on surface sediments from the Laptev Sea

Sediment samples from the Laptev Sea, taken during the 1993 RV Polarstern expedition ARK IX/4 and the RV Ivan Kireyev expedition TRANSDRIFT I, were investigated for the amount and composition of their organic carbon fractions. Of major interest was the identification of different processes controlling organic carbon deposition (i.e. terrigenous supply vs. surface water productivity). Long-chain unsaturated alkenones derived from prymnesiophytes, and fatty acids derived from diatoms and dinoflagellates, were analysed by means of gas chromatography and mass spectrometry. First results on the distribution of these biomarkers in surface sediments indicate that the surface water productivity signal is well preserved in the sediment data. This is shown by the distribution of the 16:1(n-7) and 20:5(n-3) fatty acids indicative for diatoms, and the excellent correlation with the chlorophyll a concentrations in the surface water masses and the biogenic-opal content and increased hydrogen indices of the sediments. The high concentration of these unsaturated fatty acids in shallow water sediments shows the recent deposition of the organic material. In deep-sea sediments, on the other hand, the concentrations are low. This decreased content is typical for phytoplankton material which has been degraded by microorganisms or autoxidation. In general, the alkenone concentrations are very low, suggesting low production rates by prymnesiophytes. Only at one station from the lower continental margin influenced by the inflow of Atlantic water masses, were some higher amounts of alkenones determined. Long-chain n-alkanes as well as high C/N ratios and low hydrogen indices indicate the importance of (fluvial) supply of terrigenous organic matter.

Macerals in surface sediments of the Laptev Sea (Arctic Ocean)

Surface sediments from the Laptev Sea and adjacent continental slope were studied for their composition of particulate organic matter (OM) by means of maceral analysis. The composition of macerals in sediments gives information about the environment, terrigenous supply from the hinterland, and marine OM. With reference to their biological sources, we distinguish between terrigenous and marine macerals. We found that the particulate OM in the surface sediments of the Laptev Sea is predominantly of terrigenous origin (mean: 78%). However, distinct variations exist when looking in detail. In the shelf area, sediments may contain up to 99% terrigenous OM. Freshwater algae occur directly north of the river mouths, reflecting the strong fluvial influence. Relatively high amounts of marine OM (20-40%) are restricted to the upper continental slope, the Vilkitsky Strait and west of the New Siberian Islands, explained by increased surface-water productivity due to increased fluvial nutrient supply, open-water conditions, and phytoplankton blooms at the ice-edge.

Data compilation of ESOP

The work in this sub-project of ESOP focuses on the advective and convective transforma-tion of water masses in the Greenland Sea and its neighbouring areas. It includes observational work on the sub-mesoscale and analysis of hydrographic data up to the gyre-scale. Observations of active convective plumes were made with a towed chain equipped with up to 80 CTD sensors, giving a horizontal and vertical resolution of the hydrographic fields of a few metres. The observed scales of the penetrative convective plumes compare well with those given by theory. On the mesoscale the structure of homogeneous eddies formed as a result of deep convection was observed and the associated mixing and renewal of the intermediate layers quantified. The relative importance and efficiency of thermal and haline penetrative convection in relation to the surface boundary conditions (heat and salt fluxes and ice cover) and the ambient stratification are studied using the multi year time series of hydro-graphic data in the central Greenland Sea. The modification of the water column of the Greenland Sea gyre through advection from and mixing with water at its rim is assessed on longer time scales. The relative contributions are quantified using modern water mass analysis methods based on inverse techniques. Likewise the convective renewal and the spreading of the Arctic Intermediate Water from its formation area is quantified. The aim is to budget the heat and salt content of the water column, in particular of the low salinity surface layer, and to relate its seasonal and interannual variability to the lateral fluxes and the fluxes at the air-sea-ice interface. This will allow to estimate residence times for the different layers of the Greenland Sea gyre, a quantity important for the description of the Polar Ocean carbon cycle.