947 resultados para Camberwell Assessment of Need
Resumo:
Preface This study was prepared for the Government of Jamaica following the significant physical damage and economic losses that the country sustained as a result of flood rains associated with the development of Hurricane Michelle. The Planning Institute of Jamaica (PIOJ) submitted a request for assistance in undertaking a social, environmental and economic impact assessment to the Economic Commission for Latin America and the Caribbean (ECLAC) on 14 November 2001. ECLAC responded with haste and modified its work plan to accommodate the request. A request for training in the use of the ECLAC Methodology to be delivered to personnel in Jamaica was deferred until the first quarter of 2002, as it was impossible to mount such an initiative at such short notice. This appraisal considers the consequences of the three instances of heavy rainfall that brought on the severe flooding and loss of property and livelihoods. The study was prepared by three members of the ECLAC Natural Disaster Damage Assessment Team over a period of one week in order to comply with the request that it be presented to the Prime Minister on 3 December 2001. The team has endeavoured to complete a workload that would take two weeks with a team of 15 members working assiduously with data already prepared in preliminary form by the national emergency stakeholders. There is need for training in disaster assessment as evidenced by the data collected by the Jamaican officials engaged in the exercise. Their efforts in the future will be more focused and productive after they have received training in the use of the ECLAC Methodology. This study undertakes a sectoral analysis leading to an overall assessment of the damage. It appraises the macroeconomic and social effects and proposes some guidelines for action including mitigating actions subsequent to the devastation caused by the weather system. The team is grateful for the efforts of the Office of Disaster Preparedness and Emergency Management (ODPEM), the associated government ministries and agencies, the Statistical Institute of Jamaica (STATIN), the Planning Institute of Jamaica and the Inter American Development Bank (IDB) for assistance rendered to the team. Indeed, it is the recommendation of the team that STATIN is poised to play a pivotal role in any disaster damage assessment and should be taken on board in that regard. The direct and indirect damages have been assessed in accordance with the methodology developed by ECLAC (1). The results presented are based on the mission's estimates. The study incorporates the information made available to the team and evidence collected in interviews and visits to affected locations. It is estimated that the magnitude of the losses exceeds the country's capacity to address reparations and mitigation without serious dislocation of its development trajectory. The government may wish to approach the international community for assistance in this regard. This appraisal is therefore designed to provide the government and the international community with guidelines for setting national and regional priorities in rehabilitation and reconstruction or resettlement programmes. A purely economic conception of the problem would be limited. A more integrated approach would have a human face and consider the alleviation of human suffering in the affected areas while attending to the economic and fiscal fallout of the disaster. Questions of improved physical planning, watershed management, early warning, emergency response and structural preparedness for evacuation and sheltering the vulnerable population are seen as important considerations for the post disaster phase. Special attention and priority should be placed on including sustainability and increased governance criteria in making social and productive investments, and on allocating resources to the reinforcing and retrofitting of vulnerable infrastructure, basic lifelines and services as part of the reconstruction and rehabilitation strategy. The Jamaican society and government face the opportunity of undertaking action with the benefit of revised paradigms, embarking on institutional, legal and structural reforms to reduce economic, social and environmental vulnerability. The history of flood devastation in the very areas of Portland and St. Mary shows a recurrence of flooding. Accounts of flooding from the earliest recorded accounts pertaining to 1837 are available. Recurrences in 1937, 1940, 1943 and 2001 indicate an ever-present probability of recurrence of similar events. The Government may wish to consider the probable consequences of a part of its population living in flood plains and address its position vis-à¶is land use and the probability of yet another recurrence of flood rains. (1) ECLAC/IDNDR, Manual for estimating the Socio-Economic Effects of Natural Disasters, May,1999.
Resumo:
Includes bibliography
Resumo:
Caribbean policymakers are faced with special challenges from climate change and these are related to the uncertainties inherent in future climate projections and the complex linkages among climate change, physical and biological systems and socioeconomic sectors. The impacts of climate change threaten development in the Caribbean and may well erode previous gains in development as evidenced by the increased incidence of climate migrants internationally. This brief which is based on a recent study conducted by the Economic Commission for Latin America and the Caribbean (LC/CAR/L.395)1 provides a synthesis of the assessment of the economic and social impacts of climate change on the coastal and marine sector in the Caribbean which were undertaken. It provides Caribbean policymakers with cutting-edge information on the region’s vulnerability and encourages the development of adaptation strategies informed by both local experience and expert knowledge. It proceeds from an acknowledgement that the unique combination of natural resources, ecosystems, economic activities, and human population settlements of the Caribbean will not be immune to the impacts of climate change, and local communities, countries and the subregion as a whole need to plan for, and adapt to, these effects. Climate and extreme weather hazards related to the coastal and marine sector encompass the distinct but related factors of sea level rise, increasing coastal water temperatures, tropical storms and hurricanes. Potential vulnerabilities for coastal zones include increased shoreline erosion leading to alteration of the coastline, loss of coastal wetlands, and changes in the abundance and diversity of fish and other marine populations. The study examines four key themes in the analysis: climate, vulnerability, economic and social costs associated with climate change impacts, and adaptive measures.
Resumo:
This report analyses the coastal and human settlements, tourism and transport sectors in Barbados to assess the potential economic impact of climate change on the sectors. The fundamental aim of this report is to assist with the development of strategies to deal with the potential impact of climate change on Barbados. Some of the key anticipated manifestations of climate change for the Caribbean include elevated air and sea-surface temperatures, sea-level rise, possible changes in extreme events and a reduction in freshwater resources. The economic impact of climate change on the three sectors was estimated for the A2 and B2 IPCC scenarios until 2050 (tourism and transport sectors) and 2100 (coastal and human settlements sector). An exploration of various adaptation strategies was also undertaken for each sector using standard evaluation techniques. The analysis has shown that based upon exposed assets and population, SLR can be classified as having the potential to create potential catastrophe in Barbados. The main contributing factor is the concentration of socioeconomic infrastructure along the coastline in vulnerable areas. The A2 and B2 projections have indicated that the number of catastrophes that can be classified as great is likely to be increased for the country. This is based upon the possible effects of the projected unscheduled impacts to the economy both in terms of loss of life and economic infrastructure. These results arise from the A2 and B2 projections, thereby indicating that growth in numbers and losses are largely due to socioeconomic changes over the projection period and hence the need for increased adaptation strategies. A key adaptation measure recommended is for the government of Barbados to begin reducing the infrastructure deficit by continuously investing in protective infrastructure to decrease the country’s vulnerability to changes in the climate. With regard to the tourism sector, it was found that by combining the impacts due to a reduction in tourist arrivals, coral reef loss and SLR, estimated total economic impact of climate change is US $7,648 million (A2 scenario) and US $5,127 million (B2 scenario). An economic analysis of the benefits and costs of several adaptation options was undertaken to determine the cost effectiveness of each one and it was found that four (4) out of nine (9) options had high cost-benefit ratios. It is therefore recommended that the strategies that were most attractive in terms of the cost-benefit ratios be pursued first and these were: (1) enhanced reef monitoring systems to provide early warning alerts of bleaching events; (2) artificial reefs or fish-aggregating devices; (3) development of national adaptation plans (levee, sea wall and boardwalk); (4) revision of policies related to financing carbon neutral tourism; and (5) increasing recommended design wind speeds for new tourism-related structures. The total cost of climate change on international transportation in Barbados aggregated the impacts of changes in temperature and precipitation, new climate policies and SLR. The impact for air transportation ranges from US$10,727 million (B2 scenario) to US$12,279 million (A2 scenario) and for maritime transportation impact estimates range from US$1,992 million (B2 scenario) to US$2,606 million (A2 scenario). For international transportation as a whole, the impact of climate change varies from US$12,719 million under the B2 scenario to US$14,885 million under the A2 scenario. Barbados has the institutions set up to implement adaptive strategies to strengthen the resilience of the existing international transportation system to climate change impacts. Air and sea terminals and facilities can be made more robust, raised, or even relocated as need be, and where critical to safety and mobility, expanded redundant systems may be considered.
Resumo:
Changing precipitation patterns and temperature relate directly to water resources and water security. This report presents the findings of an assessment of the water sector in Grenada with respect to the projected impact of climate change. Grenada‘s water resources comprise primarily surface water, with an estimated groundwater potential to satisfy about 10%-15% of the present potable requirement. On the smaller islands Carriacou and Petite Martinique, domestic water is derived exclusively from rainwater catchments. Rainfall seasonality is marked and the available surface water during the dry season declines dramatically. Changing land use patterns, increase in population, expansion in tourism and future implementation of proposed irrigation schemes are projected to increase future water requirements. Economic modeling approaches were implemented to estimate sectoral demand and supply between 2011 and 2050. Residential, tourism and domestic demand were analysed for the A2, B2 and BAU scenarios as illustrated. The results suggest that water supply will exceed forecasted water demand under B2 and BAU during all four decades. However under the A2 scenario, water demand will exceed water supply by the year 2025. It is important to note that the model has been constrained by the omission of several key parameters, and time series for climate indicators, data for which are unavailable. Some of these include time series for discharge data, rainfall-runoff data, groundwater recharge rates, and evapotranspiration. Further, the findings which seem to indicate adequacy of water are also masked by seasonality in a given year, variation from year to year, and spatial variation within the nation state. It is imperative that some emphasis be placed on data generation in order to better project for the management of Grenada‘s water security. This analysis indicates the need for additional water catchment, storage and distribution infrastructure, as well as institutional strengthening, in order to meet the future needs of the Grenadian population. Strategic priorities should be adopted to increase water production, increase efficiency, strengthen the institutional framework, and decrease wastage. Grenada has embarked on several initiatives that can be considered strategies toward adaptation to the variabilities associated with climate change. The Government should ensure that these programs be carried out to the optimal levels for reasons described above. The ―no-regrets approach‖ which intimates that measures will be beneficial with or without climate change should be adopted. A study on the Costs of Inaction for the Caribbean in the face of climate change listed Grenada among the countries which would experience significant impacts on GDP between now and 2100 without adaptation interventions. Investment in the water sector is germane to building Grenada‘s capacity to cope with the multivariate impact of changes in the parameters of climate.
Resumo:
The best description of water resources for Grand Turk was offered by Pérez Monteagudo (2000) who suggested that rain water was insufficient to ensure a regular water supply although water catchment was being practised and water catchment possibilities had been analysed. Limestone islands, mostly flat and low lying, have few possibilities for large scale surface storage, and groundwater lenses exist in very delicate equilibrium with saline seawater, and are highly likely to collapse due to sea level rise, improper extraction, drought, tidal waves or other extreme event. A study on the impact of climate change on water resources in the Turks and Caicos Islands is a challenging task, due to the fact that the territory of the Islands covers different environmental resources and conditions, and accurate data are lacking. The present report is based on collected data wherever possible, including grey data from several sources such as the Intergovernmental Panel on Climate Change (IPCC) and Cuban meteorological service data sets. Other data were also used, including the author’s own estimates and modelling results. Although challenging, this was perhaps the best approach towards analysing the situation. Furthermore, IPCC A2 and B2 scenarios were used in the present study in an effort to reduce uncertainty. The main conclusion from the scenario approach is that the trend observed in precipitation during the period 1961 - 1990 is decreasing. Similar behaviour was observed in the Caribbean region. This trend is associated with meteorological causes, particularly with the influence of the North Atlantic Anticyclone. The annual decrease in precipitation is estimated to be between 30-40% with uncertain impacts on marine resources. After an assessment of fresh water resources in Turks and Caicos Islands, the next step was to estimate residential water demand based on a high fertility rate scenario for the Islands (one selected from four scenarios and compared to countries having similar characteristics). The selected scenario presents higher projections on consumption growth, enabling better preparation for growing water demand. Water demand by tourists (stopover and excursionists, mainly cruise passengers) was also obtained, based on international daily consumption estimates. Tourism demand forecasts for Turks and Caicos Islands encompass the forty years between 2011 and 2050 and were obtained by means of an Artificial Neural Networks approach. for the A2 and B2 scenarios, resulting in the relation BAU>B2>A2 in terms of tourist arrivals and water demand levels from tourism. Adaptation options and policies were analysed. Resolving the issue of the best technology to be used for Turks and Caicos Islands is not directly related to climate change. Total estimated water storage capacity is about 1, 270, 800 m3/ year with 80% capacity load for three plants. However, almost 11 desalination plants have been detected on Turks and Caicos Islands. Without more data, it is not possible to estimate long term investment to match possible water demand and more complex adaptation options. One climate change adaptation option would be the construction of elevated (30 metres or higher) storm resistant water reservoirs. The unit cost of the storage capacity is the sum of capital costs and operational and maintenance costs. Electricity costs to pump water are optional as water should, and could, be stored for several months. The costs arising for water storage are in the range of US$ 0.22 cents/m3 without electricity costs. Pérez Monteagudo (2000) estimated water prices at around US$ 2.64/m3 in stand points, US$ 7.92 /m3 for government offices, and US$ 13.2 /m3for cistern truck vehicles. These data need to be updated. As Turks and Caicos Islands continues to depend on tourism and Reverse Osmosis (RO) for obtaining fresh water, an unavoidable condition to maintaining and increasing gross domestic product(GDP) and population welfare, dependence on fossil fuels and vulnerability to increasingly volatile prices will constitute an important restriction. In this sense, mitigation supposes a synergy with adaptation. Energy demand and emissions of carbon dioxide (CO2) were also estimated using an emissions factor of 2. 6 tCO2/ tonne of oil equivalent (toe). Assuming a population of 33,000 inhabitants, primary energy demand was estimated for Turks and Caicos Islands at 110,000 toe with electricity demand of around 110 GWh. The business as usual (BAU), as well as the mitigation scenarios were estimated. The BAU scenario suggests that energy use should be supported by imported fossil fuels with important improvements in energy efficiency. The mitigation scenario explores the use of photovoltaic and concentrating solar power, and wind energy. As this is a preliminary study, the local potential and locations need to be identified to provide more relevant estimates. Macroeconomic assumptions are the same for both scenarios. By 2050, Turks and Caicos Islands could demand 60 m toe less than for the BAU scenario.
Resumo:
Climate change has the potential to impact on global, regional, and national disease burdens both directly and indirectly. Projecting and valuing these health impacts is important not only in terms of assessing the overall impact of climate change on various parts of the world, but also in terms of ensuring that national and regional decision-making institutions have access to the data necessary to guide investment decisions and future policy design. This report contributes to the research focusing on projecting and valuing the impacts of climate change in the Caribbean by projecting the climate change-induced excess disease burden for two climate change scenarios in Montserrat for the period 2010 - 2050, and by estimating the monetary value associated with this excess disease burden. The diseases initially considered in this report are variety of vector and water-borne impacts and other miscellaneous conditions; specifically, malaria, dengue fever, gastroenteritis/diarrheal disease, schistosomiasis, leptospirosis, ciguatera poisoning, meningococcal meningitis, and cardio-respiratory diseases. Disease projections were based on derived baseline incidence and mortality rates, available dose-response relationships found in the published literature, climate change scenario population projections for the A2 and B2 IPCC SRES scenario families, and annual temperature and precipitation anomalies as projected by the downscaled ECHAM4 global climate model. Monetary valuation was based on a transfer value of statistical life approach with a modification for morbidity. Using discount rates of 1%, 2% and 4%, results show mean annual costs (morbidity and mortality) ranges of $0.61 million (in the B2 scenario, discounted at 4% annually) – $1 million (in the A2 scenario, discounted at 1% annually) for Montserrat. These costs are compared to adaptation cost scenarios involving increased direct spending on per capita health care. This comparison reveals a high benefit-cost ratio suggesting that moderate costs will deliver significant benefit in terms of avoided health burdens in the period 2010-2050. The methodology and results suggest that a focus on coordinated data collection and improved monitoring represents a potentially important no regrets adaptation strategy for Montserrat. Also the report highlights the need for this to be part of a coordinated regional response that avoids duplication in spending.
Resumo:
Climate change has the potential to impact on global, regional, and national disease burdens both directly and indirectly. Projecting and valuing these health impacts is important not only in terms of assessing the overall impact of climate change on various parts of the world, but also of ensuring that national and regional decision-making institutions have access to the data necessary to guide investment decisions and future policy design. This report contributes to the research focusing on projecting and valuing the impacts of climate change in the Caribbean by projecting the climate change-induced excess disease burden for two climate change scenarios in Saint Lucia for the period 2010 - 2050, and by estimating the non-market, statistical life-based costs associated with this excess disease burden. The diseases initially considered in this report are a variety of vector and water-borne impacts and other miscellaneous conditions; specifically, malaria, dengue fever, gastroenteritis/diarrhoeal disease, schistosomiasis, leptospirosis, ciguatera poisoning, meningococcal meningitis, and cardio-respiratory diseases. Disease projections were based on derived baseline incidence and mortality rates, available dose-response relationships found in the published literature, climate change scenario population projections for the A2 and B2 IPCC SRES scenario families, and annual temperature and precipitation anomalies as projected by the downscaled ECHAM4 global climate model. Monetary valuation was based on a transfer value of statistical life approach with a modification for morbidity. Using discount rates of 1, 2, and 4%, results show mean annual costs (morbidity and mortality) ranges of $80.2 million (in the B2 scenario, discounted at 4% annually) -$182.4 million (in the A2 scenario, discounted at 1% annually) for St. Lucia.1 These costs are compared to adaptation cost scenarios involving direct and indirect interventions in health care. This comparison reveals a high benefit-cost ratio suggesting that moderate costs will deliver significant benefit in terms of avoided health costs from 2010-2050. In this context indirect interventions target sectors other than healthcare (e.g. water supply). It is also important to highlight that interventions can target both the supply of health infrastructure (including health status and disease monitoring), and households. It is suggested that a focus on coordinated data collection and improved monitoring represents a potentially important no regrets adaptation strategy for St Lucia. Also, the need for this to be part of a coordinated regional response that avoids duplication in spending is highlighted.
Resumo:
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.
Resumo:
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.
Resumo:
This study represents a collaborative effort by the Economic Commission for Latin America and the Caribbean (ECLAC) Subregional Headquarters for the Caribbean and the United Nations Development Fund for Women (UNIFEM) to assess these actions with the aim of informing the future work of these agencies around gender-based violence. An important dimension of the mandate of the ECLAC Subregional Headquarters for the Caribbean is the provision of strategic thinking and information to governments for policy formulation. This is accomplished through technical assistance and through research activities. At the Third Economic Commission for Latin America and the Caribbean/Caribbean Development and Cooperation Committee (ECLAC/CDCC) Ministerial Conference on Women held in October 1999, violence against women was identified as a barrier to achieving gender equality. The recommendations spoke not only of the need to extend services to victims, but also to take actions based on an understanding of the root causes of violence. This study forms one component in a scope of work in which the ECLAC Subregional Headquarters for the Caribbean has been engaged since 1999.
Resumo:
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Resumo:
Translation, cross-cultural adaptation and validation of the DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. The original English version of the DYMUS was translated using the forward-backward technique, cross-culturally adaptated, pilot-tested in 40 patients, and then applied to 100 multiple sclerosis patients to assess the reliability and construct validity. Construct validity was assessed by Mann–Whitney test and Spearman’s correlation coefficient (rs). The internal consistency of the questionnaire was evaluated using Cronbach’s alpha coefficient and inter-item correlation. DYMUS-BR internal consistency was high (Cronbach’s alpha= 0.72); Cronbach’s alpha was 0.65 for the ‘dysphagia for solids’ subscale and 0.67 for the ‘dysphagia for liquids’ subscale and positive inter-item correlations was found between all items, except for weight loss question. Significant association (p<0.001) and correlation (rs = 0,357; p = 0.01) was found between DYMUS-BR and dysphagia self-assessment. The DYMUS-BR questionnaire maintained the characteristics of that originally described, demonstrating to be a reliable, valid, easy and consistent tool to be used by health professionals for preliminary selection of Brazilian MS patients who need more specific instrumental analyses of swallowing.
Resumo:
The reproductive capacity of the swimming crab Callinectes danae Smith, 1869 was assessed based on the reproductive investment (RI) of ovigerous females and the gonadosomatic index (GI) of non-ovigerous adult females. Crabs were collected in June 2009 with a shrimp fishing boat at Ubatuba (23° 26′S 45° 02′W) São Paulo, Brazil. Overall, 191 adult females were analyzed, of which 108 were ovigerous and 83 non-ovigerous. The size of ovigerous females ranged from 54.5 to 79.8 mm carapace width (CW) and non-ovigerous females ranged from 56.0 to 80.9 mm CW. RI values did not differ among the size classes (ANOVA, p > 0.05), with an overall mean of 15.8%. The same occurred with the Gonadossomatic index for non-ovigerous females, for which the mean value was 11.7%. The regression between the dry weight of the egg mass and the dry weight of the crab (Student’s t, p = 0.25; ttab = 1.66; tcal = 0.66) indicated an isometric relationship for the variables analyzed. The simultaneous occurrence of gonadal maturation and embryonic development in ovigerous females suggests that these crabs may spawn at least twice in the same breeding season and reveals the need for evaluation of the allocation of energy in subsequent spawns.
Resumo:
Background: The main manifestation of hyperglycaemia during pregnancy is gestational diabetes mellitus. It can herald diabetes mellitus type 2 and its deleterious long-term effects, such as hypertension and cardiovascular disease. The aim of this study was to assess diastolic function in women with gestational diabetes mellitus, one of the first signs of future cardiovascular disease.Methods: A total of 21 women with gestational diabetes mellitus and 23 healthy pregnant women (control group) between 34 and 37weeks of gestation underwent echocardiographic assessment. The diagnosis of gestational diabetes mellitus was made in agreement with the American Diabetes Association criteria. Echocardiographic images obtained were analysed according to the criteria of the American Society of Echocardiography. Data were analysed using Pearson correlation coefficient, analysis of variance and Student's t-test.Results: Women with gestational diabetes mellitus had higher posterior wall and interventricular septum thickness, increased left ventricular mass and left ventricular mass index, lower early diastolic annular velocity and early diastolic annular velocity/late diastolic annular velocity ratio. There was a positive correlation between left ventricular mass index and fasting glucose and pregnancy body mass index.Conclusion: Patients with gestational diabetes mellitus seem to have a different diastolic profile as well as a mildly dysfunctional pattern on echocardiogram, which may show a need for greater glycaemic control.