Pulmonary Hypertension in Latin America Pulmonary Vascular Disease: The Global Perspective

Latin America is here defined as all of the Americas south of the United States. In the setting of pulmonary hypertension, there are social inequalities and geophysical aspects in this region that account for a high prevalence of certain etiologies. This review aimed to analyze some of these factors. Data were collected from the existing literature. Information also was obtained from local tertiary-care centers to where patients with pulmonary hypertension generally are referred. Further, local experience and expertise was taken into consideration. Three etiologies of pulmonary hypertension were found to be the most prevalent: schistosomiasis (similar to 1 million affected people in Brazil), high altitude (particularly in the Andes), and congenital heart disease (late diagnosis of congenital left-to-right shunts leading to development of pulmonary vasculopathy). The diversity in terms of ancestries and races probably accounts for the differences in phenotype expression of pulmonary hypertension when a given region is considered (eg, schistosomiasis-, high-altitude-, or congenital heart disease-associated pulmonary hypertension). Governmental measures are needed to improve social and economic inequalities with an obvious impact on certain etiologies, such as schistosomiasis and congenital heart disease. Early diagnosis of pulmonary hypertension and access to medication remain important challenges all over Latin America. CHEST 2010; 137(6)(Suppl):78S-84S

Responsible research and innovation: a global perspective

Based on the paper presented at the Doctorate Conference on Technologogy Assessment in July 2013 at the University Nova Lisboa, Caparica campus

Responsible research and innovation: a global perspective

Based on the paper presented at the Doctorate Conference on Technologogy Assessment in July 2013 at the University Nova Lisboa, Caparica campus

Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective

The goal of this Report is to review all the relevant research in order to generate a comprehensive series of recommendations on food, nutrition, and physical activity, designed to reduce the risk of cancer and suitable for all societies. This process is also the basis for a continuous review of the evidence.

The Role of Public Administration: A Global Perspective

From my experience with public administration in my country, Cape Verde, and through readings in the area of development administration, I have found that a distinctive role and specific societal goals are usually ascribed to public administration in developing country. In studying American public administration approaches and operation, I was stuck by the fact that the definition of roles and societal goals for public administration seems not to be a forefront concern in the field. How to do things and achieve efficiency, in a managerial and rational perspective, seemed to draw much more attention than the purpose of doing things. Somehow, the contrast with the concept of development administration seemed too sharp, and I became curious about the reasons for such disparate approaches. Historical, cultural, and environmental differences would probably not be the only explanation for that since the concept of development administration was shaped, in the late 50’s and 60’s, by American authors and institutional aid agencies, and then “offered” to developing countries. At the same time, looking to poor results of the successive prescriptions of the development administration movement, I was no sure that such a concept and the framework it establishes was worthwhile. What practical answers and arrangement did they bring to the needs and challenges of public administrations in developing countries? …

A global perspective on Langmuir turbulence in the ocean surface boundary layer.

The turbulent mixing in thin ocean surface boundary layers (OSBL), which occupy the upper 100 m or so of the ocean, control the exchange of heat and trace gases between the atmosphere and ocean. Here we show that current parameterizations of this turbulent mixing lead to systematic and substantial errors in the depth of the OSBL in global climate models, which then leads to biases in sea surface temperature. One reason, we argue, is that current parameterizations are missing key surface-wave processes that force Langmuir turbulence that deepens the OSBL more rapidly than steady wind forcing. Scaling arguments are presented to identify two dimensionless parameters that measure the importance of wave forcing against wind forcing, and against buoyancy forcing. A global perspective on the occurrence of waveforced turbulence is developed using re-analysis data to compute these parameters globally. The diagnostic study developed here suggests that turbulent energy available for mixing the OSBL is under-estimated without forcing by surface waves. Wave-forcing and hence Langmuir turbulence could be important over wide areas of the ocean and in all seasons in the Southern Ocean. We conclude that surfacewave- forced Langmuir turbulence is an important process in the OSBL that requires parameterization.

Paediatric rheumatology - A global perspective

This chapter aims to give a global perspective to paediatric rheumatology. The main points covered are the incidence, recognition of paediatric autoimmune diseases, and ethnic/geographic distribution. The most prevalent disease is juvenile idiopathic arthritis; robust data are still required for childhood-onset systemic lupus erythematosus, dermatomyositis, and scleroderma. Mimicking or overlapping infections are a major challenge in developing countries, and immunization policies in our patients in these areas need specific attention. The delivery of paediatric rheumatology care is also overviewed. Discrepancies in health-care resources and priorities are found in developing countries. Although most anti-rheumatic treatments are available worldwide, they are prohibitively expensive in many countries. For more traditional antirheumatic drugs there is still an ongoing need for good core outcome data across the world to ensure valid comparisons. Parent/patient education has been implemented worldwide in paediatric rheumatology through the power of the Internet. Physician and undergraduate training goals must be met to facilitate competent musculoskeletal assessment, a proper understanding of age-dependent variations, diagnosis, referral to specialists, and improved standards of care.

Development strategies for the information and communications technology sector in the Caribbean: A global perspective

This occasional paper examines the experiences of three leading global centres of the ICT industry – India, Silicon Valley, and Estonia – to reflect on how the lessons of these models can be applied to the context of countries in the Caribbean region.Several sectors of the technology industry are considered in relation to the suitability for their establishment in the Caribbean. Animation is an area that is showing encouraging signs of development in several countries, and which offers some promise to provide a significant source of employment in the region. However, the global market for animation production is likely to become increasingly competitive, as improved technology has reduced barriers to entry into the industry not only in the Caribbean, but around the world. The region’s animation industry will need to move swiftly up the value chain if it is to avoid the downsides of being caught in an increasingly commoditized market. Mobile applications development has also been widely a heralded industry for the Caribbean. However, the market for consumer-oriented smartphone applications has matured very quickly, and is now a very difficult sector in which to compete. Caribbean mobile developers would be better served to focus on creating applications to suit the needs of regional industries and governments, rather than attempting to gain notice in over-saturated consumer marketplaces such as the iTunes App Store and Google Play. Another sector considered for the Caribbean is “big data” analysis. This area holds significant potential for growth in coming years, but the Caribbean, which is generally considered to be a datapoor region, currently lacks a sufficient base of local customers to form a competitive foundation for such an industry. While a Caribbean big data industry could plausibly be oriented toward outsourcing, that orientation would limit positive externalities from the sector, and benefits from its establishment would largely accrue only to a relatively small number of direct participants in the industry. Instead, development in the big data sector should be twinned with the development of products to build a regional customer base for the industry. The region has pressing needs in areas such as disaster risk reduction, water resource management, and support for agricultural production. Development of big data solutions – and other technology products – to address areas such as these could help to establish niche industries that both support the needs of local populations, and provide viable opportunities for the export of higher-value products and services to regions of the world with similar needs.