Sustainable Tourism and Eradication of Poverty (Step): impact assessment of a tourism development program in Brazil

This paper aims to evaluate the social impacts of the Tourism Development Program (Prodetur) in the northeastern town of Porto Seguro, Bahia, Brazil. The method used is based on the difference in difference technique applied to the 1991 and 2000 Census microdata. The results suggest social advances following from poverty relief based on income - where the benefits are distributed, generally, in a relatively equal manner between the native and migrant population. There is a relative deterioration in the sanitary situation, which consists of a very serious problem in the mid- and long-term, whose costs are mostly borne by the native population. Therefore, maintaining the natural capital is the main aspect that distances Porto Seguro’s tourism supply from the concept of sustainability. The article also relies on difference in difference estimators to assess the impacts of local public policies related to the sector.

Evaluation of parasitological examination, kDNA polymerase chain reaction and rK39-based immunochromatography for the diagnosis of visceral leishmaniasis in seropositive dogs from the screening-culling program in Brazil

Introduction Dogs play a primary role in the zoonotic cycle of visceral leishmaniasis (VL). Therefore, the accurate diagnosis of infected dogs, primarily asymptomatic dogs, is crucial to the efficiency of VL control programs. Methods We investigated the agreement of four diagnostic tests for canine visceral leishmaniasis (CVL): parasite detection, either after myeloculture or by direct microscopic examination of tissue imprints; kinetoplast-deoxyribonucleic acid-polymerase chain reaction (kDNA-PCR); and an immunochromatographic test (ICT). An enzyme-linked immunosorbent assay (ELISA) and an indirect immunofluorescence test (IFAT), both of which were adopted as part of the screening-culling program in Brazil, were used as reference tests. Our sample set consisted of 44 seropositive dogs, 25 of which were clinically asymptomatic and 19 were symptomatic for CVL according to ELISA-IFAT. Results The highest and lowest test co-positivities were observed for ICT (77.3%) and myeloculture (58.1%), respectively. When analyzed together, the overall percentage of co-positive tests was significantly higher for the symptomatic group compared to the asymptomatic group. However, only ICT was significantly different based on the results of a separate analysis per test for each group of dogs. The majority (93.8%) of animals exhibited at least one positive test result, with an average of 2.66 positive tests per dog. Half of the symptomatic dogs tested positive for all four tests administered. Conclusions The variability between test results reinforces the need for more efficient and reliable methods to accurately diagnose canine VL, particularly in asymptomatic animals.

Oropharyngeal colonization by Haemophilus influenzae in healthy children from Taubaté (São Paulo), prior to the Haemophilus influenzae type b vaccination program in Brazil

Haemophilus influenzae is one of the most important bacterial agents of otitis and sinusitis. H. influenzae type b (Hib) is one of the main causes of meningitis, pneumonia, and septicemia in nonvaccinated children under 6 years of age. The aims of this study were to determine the prevalence of H. influenzae and Hib oropharyngeal colonization prior to the onset of the Hib vaccination program in Brazil in previously healthy children and to assess the susceptibility profile of this microorganism to a selected group of antimicrobials that are used to treat acute respiratory infections. METHOD: Cultures of Haemophilus influenzae were made from oropharynx swabs from 987 children under 6 years of age who were enrolled in 29 day-care centers in Taubaté (a city of São Paulo state, Brazil) between July and December 1998. RESULTS: The prevalence of H. influenzae carriers was 17.4%, and only 5.5% of the strains were beta-lactamase producers. The prevalence of Hib carriers was high, 7.3% on average (range, 0.0 - 33.3%). CONCLUSIONS: The low prevalence of colonization by penicillin-resistant strains indicates that it is not necessary to substitute ampicilin or amoxicilin to effectively treat otitis and sinusitis caused by H. influenzae in Taubaté.

An MD-PhD program in Brazil: students’ concepts of science and of common sense

In 1995, a pioneering MD-PhD program was initiated in Brazil for the training of medical scientists in experimental sciences at the Federal University of Rio de Janeiro. The program’s aim was achieved with respect to publication of theses in the form of papers with international visibility and also in terms of fostering the scientific careers of the graduates. The expansion of this type of program is one of the strategies for improving the preparation of biomedical researchers in Brazil. A noteworthy absence of interest in carrying out clinical research limits the ability of young Brazilian physicians to solve biomedical problems. To understand the students’ views of science, we used qualitative and quantitative triangulation methods, as well as participant observation to evaluate the students’ concepts of science and common sense. Subjective aspects were clearly less evident in their concepts of science. There was a strong concern about "methodology", "truth" and "usefulness". "Intuition", "creativity" and "curiosity" were the least mentioned thematic categories. Students recognized the value of intuition when it appeared as an explicit option but they did not refer to it spontaneously. Common sense was associated with "consensus", "opinion" and ideas that "require scientific validation". Such observations indicate that MD-PhD students share with their senior academic colleagues the same reluctance to consider common sense as a valid adjunct for the solution of scientific problems. Overcoming this difficulty may be an important step toward stimulating the interest of physicians in pursuing experimental research.

An assessment of criteria to evaluate the graduate education program in Brazil

This study sought to identify criteria adequate for the evaluation of graduate programs in Brazil. A survey was the means for collecting the ratings and rankings given by faculty members at selected Brazilian graduate programs. A questionnaire using Likerttype and ranking items asked the importance attributed by each respondent to each of the 109 items listed. The data analysis reported in this dissertation indicates that the most highly rated criteria and indicators were: (1) Library: current periodicals; (2) Facilities: classrooms and laboratories; (3) Library: books and monographs; (4) Academic Environment: discussion, investigation, and expression; and (5) Facilities: research space and equipment. The study presents the means and standard deviations obtained for each indicator and also includes some figures obtained for a relational analysis. This dissertation was developed to provide useful information to educational planners, policy makers, administrators, and evaluators involved in Brazilian higher education or comparative studies. It is suggested that additional investigations concentrate on more specific and in-depth analysis and interpretation of the policymaking processes, i.e., on the study of social facts or organizational and academic variables in their relationships with aspects of the educational system. The appendices section includes a facsimile of the questionnaire and additional data.

Avaliação do impacto do Programa Farmácia Popular em uma rede independe de drogarias

A despeito de o Brasil contar com modelo de distribuição pública gratuita de medicamentos, representando avanço em relação à maioria dos países em desenvolvimento, o cenário geral apresenta problemas de diversas ordens. O abastecimento público é falho e ineficiente, contando com profissionais pouco motivados e com pouco treinamento. Isso resulta em perdas oriundas de desvios, má condição de estocagem e processos inadequados de distribuição. A utilização da malha privada através do Programa Farmácia Popular do Brasil, do ponto de vista do governo, promove capilaridade no atendimento, aumentando o bem estar social e reduz custos com a utilização de pessoal. Do ponto de vista da sociedade, amplia o acesso de medicamentos à população. Deste modo, o programa tem representado uma solução eficiente para a distribuição de medicamentos no país. No entanto, do ponto de vista empresarial, os resultados da utilização da malha privada para a distribuição gratuita de medicamentos ainda são pouco descritos. O presente estudo pretende avaliar os impactos relacionados ao credenciamento no programa do governo federal em redes independentes de farmácias e drogarias privadas na distribuição gratuita de medicamentos para a população. Aborda um assunto multifuncional, além de consistir em uma análise do programa que faz parte das diretrizes do governo federal e ser um tema de caráter inédito com foco no ambiente empresarial. Do ponto de vista empresarial, o atendimento ao programa de distribuição gratuita de medicamentos em atendimento ao programa do governo federal pode representar um fator de alavancagem dos negócios ao trazer consumidores potenciais para o estabelecimento. No entanto, é necessário que ocorram adaptações na gestão do capital de giro para suportar os possíveis atrasos no repasse do governo e suprir o abastecimento de medicamentos à demandas crescentes. Assim, as drogarias inseridas no setor varejista farmacêutico em cidades em desenvolvimento adquirem vantagem competitiva e fornecem maior valor a seus consumidores. Em suma, o projeto de acesso a medicamentos, implica em benefícios líquidos generalizados. Para a população, o acesso direto e efetivo. Para o setor privado, a ampliação do mercado e a estabilidade da demanda. Para o governo, a substituição de uma estratégia que converge para o desgaste econômico, social e político.

Batrachochytrium dendrobatidis in amphibians confiscated from illegal wildlife trade and used in an ex situ breeding program in Brazil

This paper describes an outbreak of chytridiomycosis affecting a group of Dendrobates tinctorius, a Neotropical anuran species, confiscated from the illegal wildlife trade and housed in a private zoo in Brazil as part of an ex situ breeding program. We examined histological sections of the skin of 30 D. tinctorius and 20 Adelphobates galactonotus individuals. Twenty D. tinctorius (66.7%) and none of the A. galactonotus were positive for Batrachochytrium dendrobatidis (Bd). Multiple development stages of Bd infection were observed. The reasons for the interspecific difference in the rate of infection could not be determined, and further studies are advised. Because the examined population consisted of confiscated frogs, detailed epidemiological aspects could not be investigated, and the source of the fungus remains uncertain. The existence of ex situ amphibian populations is important for protecting species at higher risk in the wild, and ex situ amphibian conservation and breeding programs in Brazil may be established using confiscated frogs as founders. However, this paper alerts these programs to the urgency of strict quarantine procedures to prevent the introduction of potential pathogens, particularly Bd, into ex situ conservation programs.

Operation of the PL480 program in Brazil

"Literature cited": p. 26-28.

Medicamentos utilizados no controle da hipertensão no Distrito Administrativo DAGUA em Belém, PA

A Hipertensão Arterial Sistêmica (HAS) é uma condição associada a elevados índices de morbidade e mortalidade com baixas taxas de controle, sendo um dos mais importantes problemas de saúde publica no mundo. Trata-se de um estudo descritivo exploratório de natureza transversal e observacional, realizado em cinco unidades de saúde do Distrito Administrativo DAGUA, localizadas no municipio de Belém-PA, no período entre março de 2010 a agosto de 2011. A pesquisa também realizou estudo documental onde informações foram transcritas, para formulários da pesquisa. Este estudo buscou conhecer a logística de suprimento e o perfil de utilização de medicamentos para o controle da Pressão Arterial Sistêmica no Distrito Administrativo DAGUA. Para tanto foram investigados o perfil sóciodemográfico dos participantes do programa HIPERDIA, quais os medicamentos disponibilizados pela rede municipal de saúde para o tratamento da HAS, assim como a logística empregada pelo município para a disponbibilidade de acesso aos mesmos. A população deste estudo se caracterizou por ser principalmente idosa, com baixa escolaridade e predominantemente formada por pardos. Observou-se, que 53,78% dos pacientes faz uso de monoterapia e 46,22% de politerapia. 36,84% utiliza somente Captopril. 65,31% dos pacientes que fazem politerapia utilizam a associação de Captopril e hidroclorotiazida. Não se encontrou correlações significativas entre os aspectos socioeconômicos dos participantes e o controle dos níveis de pressão arterial. O conhecimento sobre a HAS não influenciou os resultados da PA. 51,96% dos pacientes apresenta PA não controlada. Em função da falta de abastecimento de medicamentos nas unidades de saúde e do perfil socioeconômico dos usuários, o Programa Farmácia Popular do Brasil apresenta-se como uma importante estrátegia para o acesso desses pacientes ao seu tratamento. Por fim, resumindo os achados, observou-se que o ciclo logístico da Assistência Farmacêutica em Belém – em especial as etapas de programação, aquisição e dispensação de medicamentos – não respeita o atual arcabouço legal que regulamenta a Política Nacional de Assistência Farmacêutica. Contatou-se falta de uniformização entre os medicamentos programados para unidades localizadas na mesma região, além da grande diferença entre as condições de compra dos medicamentos quando comparado a outras licitações, que chegam a gerar diferenças de preços de até 3000%. Conclui-se que que a gestão técnica da assistência farmacêutica no município de Belém é inefetiva e ineficiente para o cuidado de pacientes portadores de Hipertensão Arterial Sistêmica.

Biofuels and Sustainable Energy Development in Brazil

Through the assessment of three decades of the Alcohol Program in Brazil, the paper shows that adequate public policies regarding biomass production can deliver direct benefits like energy security improvement, foreign exchange savings, and local employment generation, reduced urban air pollution and avoided CO(2) emissions. Moreover, the paper shows that Brazilian produced ethanol has faced economies of scale, technical progress and productivity gains and is no longer dependent on subsidies to be competitive. The paper also examines the potential in Brazil for fostering other biofuels, namely biodiesel obtained from vegetable oils, as well as their implications on sustainable energy development. (C) 2011 Elsevier Ltd. All rights reserved.

Cost-effectiveness analysis of universal childhood vaccination against varicella in Brazil

This study conducts a cost-effectiveness analysis of a childhood universal varicella vaccination program in Brazil. An age and time-dependent dynamic model was developed to estimate the incidence of varicella for 30 years. Assuming a single-dose schedule; vaccine efficacy of 85% and coverage of 80%, the program could prevent 74,422,058 cases and 2905 deaths. It would cost R$ 3,178,396,110 and save R$ 660,076,410 to the society and R$ 365,602,305 to the healthcare system. The program is cost-effective (R$ 14,749 and R$ 16,582 per life-year saved under the societal and the healthcare system`s perspective, respectively). The program`s cost-effectiveness is highly sensitive to the vaccine price and number of doses. (C) 2008 Elsevier Ltd. All rights reserved.

Cost-effectiveness analysis of universal childhood hepatitis A vaccination in Brazil: Regional analyses according to the endemic context

Objective: To To conduct a cost-effectiveness analysis of a universal childhood hepatitis A vaccination program in Brazil. Methods: An age and time-dependent dynamic model was developed to estimate the incidence of hepatitis A for 24 years. The analysis was run separately according to the pattern of regional endemicity, one for South + Southeast (low endemicity) and one for the North + Northeast + Midwest (intermediate endemicity). The decision analysis model compared universal childhood vaccination with current program of vaccinating high risk individuals. Epidemiologic and cost estimates were based on data from a nationwide seroprevalence survey of viral hepatitis, primary data collection, National Health Information Systems and literature. The analysis was conducted from both the health system and societal perspectives. Costs are expressed in 2008 Brazilian currency (Real). Results: A universal immunization program would have a significant impact on disease epidemiology in all regions, resulting in 64% reduction in the number of cases of icteric hepatitis, 59% reduction in deaths for the disease and a 62% decrease of life years lost, in a national perspective. With a vaccine price of R$16.89 (US$7.23) per dose, vaccination against hepatitis A was a cost-saving strategy in the low and intermediate endemicity regions and in Brazil as a whole from both health system and society perspective. Results were most sensitive to the frequency of icteric hepatitis, ambulatory care and vaccine costs. Conclusions: Universal childhood vaccination program against hepatitis A could be a cost-saving strategy in all regions of Brazil. These results are useful for the Brazilian government for vaccine related decisions and for monitoring population impact if the vaccine is included in the National Immunization Program. (C) 2012 Elsevier Ltd. All rights reserved.

Human immunodeficiency virus prevalence, incidence, and residual risk of transmission by transfusions at Retrovirus Epidemiology Donor Study-II blood centers in Brazil

BACKGROUND: In Brazil nationally representative donor data are limited on human immunodeficiency virus (HIV) prevalence, incidence, and residual transfusion risk. The objective of this study was to analyze HIV data obtained over 24 months by the Retrovirus Epidemiology Donor Study-II program in Brazil. STUDY DESIGN AND METHODS: Donations reactive to third-and fourth-generation immunoassays (IAs) were further confirmed by a less-sensitive (LS) IA algorithm and Western blot (WB). Incidence was calculated for first-time (FT) donors using the LS-EIA results and for repeat donors with a model developed to include all donors with a previous negative donation. Residual risk was projected by multiplying composite FT and repeat donor incidence rates by HIV marker-negative infectious window periods. RESULTS: HIV prevalence among FT donors was 92.2/ 105 donations. FT and repeat donor and composite incidences were 38.5 (95% confidence interval [CI], 25.651.4), 22.5 (95% CI, 17.6-28.0), and 27.5 (95% CI, 22.0-33.0) per 100,000 person-years, respectively. Male and community donors had higher prevalence and incidence rates than female and replacement donors. The estimated residual risk of HIV transfusion transmission was 11.3 per 106 donations (95% CI, 8.4-14.2), which could be reduced to 4.2 per 106 donations (95% CI, 3.2-5.2) by use of individual-donation nucleic acid testing (NAT). CONCLUSION: The incidence and residual transfusion risk of HIV infection are relatively high in Brazil. Implementation of NAT will not be sufficient to decrease transmission rates to levels seen in the United States or Europe; therefore, other measures focused on decreasing donations by at-risk individuals are also necessary.

Television violence and young adults in Brazil: a content analysis of the popular telenovella, Malhação = Violência na televisão brasileira e jovens : uma análise de conteúdo da telenovela popular, Malahção

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

The actual incidence of congenital adrenal hyperplasia in Brazil may not be as high as inferred - An estimate based on a public neonatal screening program in the state of Goias

The incidence of 21-hydroxylase deficiency (CYP21 D) congenital adrenal hyperplasia (CAH) in Brazil is purportedly one of the highest in the world (1:7,533). However, this information is not based on official data. The aim of this study was to determine the incidence of CYP21 D CAH in the state of Goias, Brazil, based on the 2005 results of government-funded mandatory screening. Of the live births during this period, 92.95% were screened by heel-prick capillary 17 alpha-hydroxyprogesterone (17-OHP). Of these, 82,343 were normal, 28 were at high risk for CAH and 232 at low risk for CAH. Eight cases, all from the high risk group, were confirmed. Eight asymptomatic children at 6-18 months of age still have high 17-OHP levels and await diagnostic definition. Based on the number of confirmed CYP21 D CAH cases among the 82,603 screened, the estimated annual incidence of the disease was 1:10,325, lower than the previously reported rate in Brazil.