How has the sustainability of countries changed after COVID-19? Evidence from the pandemics' first year.

The Covid-19 crisis has caused several social-related issues; the sanitary is, perhaps, the most significant one. Lockdowns and vaccination were implemented to fight the Covid-19 virus. From a sustainability perspective, Covid-19 has been considered a meaningful crisis driver that has affected nations' economies and social and natural capitals. The literature presents clues that effects appear to be different among countries. Recognizing its importance as public policies for sustainability, this study aims to assess how the sustainability of countries has changed after Covid-19, focusing on countries' economic power that reflects their capacity to face the crisis. A sample of 89 countries is considered, and 2019-2020 are set as base years for data gathering, which covers the first year of the Covid-19 crisis. Sustainability is conceptually supported and represented by a 3-D cube. The natural environment is expressed by the ecological footprint (EF) method, the economic capital by the gross domestic product (GDP), and the social capital by the happiness index. Results show that sustainability of economies was negatively affected after first year of Covid-19 crisis, but in different magnitudes, according to nations' economic power. While the sustainability of the wealthiest economies was slightly changed during 2019-2020 but maintained within the named 'useful-order' world (environmentally unsustainable, productive, and happy), the poorest economies pushed about 169 million people into the worst performance, reaching the 'ineffective' world (environmentally unsustainable, unproductive, and unhappy). Numbers highlight the inequalities of sustainability performance among countries, according to their capacity to face the Covid-19 crisis. The shield of the richest evaluated countries comprising 5 % of the world population is more powerful than the shield of the poorest evaluated countries carrying 67 % of the world population. Results claims for efforts to make different policies and provide economic support differently for countries, since although we are all under the same storm, but in different boats.

Distribution of galling insects and their parasitoids on Caryocar brasiliense tree crowns / Distribuição de insetos galhadores e seus parasitoides em copas de pequizeiros (Caryocar brasiliense)

Caryocar brasiliense Camb. (Malpighiales: Caryocaraceae) is widely distributed in the Brazilian savanna and its fruits are used by humans for food, production of cosmetics, lubricants, and in the pharmaceutical industry. This plant is damaged by galling insects. Number of these galling insects and their parasitoids was recorded, in the field (galls) and in the laboratory (adults emerged from the galls), from three C. brasiliense crown heights, during three years. Numbers of adults of Eurytoma sp. (Hymenoptera: Eurytomidae), galling insect (younger attack) and Sycophila sp. (Hymenoptera: Eurytomidae) (a parasitoid of Eurytoma sp.), were greater on the apical parts of C. brasiliense tree crowns. Numbers and groups of Eurytoma sp. globoid galls (older attack) were higher in the median and basal crown parts. The numbers of Eurytoma sp. galls were higher on apical part of C. brasiliense tree crown and also of their parasitoids.

Caryocar brasiliense Camb. (Malpighiales: Caryocaraceae) é, amplamente, distribuída no cerrado brasileiro e seus frutos são utilizados para alimentação humana, produção de cosméticos, lubrificantes e na indústria farmacêutica, no entanto, é danificada por insetos galhadores. O número de insetos galhadores e seus parasitoides foram avaliados, em campo (galhas) e em laboratório (emergência de adultos das galhas), em três alturas do dossel de C. brasiliense, durante três anos. Os números de adultos Eurytoma sp. (Hymenoptera: Eurytomidae), inseto galhador (galhas novas) e de Sycophila sp. (Hymenoptera: Eurytomidae), parasitoide de Eurytoma sp., foram maiores na parte apical do dossel da copa de árvores de C. brasiliense. A quantidade de galhas globoides de Eurytoma sp., isoladas ou em grupo (galhas velhas), foi maior na parte mediana e basal da copa. Os números de adultos do galhador Eurytoma sp. e de seus parasitoides, que os seguem, foram maiores na parte apical da copa de árvores de C. brasiliense.

Distribution of galling insects and their parasitoids on Caryocar brasiliense tree crowns

Abstract Caryocar brasiliense Camb. (Malpighiales: Caryocaraceae) is widely distributed in the Brazilian savanna and its fruits are used by humans for food, production of cosmetics, lubricants, and in the pharmaceutical industry. This plant is damaged by galling insects. Number of these galling insects and their parasitoids was recorded, in the field (galls) and in the laboratory (adults emerged from the galls), from three C. brasiliense crown heights, during three years. Numbers of adults of Eurytoma sp. (Hymenoptera: Eurytomidae), galling insect (younger attack) and Sycophila sp. (Hymenoptera: Eurytomidae) (a parasitoid of Eurytoma sp.), were greater on the apical parts of C. brasiliense tree crowns. Numbers and groups of Eurytoma sp. globoid galls (older attack) were higher in the median and basal crown parts. The numbers of Eurytoma sp. galls were higher on apical part of C. brasiliense tree crown and also of their parasitoids.

Resumo Caryocar brasiliense Camb. (Malpighiales: Caryocaraceae) é, amplamente, distribuída no cerrado brasileiro e seus frutos são utilizados para alimentação humana, produção de cosméticos, lubrificantes e na indústria farmacêutica, no entanto, é danificada por insetos galhadores. O número de insetos galhadores e seus parasitoides foram avaliados, em campo (galhas) e em laboratório (emergência de adultos das galhas), em três alturas do dossel de C. brasiliense, durante três anos. Os números de adultos Eurytoma sp. (Hymenoptera: Eurytomidae), inseto galhador (galhas novas) e de Sycophila sp. (Hymenoptera: Eurytomidae), parasitoide de Eurytoma sp., foram maiores na parte apical do dossel da copa de árvores de C. brasiliense. A quantidade de galhas globoides de Eurytoma sp., isoladas ou em grupo (galhas velhas), foi maior na parte mediana e basal da copa. Os números de adultos do galhador Eurytoma sp. e de seus parasitoides, que os seguem, foram maiores na parte apical da copa de árvores de C. brasiliense.

Distribution of galling insects and their parasitoids on Caryocar brasiliense tree crowns / Distribuição de insetos galhadores e seus parasitoides em copas de pequizeiros (Caryocar brasiliense)

Caryocar brasiliense Camb. (Malpighiales: Caryocaraceae) is widely distributed in the Brazilian savanna and its fruits are used by humans for food, production of cosmetics, lubricants, and in the pharmaceutical industry. This plant is damaged by galling insects. Number of these galling insects and their parasitoids was recorded, in the field (galls) and in the laboratory (adults emerged from the galls), from three C. brasiliense crown heights, during three years. Numbers of adults of Eurytoma sp. (Hymenoptera: Eurytomidae), galling insect (younger attack) and Sycophila sp. (Hymenoptera: Eurytomidae) (a parasitoid of Eurytoma sp.), were greater on the apical parts of C. brasiliense tree crowns. Numbers and groups of Eurytoma sp. globoid galls (older attack) were higher in the median and basal crown parts. The numbers of Eurytoma sp. galls were higher on apical part of C. brasiliense tree crown and also of their parasitoids.

Caryocar brasiliense Camb. (Malpighiales: Caryocaraceae) é, amplamente, distribuída no cerrado brasileiro e seus frutos são utilizados para alimentação humana, produção de cosméticos, lubrificantes e na indústria farmacêutica, no entanto, é danificada por insetos galhadores. O número de insetos galhadores e seus parasitoides foram avaliados, em campo (galhas) e em laboratório (emergência de adultos das galhas), em três alturas do dossel de C. brasiliense, durante três anos. Os números de adultos Eurytoma sp. (Hymenoptera: Eurytomidae), inseto galhador (galhas novas) e de Sycophila sp. (Hymenoptera: Eurytomidae), parasitoide de Eurytoma sp., foram maiores na parte apical do dossel da copa de árvores de C. brasiliense. A quantidade de galhas globoides de Eurytoma sp., isoladas ou em grupo (galhas velhas), foi maior na parte mediana e basal da copa. Os números de adultos do galhador Eurytoma sp. e de seus parasitoides, que os seguem, foram maiores na parte apical da copa de árvores de C. brasiliense.

Persistent and emerging pollutants assessment on aquaculture oysters (Crassostrea gigas) from NW Portuguese coast (Ria De Aveiro).

The study aim was to determine a range of relevant persistent and emerging pollutants in oysters produced in an aquaculture facility located in an important production area, to assure their safety for human consumption. Pollutants, including 16 PAHs, 3 butyltins (BTs), 29 flame retardants (FRs, including organophosphate and halogenated FRs), 35 pesticides (including 9 pyrethroid insecticides) and 13 personal care products (PCPs, including musks and UV filters), were determined in oysters' tissues collected during one year in four seasonal sampling surveys. The seasonal environmental pollution on the production site was evaluated by water and sediment analysis. Furthermore, oysters' nutritional quality was also assessed and related with the consumption of healthy seafood, showing that oysters are a rich source of protein with low fat content and with a high quality index all year around. Results showed that most analysed pollutants were not detected either in oyster tissues or in environmental matrixes (water and sediments). The few pollutants detected in oyster tissues, including both regulated and non-legislated pollutants, such as a few PAHs (fluorene, phenanthrene, anthracene, fluoranthene, pyrene and indenopyrene), FRs (TPPO, TDCPP, DCP, BDE-47, BDE-209 and Dec 602) and PCPs (galaxolide, galaxolidone, homosalate and octocrylene), were present at low levels (in the ng/g dw range) and did not represent a significant health risk to humans. The observed seasonal variations related to human activities (e.g. tourism in summer) highlights the need for environmental protection and sustainable resource exploration for safe seafood production.

Assessment of FTA card employment for Pasteurella multocida DNA transport and detection of virulence-associated genes in strains isolated from fowl cholera in the United States / Avaliação do emprego de cartões FTA para o transporte do DNA de Pasteurella multocida e pesquisa de genes associados à virulência em cepas isoladas de cólera aviária nos Estados Unidos

Fowl Cholera (FC) is a disease caused by Pasteurella multocida. The severity of this disease is partly caused by virulence factors. Genes encoding fimbriae, capsule, sialidases and proteins for iron metabolism may be related to P. multocida's ability to infect the host. Besides to examining DNA for the presence of virulence genes, DNA is essential for the diagnostic and FTA cards are an alternative for genetic material transport. The study aims to evaluate the viability of P. multocida DNA transport using the cards and to detect 14 virulence genes in 27 strains isolated from FC cases in the United States by multiplex-PCR. No growth was observed in any of the FTA cards, which was essential to assess the security. Furthermore, DNA detection was possible in 100% of the samples, independent of the storage period (7 to 35 days) and temperature (4°C and 37°C). ptfA, exbd-tonB, hgbA, nanB, oma87, hyaD-hyaC, sodC, hgbB, sodA, nanH and pfhA genes were detected in more than 80% of the samples. FTA cards have proven to be a viable and safe tool for DNA transport of P. multocida. A majority of genes showed a high frequency, which was similar to strains isolated from FC cases.(AU)

Cólera aviária (CA) é uma doença causada pela bactéria Pasteurella multocida e a severidade dos casos é em parte justificada por fatores de virulência. Genes codificando fímbrias, cápsulas, sialidases, dismutases e proteínas do metabolismo férrico podem ser relacionados à capacidade do agente em infectar o hospedeiro. Além da obtenção do DNA para pesquisa de genes de virulência, o material genético é fundamental para o diagnóstico, e os cartões FTA seriam uma alternativa no transporte de microrganismos. Os objetivos da presente pesquisa foram avaliar a viabilidade do transporte de DNA de P. multocida através dos cartões e detectar 14 genes de virulência em 27 cepas isoladas de CA nos Estados Unidos, por meio de multiplex-PCR. Nenhuma das amostras para análise microbiológica da segurança dos cartões apresentou crescimento. Foi possível a detecção do DNA em 100% das amostras, independentemente do tempo de estocagem (sete a 35 dias) e das temperaturas (4°C e 37°C) avaliadas. Genes ptfA, exbd-tonB, hgbA, nanB, oma87, hyaD-hyaC, sodC, hgbB, sodA, nanH e pfhA foram detectados em mais de 80% das amostras. Os cartões FTA demonstraram ser uma ferramenta viável e segura para o transporte do DNA de P. multocida. A maioria dos genes apresentou uma alta frequência, compatível com isolados de CA.(AU)

Protocol for a randomised controlled trial for Reducing Arthritis Fatigue by clinical Teams (RAFT) using cognitive-behavioural approaches.

INTRODUCTION: Rheumatoid arthritis (RA) fatigue is distressing, leading to unmanageable physical and cognitive exhaustion impacting on health, leisure and work. Group cognitive-behavioural (CB) therapy delivered by a clinical psychologist demonstrated large improvements in fatigue impact. However, few rheumatology teams include a clinical psychologist, therefore, this study aims to examine whether conventional rheumatology teams can reproduce similar results, potentially widening intervention availability. METHODS AND ANALYSIS: This is a multicentre, randomised, controlled trial of a group CB intervention for RA fatigue self-management, delivered by local rheumatology clinical teams. 7 centres will each recruit 4 consecutive cohorts of 10-16 patients with RA (fatigue severity ≥ 6/10). After consenting, patients will have baseline assessments, then usual care (fatigue self-management booklet, discussed for 5-6 min), then be randomised into control (no action) or intervention arms. The intervention, Reducing Arthritis Fatigue by clinical Teams (RAFT) will be cofacilitated by two local rheumatology clinicians (eg, nurse/occupational therapist), who will have had brief training in CB approaches, a RAFT manual and materials, and delivered an observed practice course. Groups of 5-8 patients will attend 6 × 2 h sessions (weeks 1-6) and a 1 hr consolidation session (week 14) addressing different self-management topics and behaviours. The primary outcome is fatigue impact (26 weeks); secondary outcomes are fatigue severity, coping and multidimensional impact, quality of life, clinical and mood status (to week 104). Statistical and health economic analyses will follow a predetermined plan to establish whether the intervention is clinically and cost-effective. Effects of teaching CB skills to clinicians will be evaluated qualitatively. ETHICS AND DISSEMINATION: Approval was given by an NHS Research Ethics Committee, and participants will provide written informed consent. The copyrighted RAFT package will be freely available. Findings will be submitted to the National Institute for Health and Care Excellence, Clinical Commissioning Groups and all UK rheumatology departments. ISRCTN: 52709998; Protocol v3 09.02.2015.

Assessment of the non-protein amino acid BMAA in Mediterranean mussel Mytilus galloprovincialis after feeding with estuarine cyanobacteria.

To determine whether 2-amino-3-methylaminopropanoic acid (BMAA) could be taken up by marine organisms from seawater or their diet mussels Mytilus galloprovincialis, collected from the North Atlantic Portuguese shore, were exposed to seawater doped with BMAA standard (for up to 48 h) or fed with cyanobacteria (for up to 15 days). Mussels were able to uptake BMAA when exposed to seawater. Mussels fed with cyanobacteria Synechocystis salina showed a rise in BMAA concentration during feeding and a decline in concentration during the subsequent depuration period. Cells from the gills and hepatopancreas of mussels fed with S. salina showed lessened metabolic activity in mussels fed for longer periods of time. A hot acidic digestion (considered to account for total BMAA) was compared with a proteolytic digestion, using pepsin, trypsin and chymotrypsin. The latter was able to extract from mussels approximately 30% of total BMAA. Implications for BMAA trophic transfers in marine ecosystems are discussed.

Espinheira-santa (Maytenus ilicifolia Mart. ex Reiss.): saber de erveiros e feirantes em Pelotas (RS) / Espinheira-santa (Maytenus ilicifolia Mart. ex Reiss.): knowledge by herbalists and marketers in Pelotas (RS)

RESUMO O objetivo deste trabalho é descrever o conhecimento popular relacionado à espinheira-santa (Maytenus ilicifolia) entre erveiros e feirantes que comercializam a planta no centro de Pelotas, Rio Grande do Sul, Brasil. Foi realizada uma pesquisa de abordagem qualitativa, exploratória e descritiva, de agosto a outubro de 2013. Entrevistas semi-estruturadas, com questões sobre os saberes e práticas relacionados à espinheira-santa, foram aplicadas a cinco erveiros e três feirantes do mercado informal de plantas medicinais. Para a análise dos dados foi utilizada a proposta operativa de Minayo, sendo Capra o referencial teórico para este estudo. Foi verificado que o saber relacionado ao uso da espinheira-santa é transmitido de geração a geração, embora existam outras fontes de conhecimento. As indicações do uso popular da espinheira-santa com finalidade terapêutica estão relacionadas a distúrbios gástricos, cicatrização e depuração do sangue. As diferentes formas dos sujeitos deste estudo interagirem com o ambiente, com sua família e em outras relações interpessoais resultam em diferentes saberes relacionados à espinheira-santa.

ABSTRACT The aim of this study was to describe the popular knowledge related to the espinheira-santa (Maytenus ilicifolia) among herbalists and marketers that sell this plant in the center of Pelotas/Rio Grande do Sul State, Brazil. A qualitative, exploratory and descriptive research was performed between August and July of 2013. Semi-structured interviews, with questions regarding the knowledge and practices related to this plant, were applied to five herbalists and three marketers inserted in the informal market of medicinal plants. The operative proposal by Minayo was used in order to analyze the data, and the theoretical framework by Capra was used in the discussion. The popular knowledge related to the use of espinheira-santa is passed on from generation to generation, although nowadays there are other sources ofinformation. The popular clueswith therapeutic purposes are related to gastric disorders, healing and blood clearance. The study participants have different forms of interaction with the environment, the family and other interpersonal relationships, resulting in different popular knowledges related to this medicinal plant.

Assessment of the water self-purification capacity on a river affected by organic pollution: application of chemometrics in spatial and temporal variations.

Water pollution caused by organic matter is a major global problem which requires continuous evaluation. Multivariate statistical analysis was applied to assess spatial and temporal changes caused by natural and anthropogenic phenomena along Potrero de los Funes River. Cluster analysis (CA), principal component analysis (PCA) and analysis of variance (ANOVA) were applied to a data set collected throughout a period of 3 years (2010-2012), which monitored 22 physical, chemical and biological parameters. Content of dissolved oxygen in water and biochemical oxygen demand in a watercourse are indicators of pollution caused by organic matter. For this reason, the Streeter-Phelps model was used to evaluate the water self-purification capacity. Hierarchical cluster analysis grouped the sampling sites based on the similarity of water quality characteristics. PCA resulted in two latent factors explaining 75.2 and 17.6 % of the total variance in water quality data sets. Multidimensional ANOVA suggested that organic pollution is mainly due to domestic wastewater run-offs and anthropogenic influence as a consequence of increasing urbanization and tourist influx over the last years. Besides, Streeter-Phelps parameters showed a low reaeration capacity before dam with low concentration of dissolved oxygen. Furthermore, self-purification capacity loss was correlated with the decrease of the Benthic Index. This measurement suggested that biological samplings complement the physical-chemical analysis of water quality.

Assessment of imposex and butyltin concentrations in Gemophos viverratus (Kiener, 1834), from São Vicente, Republic of Cabo Verde (Africa).

This work constitutes the first assessment of tributyltin (TBT) pollution levels in the Republic of Cabo Verde (Africa) and proposes the marine gastropod Gemophos viverratus (Kiener, 1834) as a new bioindicator of TBT pollution in the Macaronesia and west coast of Africa. Specimens were collected between August and October 2012 along a gradient of naval traffic in São Vicente Island. The results clearly indicate an increase of imposex levels (percentage of females affected with imposex, 0-100 %; vas deferens sequence index, 0-4.1; relative penis length index, 0-54.6 %) and female TBT contamination (from 5 to 37 ngSn g(-1) dry weight (dw)) from outside to inside the harbour of Porto Grande Bay and identify this area as the focus of TBT pollution in the island. The butyltin degradation index for G. viverratus tissues ranged between 1.3 and 2.2, which being above 1 suggests that a considerable part of TBT inputs to the bay may not be very recent. Sterile females were found inside the harbour with an incidence up to 21.4 %. Considering the existence of a planktonic veliger stage in the life cycle of G. viverratus, it is expected that recruitment of newborn individuals can be supplied from unaffected breeding females inside and outside the Porto Grande Bay, resulting in a reduced impact of TBT pollution on population abundance. G. viverratus is very promising to be used as a simple, inexpensive and efficient novel tool for TBT pollution biomonitoring in the Macaronesia and west coast of Africa, a region for which there is an astonishing lack of information concerning levels and ecological impacts of TBT pollution.

Assessment of mother-to-child HIV-1 and HIV-2 transmission: an AIDS reference laboratory collaborative study.

OBJECTIVE: A prospective study was carried out to assess HIV-1 and HIV-2 mother-to-child transmission (MTCT) rates in Portugal between 1999 and 2005 by analysing the proportion of diagnosed infected children born to HIV-positive mothers. MATERIALS AND METHODS: Serial blood samples were collected from 1315 children at risk of HIV-1 infection, 131 children at risk of HIV-2 infection and six children at risk of both HIV-1 and HIV-2 infections attending 25 Health Institutions. HIV proviral DNA was detected by nested polymerase chain reaction (PCR) and statistical analysis was performed using spss. RESULTS: DNA PCR using HIV-1 and HIV-2 long terminal repeat (LTR) primers amplified 92.5% and 75% of maternal HIV infections, respectively. Overall, MTCT occurred in 3.4% [95% confidence interval (CI) 2.5-4.6%] of HIV-1 and 1.5% (95% CI 0.2-5.4%) of HIV-2 mother-child pairs. A significant decrease in HIV-1 MTCT was observed with time, from 7.0% (95% CI 2.6-14.6%) in 1999 to 0.5% (95% CI 0.0-2.5%) in 2005. HIV MTCT was associated with an absence of antiretroviral therapy in infected pregnant women (P<0.0001). Of the 48 infected children (46 with HIV-1 and two with HIV-2), the schedule of blood sample collection was followed for only 26 children. In 14 (53.8%) of those 26 children the infections were diagnosed in the first sample collected before they were 48 h old, suggesting in utero transmission. Despite the national recommendations for antenatal HIV testing, a high overall proportion (22.2% for HIV-1 and 44.3% for HIV-2) of mothers did not access any MTCT prevention measures, mostly because of late diagnosis in pregnancy. A small but significant proportion of HIV-2 infection was found in mothers with no identifiable link with West Africa. CONCLUSION: HIV-2 transmission rates are low (1.5% in this study), and this may have led to a lower uptake of interventions, but in the absence of interventions transmission does occur. HIV-1 transmission was also associated with a lack of intervention, mostly as a result of late presentation. Use of primers restricted to a single sequence led to false-negative maternal results in a significant proportion of cases. In part this may have been attributable to very low HIV DNA loads as well as primer template mismatches. HIV infection was not documented in children born to mothers with negative HIV DNA PCR results.

Experimental derivation of wall correction factors for ionization chambers used in high dose rate 192Ir source calibration.

At present there are no specific primary standards for 192Ir high dose rate sources used in brachytherapy. Traceability to primary standards is guaranteed through the method recommended by the AAPM that derives the air kerma calibration factor for the 192Ir gamma rays as the average of the air kerma calibration factors for x-rays and 137Cs gamma-rays or the Maréchal et al. method that uses the energy-weighted air kerma calibration factors for 250 kV x rays and 60Co gamma rays as the air kerma calibration factor for the 192Ir gamma rays. In order to use these methods, it is necessary to use the same buildup cap for all energies and the appropriate wall correction factor for each chamber. This work describes experimental work used to derive the A(W) for four different ionization chambers and different buildup cap materials for the three energies involved in the Maréchal et al. method. The A(W) for the two most common ionization chambers used in hospitals, the Farmer NE 2571 and PTW N30001 is 0.995 and 0.997, respectively, for 250 kV x rays, 0.982 and 0.985 for 192Ir gamma rays, and 0.979 and 0.991 for 60Co gamma rays, all for a PMMA build-up cap of 0.550 gm cm(-2). A comparison between the experimental values and Monte Carlo calculations shows an agreement better than 0.9%. Availability of the A(W) correction factors for all commercial chambers allows users of the in-air calibration jig, provided by the manufacturer, to alternatively use the Maréchal et al. method. Calibration laboratories may also used this method for calibration of a well-type ionization chamber with a comparable accuracy to the AAPM method.

Growth of exclusively breast-fed infants from a poor urban population.

The growth of two groups of infants were evaluated, one of them exclusively breast-fed (105 infants) and the other exclusively bottle-fed (61 infants), and compared with one another and with international standards (NCHS). All infants were evaluated by anthropometry at 1, 2, 3, 4, 5 and 6 months of age. A fourth order polynomial was adopted for each infant and for each anthropometric measurement in order to estimate individual growth, and the 5th, 50th and 95th percentiles for weight and length were obtained. For the age of 6 months, the weights of breast-fed boys and girls were always statistically equal to or higher than those of infants fed cow's milk or those of NCHS standards. Breast-fed boys presented significantly longer length than bottle-fed boys but shorter than NCHS standards, and breast-fed girls presented significantly shorter length than both bottle-fed girls and than NCHS standards. The greater weight of exclusively breast-fed infants when compared to NCHS standards at six months of age, which differentiates the present study from several other ones carried out in developing countries, was probably due to the association of the beneficial effects of breast-feeding with those of pediatric follow-up.

Considerations on methodology used in the World Health Organization 2000 Report.

The article analyzes the World Health Organization Report for 2000, with emphasis placed on the methodology used to analyze the indicators utilized to compare and classify the performance of the health systems of the 191 member countries. The Report's contribution was the compromise of monitoring the performance of the health systems of member countries, but because of the inconsistent way it was elaborated, and the utilization of questionable scientific evaluation methodologies, the Report fails to give a clear picture. A criterion-based methodology revision is imposed. The main problems in evidence are the choice of individual indicators of disparity in health that discount the population profile, the inadequate control of the impact of social disparities over the performance of the systems, the evaluation of the responsibility of systems that are only partially articulated to the right of the citizens, the lack of data for a great number of countries, consequently having inconsistent estimations, and the lack of transparency in the methodological procedures in the calculation of some indicators. The article suggests a wide methodological revision of the Report.

Growth and hematological studies on Brazilian children of low socioeconomic level.

Anemia and undernutrition are common all over the world, especially in less developed countries. The relationship between low weight, short stature and iron deficiency should be better understood so that appropriate measures might be taken to prevent these problems. A total of 115 institutionalized children aged 12 to 72 months were studied in day-care institutions in the town of Pontal, Southeastern Brazil, during the second semester of 1999. Personal data, weight, height and hematological profile were obtained from all subjects. Food intake was evaluated in 20 children by a direct food-weighing method. The prevalence of low weight for age (2.6%), low weight for height (1.7%) and low height for age (4.3%) was considered low. Anemia was observed in 68.7% of the children. Diet was found to be adequate in terms of the major nutrients evaluated, but food iron supply was of low bioavailability. In conclusion, the population studied revealed a peculiar behavior i.e., the coexistence of fairly good anthropometric nutritional status along with iron-deficiency anemia. The prevention of this kind of malnutrition cannot be limited to an adequate calorie/protein supply but should also be based on the correction of the severe iron deficiency present in this low socioeconomic level preschool children in Brazil.

Health sector reform in Brazil: a case study of inequity.

Health sector reform in Brazil built the Unified Health System according to a dense body of administrative instruments for organizing decentralized service networks and institutionalizing a complex decision-making arena. This article focuses on the equity in health care services. Equity is defined as a principle governing distributive functions designed to reduce or offset socially unjust inequalities, and it is applied to evaluate the distribution of financial resources and the use of health services. Even though in the Constitution the term "equity" refers to equal opportunity of access for equal needs, the implemented policies have not guaranteed these rights. Underfunding, fiscal stress, and lack of priorities for the sector have contributed to a progressive deterioration of health care services, with continuing regressive tax collection and unequal distribution of financial resources among regions. The data suggest that despite regulatory measures to increase efficiency and reduce inequalities, delivery of health care services remains extremely unequal across the country. People in lower income groups experience more difficulties in getting access to health services. Utilization rates vary greatly by type of service among income groups, positions in the labor market, and levels of education.