Government funding of cancer research in Brazil.

BACKGROUND: Cancer research is a prominent theme on national and international development agendas. In many developed countries, funding for this area comes mainly from government sources. This article analyzes government funding of cancer research in Brazil, identifying the main funding instruments and examining the regional distribution of resources, research project and researcher profiles. METHODS: Exploratory study of government funding of cancer research in Brazil between 2007 and 2016. The primary data were federal and state funding agencies. RESULTS: A total of 8565 research awards were identified for the period 2007-2016. Amounting to almost US$489 million, these awards were linked to 7622 research projects and 3068 researchers. The proportion of grants awarded to women was slightly higher. It is noteworthy that just 3% of researchers received 20 % of the grants. The multiple-grant history of individual researchers seemed to be a conditioning factor for obtaining new grants/fellowships. Funding was highly concentrated in the Southeast region, accounting for 84.4 % of total awards. There was a positive correlation between number of awards and amount awarded. The most frequently studied cancers were breast (11.8 %), head and neck (9.0 %) and skin cancer (5.3 %). Studies that did not specify the type of cancer accounted for 36.8 % of grants and 45.1 % of funding. CONCLUSION: The findings show a fall in the share of cancer research funding in the three largest funders. Cuts in government spending triggered by the country's political and economic crisis, highlight the vulnerability of science and technology. Greater transparency through access to information on funding, researcher, and research profiles is key to obtaining a better understanding the cancer research funding landscape in Brazil and reducing regional inequalities. POLICY SUMMARY: A more centralized management of public cancer research funding and constant investment and monitoring is needed to ensure the effective implementation of funding policy.

El envejecimiento desde la percepción de enfermería / Aging from the perception of nursing / Envelhecimento da percepção da enfermagem

ResumenIntroducción. El proceso de envejecimiento se concibe como un proceso heterogéneo, irreversible, universal que conlleva una disminución en las capacidades físicas. Al ser el envejecimiento objetivo de estudio de la enfermería, es necesario analizar cómo la enfermera y los estudiantes de la carrera perciben el envejecimiento.Método. Se elaboró una revisión integrativa sobre el proceso de envejecimiento desde la perspectiva de la enfermería. Se llevó a cabo una búsqueda de artículos en las bases de datos SCIELO, LILACS, EBSCO, CUIDEN y REDALYC con los descriptores "envejecimiento" "enfermería" "percepción", en inglés, portugués e inglés, a partir de enero de 2011 a noviembre de 2015. Los criterios de inclusión fueron: artículos originales en texto completo en inglés, español y/o portugués, mientras que se excluyó editoriales, cartas, artículos de opinión, reflexión o ensayo y tesis. Se encontró 388 artículos de los cuales se obtuvo una muestra de 10 que cumplían con los criterios de inclusión. Se detectó artículos originales (100%), cualitativos (90%), descriptivos, exploratorios (70%), utilizando entrevistas abiertas (90%) y análisis de contenido (70%).Resultado. Respecto de los profesionales encontrar la dirección de la percepción en el ejercicio profesional, es una manera de fomentar la formación y las relaciones extra-académicas (creencias, valores) respecto del envejecimiento.Conclusión. Para explorar la percepción respecto de un fenómeno se utiliza el estudio cualitativo. Por otra parte, la relación enfermera-adulto mayor es dada por valores y por conocimiento teórico.

AbstractIntroduction. The aging process is conceived as a heterogeneous, irreversible and universal process, this entails a decline in physical abilities. The aging is objective of study for nursing and is necessary to analyze how the nurse and nursing students perceive the aging.Method.An integrative review of the aging process from the perspective of the nurse was made. It was conducted a search on the data bases SCIELO, LILACS, EBSCO, CUIDEN and REDALYC whit the descriptors "aging" "nursing" "perception" in English, Portuguese and English from January 2011 to November 2015 concerning the theme, the inclusion criteria were: original articles in full text in English, Spanish and / or Portuguese. We excluded editorials, letters, opinion articles, reflection or essay and thesis. Were found 388 articles, was obtained a sample of 10 articles that met the inclusion criteria. Original articles (100%), Qualitative (90%), Descriptive, exploratory (70%), Using open interviews (90%), it was made content analysis (70%).Result. Regarding professionals find the address of perception in professional practice; it is a way to promote training and extra-academic relations (beliefs, values) to aging.Conclusion. They are qualitative studies to explore the perception of a phenomenon; it recognized the relationship nurse-older people whit values and theoretical knowledge.

ResumoIntrodução.O processo de envelhecimento é concebido como um processo heterogéneo universal, irreversível, conduzindo a uma diminuição da capacidade física. O objectivo de enfermagen é estudo da envelhecimento , é necessário analisar como os estudantes de enfermagem e de carreira percebem o envelhecimento.Método.Uma revisão integrativa sobre o processo de envelhecimento foi desenvolvida a partir da perspectiva da enfermagem. Eles realizaram uma pesquisa na base SCIELO, LILACS, EBSCO, CUIDEN e REDALYC dados descritores "envelhecimento" "enfermagem" "percepção" em Inglês, Português e Inglês, a partir de janeiro de 2011 a novembro 2015. Critérios de inclusão foram: artigos originais em texto completo em Inglês, Espanhol e / ou Português, enquanto os editoriais, cartas, opinião, reflexão ou ensaio e teses foram excluídos. 388 itens, dos quais uma amostra de 10 que preencheram os critérios de inclusão conheci foi obtido. Artigos originais (100%), qualitativa (90%), descritivo, exploratório (70%) foi detectada por meio de entrevistas abertas (90%) e análise de conteúdo (70%).Resultado. Em relação profissionais de encontrar o endereço de percepção, na prática profissional, é uma maneira de promover a formação e as relações extra-acadêmica (crenças, valores) para o envelhecimento.Conclusão.Para explorar a percepção de um fenômeno utilizado o estudo qualitativo. Além disso, a relação enfermeiro-idosos é dada por valores e conhecimento teórico.

Análisis bibliometrico de los trabajos libres de neurocirugía presentados en los congresos nacionales de la sociedad Chilena de neurocirugía entre los años 2010 y 2013 / A bibliometric analysis of neurosurgical free submissionspresented in the National Congress of the Chilean neurosurgical society between the years 2010 to 2013

Introduction: Bibliometric works aim to collect and to do a quantitative analysis of the scientific production. In Chile there are no studies that characterize neurosurgical scientific production. The objective of this study is to describe the free submission presented at the last four National Congress of the Society of Neurosurgery of Chile. Materials and Methods: The abstracts books of each year National Congress of Chilean Society of Neurosurgery were reviewed between the year 2010 and 2013. Results: A total of 251 free submissions were presented, and were filiated 354 participations of 51 different institutions. The 73,1 percent of the institutions named in the different submissions came from the Metropolitan Region. The most - named hospital group was the Institute of Neurosurgery Dr. Alfonso Asenjo with a 19,2 percent(68), while the most - named University was Pontificia Universidad Católica de Chile with a 6,5 percent(23). The most common topic was tumor and vascular neuropathology with a 29,4 percent(74) and 21,1 percent(53) respectively. Discussion and Conclusions: We noticed that the majority of submissions involves one institution, with an average of 1,4 institutions per free submission, this might be explained because uncompleted filiations of authors. We can see a clear centralization of the origin of the different submissions. The two more representative areas of investigation in these congresses were tumor and vascular neuropathology. We think that is necessary to create a common protocol for registration and filiations of free submissions in the different congresses to create a National database.

What are the links between research and policy?

PIP: A descriptive study was conducted by Ana Langer, Population Council's Regional Director in Latin America and Caribbean, and her colleagues on the influence of research on health policy decision making in Mexico. Four programs within the Mexican Ministry of Health were examined: those concerned with AIDS, cholera, family planning, and immunization. Data were obtained through in-depth interviews with 67 researchers and Ministry of Health officials, extensive documentary research, and case studies. Overall, it was noted that four elements figure in any interaction between research and policy: the content of the research and policy, the actors involved, the communication process, and the context of research and policy. Both the researchers and decision-makers mentioned the quality of research as influential in promoting its use in policy. The investigators noted a ¿mutual intellectual disdain¿ between researchers and decision makers, with members of both groups wanting to be recognized as the greatest contributor to the control or solution of the problem. Local and international groups were identified as actors that promote the use of research in decision making, and many informants mentioned the importance of informal contacts between researchers and decision-makers. In addition, the relative stability of Mexico's government has facilitated the incorporation of research and policy, although the centralized government structure has sometimes hindered it. Strikingly, only few participants mentioned the role of the public in influencing connections between research and policy.^ieng

High frequency of the GWG (Pro Trp) envelope variant of HIV-1 in Southeast Brazil.

The HIV-1 variant that contains the GWG amino acid sequence in the crown of the principal neutralizing determinant (PND) has been detected in a few patients in Japan, France, and Brazil by direct sequencing. We describe for the first time the use of restriction fragment length polymorphism (RFLP) and limited DNA sequencing of the C2-V3 region of the HIV-1 envelope (env) gene to determine the prevalence of the variant in 75 HIV-1-infected Brazilian patients. Overall prevalence of the GWG sequence as indicated by RFLP was 57% (43 of 75). The prevalence in females (72%) was higher than that in males (32%) and newborns (40%). Two GFG sequences and 1 GLG sequence were also detected. This finding is relevant for the planning of vaccines and for studies of the epidemiology of HIV-1 in Brazil.

PIP: Most current HIV vaccine development research is focused on the third variable domain (V3) of the HIV-1 envelope gene product that contains the GWG amino acid sequence in the crown of the principal neutralizing determinant. Direct sequencing has detected this variant in patients in Japan, France, and Brazil. The present study used restriction fragment length polymorphism (RFLP) and limited DNA sequencing of the C2-V3 region of the HIV-1 envelope gene to determine the prevalence of the variant in 75 HIV-infected patients from Ribeirao Preto, Brazil. According to RFLP, the overall prevalence of the GWG sequence was 57% (72% in females, 32% in males, and 40% in newborns). Two GFG sequences and one GLG sequence were also detected, suggesting that the GWG variant could be the founder sequence. The gene dendrogram indicated the samples clustered together within the subtype B of the main group.

Cultural feasibility studies in preparation for clinical trials to reduce maternal-infant HIV transmission in Haiti.

A cultural feasibility study is defined as one that investigates scientific as well as ethical, behavioral, and social issues in the design of clinical trials. The value of such a broadly defined assessment is illustrated through the presentation of two case studies conducted to prepare for clinical trials to reduce maternal-infant HIV transmission on Cité Soleil, Haiti. The first study addressed issues surrounding a trial of breast-feeding and exclusive bottle-feeding among HIV seropositive mothers. The second study focused on the implementation of a double-blind trial of HIV immune globulin and standard immune globulin to be administered to infants of seropositive mothers shortly after birth. Both cases used focus group interviews with mothers and in-depth interviews with key informants to investigate AIDS-related beliefs, acceptability of trial participation, risks to subjects, and community reactions and repercussions to the trial. Findings point to the difficulties posed by attempts to conduct trial involving complex research designs in socially disadvantaged populations. Recommendations highlight the need to consider the community-wide impact of a trial, and the need to undertake extensive educational preparation of participants to ensure informed consent and adherence to protocols.

PIP: Cultural feasibility studies use ethnographic methods to explore ethical, behavioral, and social issues inherent in the design of proposed clinical trials. This approach was applied in advance of clinical trials aimed at reducing maternal-infant HIV transmission in Cite Soleil, Haiti. The first focused on conditions that would be necessary to conduct a trial of breast feeding versus exclusive bottle feeding by HIV-positive mothers; the second investigated the feasibility of a double-blind trial of administration of a high- titer antibody preparation--HIV immune globulin (HIVIG)--to infants of seropositive mothers shortly after birth. Study methods included focus group discussions with mothers and in-depth interviews with key informants about AIDS-related beliefs, acceptability of trial participation, risks to subjects, and community repercussions. Concerns identified included the potential negative effect on breast feeding promotion efforts in Haiti, the scarcity of economic means to sustain safe bottle feeding, the risk of being labeled HIV-positive by virtue of study participation, the potential for the HIVIG trial to reinforce the misconception that a vaccine effective against AIDS exists, and problems explaining the concept of a double-blind study and accepting random assignment to treatment and control groups. As a result of these studies, it was decided to conduct the infant feeding study in a community with higher rates of exclusive bottle feeding and lower infant mortality than exist in Cite Soleil. The HIVIG trial could be conducted, but only after extensive community education to ensure informed consent. An objective assessment of subject comprehension was developed for this purpose.

An innovative HIV / AIDS research and education program in Puerto Rico.

PIP: The University of Puerto Rico's HIV/AIDS Research and Education Center was founded to promote research and to create programs to help prevent HIV infection through a decrease in risk practices. Specific Center goals are to create and launch research projects to identify the sociocultural factors behind risk behaviors, and to develop innovative educational programs and techniques based upon the research findings. Before the founding of the center, a survey of more than 7000 University of Puerto Rico students found that about 10% of respondents reported always using condoms during sex; male and female respondents reported averages of 6.1 and 2.5 lifetime sex partners, respectively; approximately 30% of the female respondents reported having engaged in anal intercourse; and Puerto Ricans have rigid sexual norms and polarized gender roles. These findings point to the need for meaningful HIV/AIDS interventions. The center has launched a 5-year project to relate contextual variables to the context of sexuality and gender roles in sexual negotiation and sexual practices in Puerto Rico. The center's education program is described.^ieng

[Three modes of analysis in the incorporation of a gender perspective in socio-demographic studies of urban labor in Mexico]. / Tres ejes de analisis en la incorporacion de la perspectiva de genero en los estudios sociodemograficos sobre el trabajo urbano en Mexico.

PIP: This overview of sociodemographic research on the urban female labor force in Mexico from the 1970s to the mid-1990s traces the gradual development of a gender focus. One of the first problems examined was the insufficient visibility of female economic activity, resulting from underestimation of the productive contribution of women by information producers, analysts, and the women themselves. The next phases were documentation of existing differences between male and female economic activities, and analysis of the degree to which differences were transformed into inequalities. The process involved delving in greater depth into the causes and consequences of concentration or segregation of women in specific activities or occupations, as well as into the discrimination they experienced because of their gender. Some sociodemographic studies reconsidered the relation of extra-domestic and domestic work; a gender perspective on labor force analysis must take into account the essential fact that most women in the labor force also carry out domestic functions. Most studies of domestic work in Mexico, however, have been carried out separately from studies of extra-domestic work. This survey of the evolution of sociodemographic studies of work clearly demonstrates that the gender perspective is present or not from the moment of selecting a topic for research. The gender focus allows reconceptualization of well known themes, such as the subordination of working women.^ieng

Grassroots women have their say. Programme.

PIP: The International Reproductive Rights Research Action Group was founded in 1992 to conduct international research on the meanings of "reproductive rights" for grassroots women in different settings. The qualitative ethnographic study conducted in Brazil, Egypt, Malaysia, Mexico, Nigeria, the Philippines, and the US sought to determine 1) concepts of entitlement about reproduction and sexuality; 2) how reproductive decisions are made; 3) how women practice resistance and accommodation in relation to self-identity and reproductive decision-making; and 4) what social, economic, legal, and political conditions and services affect women's decisions and reproductive life and rights. A number of interview techniques were employed with relatively small numbers of low-income people from diverse backgrounds in each country. The study revealed that significant similarities as well as differences existed among and within the study countries. The women studied exhibited a strong sense of entitlement over reproductive decisions, marriage, and sexual relations. In order to secure their needs, the women accommodated themselves to local expectations when they were unable to rely on a supportive environment to translate their sense of entitlement into effective rights.^ieng

Mexico-United States labor migration flows.

"International migration from Mexico to the United Sates is viewed very differently depending on from which side of the border this phenomenon is observed and evaluated....[It is] imperative to begin a process of ¿demythifying' migration as a necessary and sufficient condition that would allow both countries to come together within the context of bilateral relations and find ways to act jointly to address the impacts of the issue. Such a demythifying effort must begin with scientific research which can help develop a diagnosis of the costs and benefits that labor migration from Mexico to the United States brings to the two countries."

The WHO Collaborating Centre for Research and Control of Schistosomiasis at Niamey, Niger.

The Centre de Recherche sur les Méningites et les Schistosomes (CERMES) is a research institute depending on the Organisation de Coordination et de Coopération pour la lutte contre les Grandes Endémies--a West African Organization for Public Health--devoted to the studies on schistosomiasis and meningitis. The staff includes 32 persons with 11 scientists and one financial officer. The activities of the CERMES involving schistosomiasis concern three research units: (a) ecology of human and animal schistosomiasis transmission; the CERMES defined the different patterns of schistosomiasis transmission in Niger (involving African dry savana); in this field, we have shown, (i) the existence of important variability in conditions of transmission of S. haematobium and, (ii) natural hybridization between parasitic species of the ruminants (S. bovis and S. curassoni) and genetic interaction between human and animal parasites; (b) definition of morbidity indicators usable for rapid assessment methods, for appraisal of the severity of the disease and for the evaluation of the efficiency of control methods; we have established the correlation between ultrasonographic data and some cheap and simple field indicators; (c) immune response and protective immunity induced by recombinant glutathion S-transferase (Sm28, Sb28 and Sh28) in homologous and heterologous animal models including goats, sheep and non human primates (Erythrocebus patas). In Niger, we participate in all control programs against schistosomiasis to define control strategies, to supervise operations and to participate in their evaluation with external experts. International collaborations constitute a frame including four laboratories in Africa and six laboratories in developed countries (Europe and USA).

PIP: The Centre de Recherche sur les Meningites et les Schistosomoses (CERMES), a research center in Niamey, Niger, affiliated with a West African public health organization, conducts studies in the areas of parasitology, epidemiology, and immunology. Significant variability in factors related to transmission of Schistosoma haematobium have been noted. Experimental research on the Schistosoma-bulinid compatibility and field surveys of the geographic distribution and role of snails in transmission have been essential to the design of parasite control interventions in West Africa. A CERMES-sponsored project, supported by the European Community, is examining urinary schistosomiasis control in the Niger river valley and the impact of treatment on ultrasonically visualized urologic lesions. The Experimental Vaccine Unit seeks to improve the route of administration and choice of adjuvant and to propose a vaccine protocol for field testing. Recombinant proteins have been found to alter the development of the parasite either by inducing a reduction in the parasite burden or an inhibition of the fecundity of the parasite.

In sickness or in health: TDR's partners. 6. The French Development Research Institute (ORSTOM).

PIP: One of the partner agencies working with the UN Development Program/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases (TDR) is the French development research agency, ORSTOM. ORSTOM has been conducting research in intertropical regions for approximately 50 years with a particular focus on entomoparasitological aspects of vector-borne diseases. ORSTOM's close collaboration with TDR since the TDR Special Program was launched in 1975 has led to 1) improved knowledge about various aspects of trypanosomiasis that allowed identification of ways to control the epidemic; 2) reappraisal of the taxonomy of the parasitic protozoa responsible for Chagas disease and leishmaniasis; 3) improvements in the strategy to fight malaria; 4) assessment of the efficacy of ivermectin as a form of mass treatment for onchocerciasis; 5) improved knowledge about dracunculiasis that contributed to an eradication campaign; 6) expansion of the scope of biological control of bancroftian filariasis and other parasites; and 7) improved knowledge about ways to control two schistosome species. ORSTOM also participated in a training and structural enhancement initiative that resulted in creation of the Boake Medical and Veterinary Entomology Training Center. ORSTOM is currently undergoing a complete restructuring to respond to changes in international tropical disease research and to changing priorities that focus on vector-borne diseases, nutrition, AIDS, and health systems.^ieng

Brazil assessment finds unmet needs in the public sector.

PIP: An assessment conducted in municipalities in four of Brazil's nine states in 1993 revealed high rates of unwanted fertility. As many as 58% of pregnant women reported that their current pregnancy was either unwanted or mistimed. Despite Ministry of Health approval for the provision of oral contraceptives, IUDs, condoms, spermicides, diaphragms, and natural family planning methods, public-sector programs generally offered a limited range of contraceptive options and frequently were out of supplies. Also observed by the assessment team was a strong medical (as opposed to primary health care) orientation among contraceptive providers and a lack of training of physicians and nurses in family planning. On the basis of this assessment, the team recommended that efforts be directed toward strengthening the provision of methods that are often unavailable (e.g., IUDs, barrier methods, and lactational amenorrhea) rather than expanding contraceptive options. Research currently underway in Sao Paulo state seeks to identify the operational and management changes necessary to broaden contraceptive choice and improve the quality of reproductive health services. A data collection and information retrieval system has been set up to record health post activities, and a family planning training and referral system has been established. The Brazil assessment was conducted according to a three-stage model devised by the UNDP/UNFPA/WHO/World Bank Special Program of Research, Development, and Research Training in Human Reproduction.^ieng

Adventures in human population biology.

PIP: This article is a memoir of anthropologist Paul Baker's professional life. The introduction notes that the field of anthropology was altered by the impact of World War II when physical anthropologists provided vital information to the military. After the war, the GI bill supported the undergraduate and graduate studies of veterans, including Baker. After describing his academic training at the University of New Mexico and Harvard, Baker details his research training and field work in the desert for the US Climatic Research Laboratory and his work identifying the dead in Japan for the Quartermaster unit. Baker then traces his academic career at the Pennsylvania State University during which he directed two multidisciplinary research efforts for the International Biological Programme, one that sought to understand human adaptability at high altitude in Peru and another that studied migration and modernization in Samoa. Baker's last administrative positions were as staff consultant to the Man and the Biosphere (MAB) program and as chair of the US MAB committee. Baker retired from academic life at age 60 in 1987 and has devoted his time to reading and to helping organize professional associations in anthropology, especially those devoted to furthering internationally organized scientific efforts. Baker concludes this memoir by acknowledging the growth and development of the discipline of human population biology.^ieng

Emigration dynamics in developing countries.

PIP: This paper describes the research objectives and summarizes first-stage findings of a joint project of the International Organization for Migration and the UN Population Fund on emigration dynamics in developing countries. The paper was prepared for a conference in Bellagio organized to allow academics, policy-makers, and officials to evaluate the first-stage findings and to appraise the stage-two research proposals. The research methodology developed at a 1993 project launching meeting held in Geneva drew on demographic transition theory and involves inclusion in the research framework of economic; demographic; community, family, and individual; and sociopolitical variables which would provide a dynamic understanding of why different migration flows were occurring and allow projections of various types of future migration. In addition, the research was to explain all types of migration, with disaggregation by type provided. The first stage of research (reported at this conference) was devoted to obtaining and assembling data on the factors known to influence emigration dynamics. The second stage will be devoted to attempts to measure the interaction among variables in a specific region. The first-stage findings are summarized in this paper for sub-Saharan Africa, southern Asia, and Central America and the Caribbean. This paper ends by noting that this research takes the same direction as objectives cited in the 1994 UN Conference on Population and Development's (ICPD) Programme for Action. The evaluation of the proposal of second-stage research will include ways to maximize the concordance of that research with the goals of the ICPD.^ieng

Prostitution and HIV: what do we know and where might research be targeted in the future?

PIP: A review of the literature indicates that the association between human immunodeficiency virus (HIV) and prostitution varies by geographic region and can be altered substantially by well-planned public health interventions. In most African countries and in Asian countries such as Thailand, the rate of HIV infection among female prostitutes is substantially higher than the rate in the general population. Relatively few commercial sex workers in South and Central America are HIV-positive; however, their extremely high rates of infection with sexually transmitted diseases indicates the potential for future epidemic spread of HIV. In Europe and North America, HIV infection is most prevalent among drug-injecting or crack-using prostitutes. Neglected has been research on the high incidence of HIV among male transvestite and transsexual prostitutes. The lowest levels of condom use in commercial sex encounters have been recorded in regions in developing countries with the highest HIV prevalence. Also of concern are high condom breakage rates (20-50%) among female prostitutes who use petroleum-based lubricants and male prostitutes who practice anal sex. Valuable would be quantification of the additional HIV risk resulting from sex with a prostitute. Other recommended research areas include estimates of the number of male and female prostitutes working in certain geographic areas, mechanisms for monitoring condom use and substance abuse among prostitutes, the impact of HIV infection on movement into and out of prostitution, the dynamics of prostitute-client condom negotiation, and profiles of the clients of male prostitutes.^ieng

A Mexican approach to health priorities.

PIP: IDRC is helping to develop the plan for Essential National Health Research (ENHR) for Mexico. Mexico strongly supports this approach to setting public health research priorities in developing countries. The conclusions of an extensive report led to the creation of the Council on Health Research for Development (COHRED) which is made up of national committees entrusted to decide on subjects for ENHR. It is very hard for competent and committed researchers to assign priority to one problem over another, however. Researchers need to know that 90% of health problems originate in developing countries, yet 95% of the human, technical, and financial resources are in developed countries. One needs to cut down the barriers of ignorance at all levels, such as the mistrust and resistance between researchers and decision makers. COHRED is a vehicle to break through the lack of communication. Funding agencies want to clearly understand the public health problems, but researchers do not like setting priorities. The Mexican Committee for Basic Health Research (COMISA) should release its final report on research priorities in mid-1994. The chair says that globalization is occurring in the health field. For example, tourists from developed countries bring tropical diseases back to their countries. The major health problems in urban areas are chronic degenerative diseases, accidents, and cancer. Cancer of the uterus is a major cause of death among poor women in urban areas due to the absence of general screening and of routine doctor's visits. Other committees are determining the disciplines that should be promoted: molecular research, clinical research, epidemiology, health services, and administrative and financial frameworks. There are hopes to achieve an integrated global analysis of all aspects of medicine.^ieng

[Why a program on reproductive health and society?]. / Por que un programa sobre salud reproductiva y sociedad?

PIP: The concept of reproductive health refers to phenomena related to biological reproduction and includes not only health problems related to reproduction itself, but those related to the exercise of sexuality and the prevention of undesired pregnancy. Reproductive health problems of the Mexican population include maternal and neonatal morbidity and mortality, adolescent pregnancy, abortion, AIDS and other sexually transmitted diseases, and the negative consequences of some reproductive technologies. Most research in the area has been conducted from a biomedical or epidemiologic perspective, although there has been significant demographic research on fertility and family planning. Qualitative studies of the subjective processes and interpersonal relations including sexuality that underlie many reproductive health problems are increasing. But systematic studies of reproductive health issues from the social science perspective are lacking, and researchers in the field are few. Various social and cultural processes influencing reproductive health have been identified, but their mechanics are poorly understood. Important influences of this type include conditions of social inequality, differential access to health and family planning services, gender relations including domestic and sexual violence, and the design of population and health policies and functioning of the corresponding services. Laws and their application, development strategies, and changes in social spending and labor markets also have effects on reproductive health. Social scientists must become more involved in revealing the links between these phenomena and reproductive health, in order that reproductive health problems may be more effectively controlled.^ieng

[A point of departure for the program: the diagnostics on study, teaching and action programs in reproductive health]. / Un punto de partida para el programa: los diagnosticos sobre la investigacion, la docencia y los programas de accion en salud reproductiva.

PIP: As a preparatory step in development of the Reproductive Health and Society Program of the Colegio de Mexico, existing social science research and teaching programs in reproductive health and related activities of nongovernmental organizations were studied. Responses to a questionnaire sent to 185 social science, medical, and public health institutions suggest that the social sciences operate in isolation from the biomedical sciences and epidemiology. Reproductive health research, teaching, and services have a biomedical and epidemiological orientation. Family planning activities have concentrated on fertility decline, with health and quality of care aspects relatively neglected. Some of the most committed researchers, especially in the health sciences, have developed networks extending beyond their institutions. Little time is typically available for research, and resources are scarce. A very wide variety of topics were studied. The 26 social science institutions with teaching programs related to reproductive health organized their instruction in a variety of modes, but none had a specific and structured course of study in reproductive health. The postgraduate social science courses stressed the theoretical and methodological orientation of sociodemography, while themes related to reproductive health were found in undergraduate education only in courses on the social problems of women. Medical school teaching programs in reproductive health adopted a medical, biomedical, or epidemiologic perspective. It may be concluded that none of the programs has achieved an integrated and interdisciplinary vision of reproductive health, but many respondents identified an unsatisfied demand in Mexico for human resources trained in reproductive health. The nongovernmental organizations have acquired considerable experience working in reproductive health with women and base groups, especially in low income and rural areas. Most use methodologies different from those of public sector agencies, and they frequently assume a gender perspective in their theoretical orientations. Most encourage participation by their clients.^ieng

USA President Clinton acts to ensure reproductive health.

PIP: In 1984, in Mexico City, the Reagan administration announced its policy prohibiting USAID from supporting any nongovernmental organization which used its own or US funds for any abortion-related activities. Even though this policy was intended to reduce the incidence of abortion, it had the opposite effect because the cut in funding left some areas of the developing world with no family planning services or information at all. Further, this policy resulted in a loss of $17 million (US) or 25% of the budget of the International Planned Parenthood Federation (IPPF). On January 22, 1993, US President Clinton reversed this policy. IPPF considered President Clinton's action to be a significant event for women's health, human rights, and global development. This reversal will provide family planning services to about 300 million couples who want to practice family planning but could not do so because they did not have access to it. SHortly after President Clinton's announcement, IPPF began writing a proposal to USAID for funds to restore programs that the Mexico City policy eliminated. IPPF hoped the reversal would spark international recognition of the need for safe access to abortion. Other actions President Clinton has taken to promote reproductive health are reversing the Reagan and Bush administrations' rule prohibiting abortion counseling at federally-funded clinics, requesting that the US Food and Drug Administration study the possible marketing of RU-486, removing the ban on abortion in military hospitals, approving regulations allowing fetal tissue research, and appointing an abortion rights advocate as Surgeon General. The Catholic Church opposed all of Clinton's abortion policies. However, many congregations, priests, and Vatican officials are dissatisfied with the Pope's anticontraception position.^ieng