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The text discusses the trajectory of the global pharmaceutical industry towards becoming what is currently called Big Pharma. Also presents the configuration of the Health Industrial Complex and exposes its economic and political dimensions. It suggests as essential determinants of the transformation of the global pharmaceutical industry into Big Pharma the processes of financialization of the global political economy and the harmonization of the intellectual property regime carried out by the World Trade Organization through the TRIPS agreement. Furthermore, it discusses the microeconomic changes that have occurred in the companies' production process. Finally, it points out that this trajectory is part of the process of weakening multilateral representation built after the Second World War during the 1990s.

O texto discute a trajetória da indústria farmacêutica global na direção de tornar-se o que se denomina atualmente de Big Pharma. Apresenta a configuração do Complexo Industrial da Saúde e expõe suas dimensões econômicas e políticas. Sugere como determinantes essenciais da transformação da indústria farmacêutica global na Big Pharma o processo de financeirização da economia política mundial e a harmonização do regime de propriedade intelectual realizado pela Organização Mundial do Comércio através do acordo TRIPS. Além disso discute as mudanças microeconômicas ocorridas no processo produtivo das empresas. Finalmente aponta que essa trajetória se inscreve no processo de fragilização da representação multilateral construída no pós Segunda Guerra Mundial durante a década de 1990.

El texto analiza la trayectoria de la industria farmacéutica global hacia convertirse en lo que actualmente se llama Big Pharma. Presenta la configuración del Complejo Industrial de la Salud y expone sus dimensiones económicas y políticas. Sugiere como determinantes esenciales de la transformación de la industria farmacéutica global en Big Pharma el proceso de financiarización de la economía política global y la armonización del régimen de propiedad intelectual llevado a cabo por la Organización Mundial del Comercio a través del acuerdo ADPIC. Además, se analizan los cambios microeconómicos que se han producido en el proceso productivo de las empresas. Finalmente, señala que esta trayectoria es parte del proceso de debilitamiento de la representación multilateral construida después de la Segunda Guerra Mundial durante la década de 1990.

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This article draws on the recent historiography in international relations and global health, as well as selected archives, to propose some milestones for a history of global hospital governance from the late nineteenth to the mid-twentieth century. How can we identify a system of hospital governance, including formal and informal arrangements, on a global or sub-global scale? Through the lens of the International Hospital Association, founded in 1931, we highlight the significance of internationalization processes, relationships with other international organizations, transnational interpersonal networks, and forces structuring innovation. This document provides a preliminary starting point for discussion and encourages further research.

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OBJECTIVE: To evaluate variations in management of therapeutic hypothermia (TH) for neonatal hypoxic-ischemic encephalopathy (HIE) among international clinical sites and to identify areas for harmonization. STUDY DESIGN: An electronic survey was sent to Children's Hospitals Neonatal Consortium site sponsors, Canadian Neonatal Network site investigators, members of the Newborn Brain Society, and American Academy of Pediatrics Neonatology chiefs. RESULTS: One hundred five sites responded, with most from high-income regions (n = 95). Groupings were adapted from the United Nations regional groups: US (n = 52 sites); Canada (n = 20); Western Europe and other states excluding Canada and US Group (WEOG, n = 18); and non-WEOG (central and eastern Europe, Asia, Africa, Latin America, and Caribbean, n = 15). Regional variations were seen in the eligibility criteria for TH, such as the minimum gestational age, grading of HIE severity, use of electroencephalography, and the frequency of providing TH for mild HIE. Active TH during transport varied among regions and was less likely in smaller volume sites. Amplitude-integrated electroencephalogram and/or continuous electroencephalogram to determine eligibility for TH was used by most sites in WEOG and non-WEOG but infrequently by the US and Canada Groups. For sedation during TH, morphine was most frequently used as first choice but there was relatively high (33%) use of dexmedetomidine in the US Group. Timing of brain magnetic resonance imaging and neurodevelopmental follow-up were variable. Neurodevelopmental follow occurred earlier and more frequently, although for a shorter duration, in the non-WEOG. CONCLUSIONS: We found significant variations in practices for TH for HIE across regions internationally. Future guidelines should incorporate resource availability in a global perspective.

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This study investigated the occurrence and distribution of per- and polyfluoroalkyl substances (PFASs) in house dust samples from six regions across four continents. PFASs were detected in all indoor dust samples, with total median concentrations ranging from 17.3 to 197 ng/g. Among the thirty-one PFAS analytes, eight compounds, including emerging PFASs, exhibited high detection frequencies in house dust from all six locations. The levels of PFASs varied by region, with higher concentrations found in Adelaide (Australia), Tianjin (China), and Carbondale (United States, U.S.). Moreover, PFAS composition profiles also differed among regions. Dust from Australia and the U.S. contained high levels of 6:2 fluorotelomer phosphate ester (6:2 diPAP), while perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) were predominant in other regions. Furthermore, our results indicate that socioeconomic factors impact PFAS levels. The assessment of human exposure through dust ingestion and dermal contact indicates that toddlers may experience higher exposure levels than adults. However, the hazard quotients of PFASs for both toddlers and adults were below one, indicating significant health risks are unlikely. Our study highlights the widespread occurrence of PFASs in global indoor dust and the need for continued monitoring and regulation of these chemicals.

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INTRODUCTION: Various national solutions have been considered and implemented to address the factors which limit radiographer engagement in conducting research. Nevertheless, national literature continues to suggest that radiographer engagement in research remains low. The aim of this study was to extend the existing evidence base by conducting an international survey to assess diagnostic radiographers and therapeutic radiographers involvement with, barriers to and support mechanisms for research. METHODS: Data collection was obtained via an online questionnaire which was distributed by the International Society of Radiographers and Radiologic Technologists (ISRRT). The study population included an international sample of qualified diagnostic radiographers and therapeutic radiographers across clinical and academic contexts in a variety of different roles such as clinical practice, management, education and research. RESULTS: In total, 420 diagnostic radiographers and therapeutic radiographers completed the survey. Multiple reasons were identified that were considered to inhibit respondents from conducting research. 69.3% indicated a combination of reasons for lack of engagement with research, rather than one single issue. Examples of reasons include: lack of time, insufficient research funding, limited research expertise, and lack of a suitable mentorship scheme. CONCLUSION: A minor segment of survey respondents indicated involvement in research activity. Lack of dedicated time to research, mentors, and funding were among the main barriers to conduct research. Further research is required to explore what solutions are available to overcoming the barriers.

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A multinational outbreak of nosocomial fusarium meningitis occurred among immunocompetent patients who had undergone surgery with epidural anesthesia in Mexico. The pathogen involved had a high predilection for the brain stem and vertebrobasilar arterial system and was associated with high mortality from vessel injury. Effective treatment options remain limited; in vitro susceptibility testing of the organism suggested that it is resistant to all currently approved antifungal medications in the United States. To highlight the severe complications associated with fusarium infection acquired in this manner, we report data, clinical courses, and outcomes from 13 patients in the outbreak who presented with symptoms after a median delay of 39 days.

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The safe keeping of children and families that require Pediatric Palliative Care (PPC), presents a challenge to the healthcare professionals and systems, particularly in countries like Mexico. This is due to social inequities, the cultural diversity, the geo-regional position that determine specific social dynamics and nowadays the huge immigration issues that we are facing. The combination of all these factors, requires a vast knowledge from PPC providers about the necessary tools to properly provide the support needed in the most effective and efficient way, based on compassion. Knowing how to accurately understand the needs of children and their families requiring PPC and how to best assist them during the decision-making process is extremely important. At the same time, all PPC team members require expertise in addressing pediatric pathophysiology and bioethical issues that apply to diverse and heterogeneous age groups.

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This paper is the result of a scale validation process, applicable to social science research, which allows the constructs of otherness and coexistence and their relationship to be trasnformed into measurable, systematized variables. In turn, this scale is the product of a research project whose main objectives were (i) to demonstrate the relationship between coexistence as an independent variable and otherness as a dependent variable, and (ii) to create and statistically validate a scale to measure both variables, so to use it in applied research. The sample consisted of 600 participants. Three instruments were used: two semantic differentials and a 33-item questionnaire. The application was carried out virtually due to the SARS-CoV-2 virus. The method includes a mixed type of work, i.e., qualitative, and quantitative procedures. The results showed two factors, the other as strange or foreign and the other as equal. The final scale consisted of 10 items, with a Cronbach's alpha of 0.86 and variance explaining 58% of the otherness.

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The growth of international trade, coupled with an expansion of large-scale pine plantations in South America during the second half of the twentieth century, has significantly increased the opportunities for the invasion of forest insects. Bark beetles (Coleoptera: Curculionidae, Scolytinae) are a large and diverse group of insects, commonly recognized as one of the most important tree mortality agents in coniferous forests worldwide and an important group among invasive forest species. In this study, we combined data from field sampling with published records of established non-native pine bark beetles, to describe their distribution and invasion history in pine plantations across southern South America, reviewing the available information on their phenology and host range. We obtained records of established populations of six Eurasian species distributed in two major regions: the southwest region comprises plantations in Chile and the Argentine Patagonia, with four bark beetle species: Hylastes ater, Hylastes linearis, Hylurgus ligniperda, and Orthotomicus laricis; the northeastern zone includes northeastern Argentina, Uruguay, and southern Brazil, and includes three bark beetle species: Cyrtogenius luteus, H. ligniperda, and O. erosus. The establishment of non-native populations across the study area began in the 1950s, and from the 1980s onwards, there has been an exponential increase in introductions. We predict that several of these species will continue spreading across South America and that new species will continue arriving. We highlight the importance of international collaboration for early detection and management of non-native pine bark beetles.

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La pandemia del Coronavirus puso nuevamente en el centro de las agendas políticas a lo sanitario. No obstante, las Dimensiones Internacionales de la Salud y su expresión cotidiana en los ámbitos subnacionales latinoamericanos se encuentran invisibilizadas (Róvere, 1992). Este trabajo primero se propone enmarcar en términos históricos a la Salud Internacional y al Complejo Médico Industrial y Financiero (Herández, 2019: Iriart, 2008). En segundo lugar, confrontar las concepciones de salud internacional frente a la de salud global, al tiempo que describir los conceptos de filantrocapitalismo, territorio, Salud como Asunto Internacional y las Dimensiones Internacionales de la Salud (Róvere, 1992). Seguidamente, se analizarán publicaciones académicas con diferentes perspectivas sobre las barreras de acceso a la salud, enunciando las principales características que las sustentan. Finalmente se buscará problematizar y visibilizar las categorías antes expuestas a nivel local-territorial, indagando sobre las barreras de acceso que de ellas derivan.

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Since the 1980s, there has been a growing recognition of the importance of palliative care for children with life-limiting and life-threatening conditions. Collaboration, regulatory frameworks, educational initiatives and a patient-centered approach have contributed to the advancement of PPC services for children with life-limiting conditions. In spite of this progress, pediatric palliative care in Argentina is not yet fully integrated into our health care system.

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This paper investigates the intricate interplay between carbon emissions and foreign direct investment within the context of Brazil, Russia, India, China, and South Africa (BRICS) for the period spanning 2000 to 2022. In our comprehensive analysis, we incorporate ecological footprint, renewable energy, globalization, and technological innovations as exogenous variables. Employing a system of simultaneous equations across the BRICS panel, we aim to fully elucidate the proposed relationships. Our empirical findings underscore the following key insights: foreign direct investment, technological innovations, and the adoption of renewable energy sources significantly contribute to the mitigation of carbon emissions in these selected nations. However, it is essential to note that ecological footprints exhibit a positive association with carbon emissions, raising concerns on two fronts: escalating environmental degradation and increased land pressure, both of which contribute to rising ecological footprints in BRICS countries. Additionally, our analysis reveals that foreign direct investment is influenced by its capacity to reduce carbon emissions and bolster renewable energy adoption, while globalization amplifies investment trends within the BRICS nations. To address the environmental repercussions of mining activities, it is imperative to implement stringent control and regulation measures, given their potential adverse impacts, including soil pollution, acid mine drainage, erosion, biodiversity loss, excessive water resource consumption, and wastewater disposal challenges. Nevertheless, proactive steps such as recycling mining waste, adopting environmentally friendly mining equipment, combatting illegal mining, and enhancing overall mining sustainability offer promising avenues to mitigate the environmental footprint of mining operations.

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A presente entrevista explora a experiência de Rogério Matos, professor de educação física brasileiro que emigrou para o Canadá em busca de melhores oportunidades profissionais e qualidade de vida, conseguindo validar a sua formação e firmar-se como docente numa escola pública. Por meio de entrevistas seriadas descrevemos o processo de mudança, validação de diplomas, adaptação cultural e profissional no Canadá. Salientamos alguns dos desafios enfrentados neste processo, tais como a burocracia para a validação de suas qualificações profissionais, a adaptação ao clima e a cultura canadense. Do mesmo modo, mostramos como superou essas barreiras por meio de um planejamento meticuloso e persistência, estabelecendo-se como um educador respeitado na província de Quebec. A experiência de intercâmbio durante a graduação na Unicamp aparece como fundamental para a decisão de emigrar e para o sucesso de sua adaptação. Neste sentido, destaca-se a importância dos programas de internacionalização universitária na formação acadêmica-profissional.

This interview explores the experience of Rogério Matos, a Brazilian physical education teacher who emigrated to Canada in search of better professional opportunities and quality of life. He successfully validated his qualifications and established himself as a teacher in a public school. Through a series of interviews, we describe the process of relocation, diploma validation, cultural and professional adaptation in Canada. We highlight some of the challenges faced during this process, such as the bureaucracy involved in validating his professional qualifications and adapting to the Canadian climate and culture. Similarly, we demonstrate how he overcame these barriers through meticulous planning and persistence, establishing himself as a respected educator in the province of Quebec. His exchange experience during his undergraduate studies at Unicamp was fundamental in his decision to emigrate and in the success of his adaptation. In this regard, the importance of university internationalization programs in academic and professional training is emphasized.

Esta entrevista presenta la experiencia de Rogério Matos, un profesor de educación física brasileño que emigró a Canadá en busca de mejores oportunidades profesionales y de calidad de vida. Logró validar su formación y establecerse como docente en una escuela pública. A través de una serie de preguntas, describimos el proceso de cambio, validación de diplomas, adaptación cultural y profesional en Canadá. Resaltamos algunos de los desafíos enfrentados durante este proceso, como la burocracia para la validación de sus calificaciones profesionales, la adaptación al clima y la cultura canadiense. De igual manera, mostramos cómo superó estas barreras mediante una planificación meticulosa y persistencia, estableciéndose como un educador respetado en la provincia de Quebec. La experiencia de intercambio durante su licenciatura en la Unicamp aparece como fundamental para la decisión de emigrar y para el éxito de su adaptación. En este sentido, se destaca la importancia de los programas de internacionalización universitaria en la formación académico-profesional.

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Abstract This article draws on a large volume of documents retrieved from the historical archives of Institut Pasteur, in Paris, the Manguinhos library of the Oswaldo Cruz Foundation, and the Hemeroteca Digital library run by National Library of Brazil to analyze the links between the institutionalization of parasitology in São Paulo and the presence of the French physician Émile Brumpt at the São Paulo School of Medicine and Surgery in its early years. Bringing to light information from previously unresearched or little-known primary sources, this article contributes to the historiography of exchanges between French and Brazilian scholars and the institutional memory of the Faculty of Medicine, University of São Paulo.

Resumo O artigo, por meio de volumosa documentação coletada no Arquivo Histórico do Instituto Pasteur de Paris, na Biblioteca de Manguinhos da Fundação Oswaldo Cruz e na Hemeroteca Digital da Biblioteca Nacional do Brasil, analisa as relações estabelecidas entre a institucionalização da parasitologia em São Paulo e a presença do médico francês Émile Brumpt nos anos iniciais da Escola de Medicina e Cirurgia de São Paulo. Utilizando fontes primárias inéditas ou pouco conhecidas, este artigo pretende contribuir tanto para a historiografia que versa sobre as relações intelectuais franco-brasileiras como também para a memória institucional da atual Faculdade de Medicina da Universidade de São Paulo.

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Abstract This article reconstructs the origins of psychosomatic medicine in Latin America through the history of the institutionalization of psychoanalysis in Argentina and Brazil. The study focuses on the exchange between Argentine and Brazilian psychoanalysts from 1942 to 1959. The analyses indicate similarities and differences between the two projects of dissemination and theoretical production of psychosomatic medicine in both countries. The conclusions indicate that the Argentine group of psychoanalysts had the intention of strengthening psychoanalysis while, in Brazil, the main disseminator of psychosomatics, Danilo Perestrello, supported a profound transformation of traditional medicine.

Resumen Ese artículo realiza una reconstrucción de los orígenes de la medicina psicosomática en Latinoamérica a través de la historia de la institucionalización del psicoanálisis en Argentina y Brasil. El estudio enfoca el intercambio entre psicoanalistas argentinos y brasileños durante el período correspondiente a los años 1942-1959. Los análisis indican similitudes y diferencias entre los dos proyectos de difusión y producción teórica de la medicina psicosomática en ambos países. Las conclusiones apuntan a que el grupo argentino de psicoanalistas tenía la intención de fortalecer el psicoanálisis mientras que, en Brasil, el principal difusor de la psicosomática, Danilo Perestrello, sostenía una transformación profunda de la medicina tradicional.

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Active Pharmaceutical Ingredient (API) is any component of the final pharmaceutical product that serves as the active ingredient. The goal of the API Manufacturing is to produce APIs that are competitively priced and meet the quality standards with the least possible impact on the environment. The global API market is expected to experience massive growth in the coming years reaching the size of USD 355.94 billion. The global Pharmaceutical Industry is facing a new scenario in 2023 after responding to the COVID-19 pandemic. In this new panorama, rethinking the pharmaceutical production and market is necessary. Despite Brazil's prominence in terms of worldwide pharmaceutical spending, only 5% of the APIs required by local pharmaceutical companies are produced domestically. Therefore, Brazil is an untapped field for APIs' manufacturing and faces a scenario of health vulnerability associated with the reliance on foreign API imports to ensure the viability of national Pharmaceutical Production and Services. Huge investments are required to boost the growth of the API Manufacturing sector. Herein is presented a critical analysis of the current regulatory and strategic status of Brazilian national production and/or acquisition of APIs, which represent the key starting materials for the Pharmaceutical Industry.