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Cotlear D.,The World Bank | Gomez-Dantes O.,National Institute of Public Health of Mexico | Knaul F.,Harvard University | Atun R.,Boston University | And 10 more authors.
The Lancet | Year: 2015

Summary Latin America continues to segregate different social groups into separate health-system segments, including two separate public sector blocks: a well resourced social security for salaried workers and their families and a Ministry of Health serving poor and vulnerable people with low standards of quality and needing a frequently impoverishing payment at point of service. This segregation shows Latin America's longstanding economic and social inequality, cemented by an economic framework that predicted that economic growth would lead to rapid formalisation of the economy. Today, the institutional setup that organises the social segregation in health care is perceived, despite improved life expectancy and other advances, as a barrier to fulfilling the right to health, embodied in the legislation of many Latin American countries. This Series paper outlines four phases in the history of Latin American countries that explain the roots of segmentation in health care and describe three paths taken by countries seeking to overcome it: unification of the funds used to finance both social security and Ministry of Health services (one public payer); free choice of provider or insurer; and expansion of services to poor people and the non-salaried population by making explicit the health-care benefits to which all citizens are entitled. © 2015 Elsevier Ltd. Source

The expansion of screening for cervix cancer and the training of cytotechnologists in Brazil The paper discusses the emergence of the professional category of cytotechnologists in Brazil and its history from the 1970s and late 1990s. At the beginning of this period, the Pan American Health Organization considered cervix cancer as a serious public health problem, which can be controlled in developing countries. In this context, arose the first campaigns tracking the disease in the country. The institutionalization of these campaigns made the cytotechnologists indispensable for the disease control. With the expansion of demand for its activity and the emergence of the first initiatives for its formation, new issues begin to emerge. How these new professionals could be trained in adequate quantity and quality? What is the appropriate curriculum to their duties and responsibilities? How to monitor the functioning of the courses? In the field of standardization of the new activity, other questions arise: how to secure a monopoly on the activity performed, how to characterize their specificity, which required training to those who will exercise it? These points become topics of debates and negotiations, a typical process of consolidating a new profession. The process of institutionalization of the program of prevention of cancer of the cervix and the consequent need for quality assurance tests performed have made these issues return to the limelight. This study aims to contribute to the expansion of knowledge about the formation of cytotechnologists, and the more general context, the process of health training in Brazil. Source

Rasoanaivo P.,IMRA Inc | Wright C.W.,University of Bradford | Willcox M.L.,RITAM | Willcox M.L.,University of Oxford | Gilbert B.,FIOCRUZ
Malaria Journal | Year: 2011

Background: In traditional medicine whole plants or mixtures of plants are used rather than isolated compounds. There is evidence that crude plant extracts often have greater in vitro or/and in vivo antiplasmodial activity than isolated constituents at an equivalent dose. The aim of this paper is to review positive interactions between components of whole plant extracts, which may explain this. Methods. Narrative review. Results: There is evidence for several different types of positive interactions between different components of medicinal plants used in the treatment of malaria. Pharmacodynamic synergy has been demonstrated between the Cinchona alkaloids and between various plant extracts traditionally combined. Pharmacokinetic interactions occur, for example between constituents of Artemisia annua tea so that its artemisinin is more rapidly absorbed than the pure drug. Some plant extracts may have an immunomodulatory effect as well as a direct antiplasmodial effect. Several extracts contain multidrug resistance inhibitors, although none of these has been tested clinically in malaria. Some plant constituents are added mainly to attenuate the side-effects of others, for example ginger to prevent nausea. Conclusions: More clinical research is needed on all types of interaction between plant constituents. This could include clinical trials of combinations of pure compounds (such as artemisinin + curcumin + piperine) and of combinations of herbal remedies (such as Artemisia annua leaves + Curcuma longa root + Piper nigum seeds). The former may enhance the activity of existing pharmaceutical preparations, and the latter may improve the effectiveness of existing herbal remedies for use in remote areas where modern drugs are unavailable. © 2011 Rasoanaivo et al; licensee BioMed Central Ltd. Source

Organic micropollutants are often found in domestic and industrial effluents. Thus, it is important to learn their fate, the metabolites generated and their sorption during biological treatment processes. This work investigated the biodegradation of 14C-dicofol organochloride during wastewater aerobic treatment and sludge anaerobic biodigestion. The performance of these processes was evaluated by physical-chemical parameters. Radioactivity levels were monitored in both treatments, and residues of dicofol (DCF) and dichlorobenzophenone (DBP) were quantified by HPLC/UV. The efficiency of the aerobic and anaerobic processes was slightly reduced in the presence of DCF and DBP. After aerobic treatment, only 0.1% of DCF was mineralized, and 57% of radioactivity remained sorbed on biological sludge as DBP. After 18 days of anaerobiosis, only 3% of DCF and 5% of DBP were detected in the sludge. However, 70% of radioactivity remained in the sludge, probably as other metabolites. Dicofol was biodegraded in the investigated process, but not mineralized. Source

In the Neotropical Region, the excessively large number of Tachinidae genera, many of them originally described without illustrations or with characters that currently have no importance in their limits, and the absence of a unique identification key for supraespecific levels are the main problems in the identification of the taxa. This task requires the crossing of existing information from different taxonomic keys, such as: Tachinidae taxonomic works on other geographic regions (mainly Nearctic Region) and taxonomic revision works for the Neotropical Region and restricted locations. The use of information on host may be important, whenever be used with care. The existence of a reference collection is essential for this activity. © 2012, Sociedad Venezolana de Entomología. Source

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