Vegetation and climate changes in the forest of Campinas, São Paulo State, Brazil, during the last 25,000 cal yr BP

A paleoenvironmental reconstruction was performed in a Riparian Forest near Campinas to improve knowledge of paleoclimate and paleoenvironment in the State of São Paulo, Brazil. A sediment core of 182 cm depth was collected in a swamp located within a Cerrado/Seasonal Semi-deciduous ecotone forest. Te chronological frame is given by eight radiocarbon dating methods. Pollen and stable isotope analyses (d 13C and d 15N) were performed all along the core. Modern pollen rain is based on fve surface samples collected along the Riparian Forest. Results show a sequence of changes in vegetation and climate between 25 and 13 cal kyr before present (BP), and from 4 cal kyr BP to the present time, with a hiatus between 11 and 4 kyr cal BP. Drier climatic conditions characterized the late Pleistocene and early Holocene, although they had moisture peaks able to maintain an open forest. Te Riparian Forest became fully installed from 4 cal kyr BP onward. Our results are in agreement with other regional studies and contribute to build a regional frame for past climatic conditions at the latitude of São Paulo.493CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPSem informaçãoSem informação2010/16507-

Relationship between professional motivations and the expectation of staying at the same workplace: a cross-sectional descriptive study with physicians in Portugal

There is a global trend related to the migration of health professionals, particularly physicians, to the most densely populated areas. In Portugal, the unequal distribution of medical professionals is justified by the fact that in the most favoured areas, there are more career opportunities, better infrastructures and equipment, better working conditions and supervision, more and better social facilities and better salary. The aim of this work was to identify professional reasons associated with the expectation of staying at the same workplace. It was selected a simple random sample of 594 physicians out of a total of 18,711 registered physicians in Northern Regional Section of the Order of Physicians (NRSOP), Portugal Most physicians would like to stay at the same workplace due to: the prospect of training and working at the current location, the organizational level of the unit, the level of differentiation of the hospital/health centre, the availability to use the state-of-the-art medical and surgical technology, better rewards, the level of work differentiation in the unit/service, the possibility of reconciling public and private practice, good references of the current unit/working group, avoid unit/workgroup with bad references and the prospect of career progression. This study revealed that, for physicians, professional motivations/purposes have an influence on the expectations of staying or not at the same workplace. Therefore, the study recommends that policy makers should prioritize professional reasons when formulating and implementing measures to promote the fixing of medical professionals in order to achieve greater equity in access to health care.This work is supported by: the European Structural and Investment Funds in the FEDER component, through the Operational Competitiveness and Internationalization Programme (COMPETE 2020) [Project No. 006971 (UID/SOC/04011)]; and national funds, through the FCT – Portuguese Foundation for Science and Technology under the project UID/SOC/04011/2013.info:eu-repo/semantics/publishedVersio

A reference case for economic evaluations in osteoarthritis: An expert consensus article from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO)

Background: General recommendations for a reference case for economic studies in rheumatic diseases were published in 2002 in an initiative to improve the comparability of cost-effectiveness studies in the field. Since then, economic evaluations in osteoarthritis (OA) continue to show considerable heterogeneity in methodological approach. Objectives: To develop a reference case specific for economic studies in OA, including the standard optimal care, with which to judge new pharmacologic and non-pharmacologic interventions. Methods: Four subgroups of an ESCEO expert working group on economic assessments (13 experts representing diverse aspects of clinical research and/or economic evaluations) were charged with producing lists of recommendations that would potentially improve the comparability of economic analyses in OA: outcome measures, comparators, costs and methodology. These proposals were discussed and refined during a face-to-face meeting in 2013. They are presented here in the format of the recommendations of the recently published Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement, so that an initiative on economic analysis methodology might be consolidated with an initiative on reporting standards. Results: Overall, three distinct reference cases are proposed, one for each hand, knee and hip OA; with diagnostic variations in the first two, giving rise to different treatment options: interphalangeal or thumb-based disease for hand OA and the presence or absence of joint malalignment for knee OA. A set of management strategies is proposed, which should be further evaluated to help establish a consensus on the "standard optimal care" in each proposed reference case. The recommendations on outcome measures, cost itemisation and methodological approaches are also provided. Conclusions: The ESCEO group proposes a set of disease-specific recommendations on the conduct and reporting of economic evaluations in OA that could help the standardisation and comparability of studies that evaluate therapeutic strategies of OA in terms of costs and effectiveness