THE DETERMINANTS OF INTERNATIONAL TOURISM AND THE RESTRICTIONS TO THE INSERTION OF THE DEVELOPING COUNTRIES - A COMPARATIVE ANALYSIS IN SOUTH AMERICA, AFRICA AND SOUTH OF ASIA

This research had like general goal to identify the determinants of the international tourism flow, seeking diagnostic the main restrictions to the expansion of this sector in the countries in development, utilizing a comparative analysis for the regions of the South America, Africa and South of the Asia. To be specified the determinants of the international tourism flow, was applied the econometrics instrumental, aiming to establish its empirical evidence. In the analysis was utilized the panel model because it´s shown adequate to the objective of identify the prominent factors of generalized form. Furthermore, this paper discuss the performance of the countries of the South America, Africa and South of Asia in the international tourism, with base in the determinant specified, seeking identify the empirical coherence of these general determinants in case of these countries and comparing the specificities and homogeneity between these regions, constituted by countries in development. The result of the study aims that the income is a fundamental determinant for explain the emission of tourists and there are indications of an elevated elasticity, what is translated in empirical coherence. Referring to the tourism attractive, we found the relevant paper of the risk related to the security and of the development of the country, identified through of the Human Development Index - HDI. The comparative analysis between the regions of the South America, Africa and South of the Asia, showed that the performance of these countries show consistency with the general determinants, in function of their conditions, for example, their geographic distance from the rich countries.

THE DETERMINANTS OF INTERNATIONAL TOURISM AND THE RESTRICTIONS TO THE INSERTION OF THE DEVELOPING COUNTRIES - A COMPARATIVE ANALYSIS IN SOUTH AMERICA, AFRICA AND SOUTH OF ASIA

This research had like general goal to identify the determinants of the international tourism flow, seeking diagnostic the main restrictions to the expansion of this sector in the countries in development, utilizing a comparative analysis for the regions of the South America, Africa and South of the Asia. To be specified the determinants of the international tourism flow, was applied the econometrics instrumental, aiming to establish its empirical evidence. In the analysis was utilized the panel model because it's shown adequate to the objective of identify the prominent factors of generalized form. Furthermore, this paper discuss the performance of the countries of the South America, Africa and South of Asia in the international tourism, with base in the determinant specified, seeking identify the empirical coherence of these general determinants in case of these countries and comparing the specificities and homogeneity between these regions, constituted by countries in development. The result of the study aims that the income is a fundamental determinant for explain the emission of tourists and there are indications of an elevated elasticity, what is translated in empirical coherence. Referring to the tourism attractive, we found the relevant paper of the risk related to the security and of the development of the country, identified through of the Human Development Index - HDI. The comparative analysis between the regions of the South America, Africa and South of the Asia, showed that the performance of these countries show consistency with the general determinants, in function of their conditions, for example, their geographic distance from the rich countries

The impact of SARS-CoV-2 on emotional state among older adults in Latin America

In Latin America, the volume of care of infected patients, higher presence of comorbidities among older adults, and restricted access to clinical controls have become this age group into one with the highest risk (Dubey etal., 2020). Under confinement circumstances, older people can experience feelings of helplessness and uncertainty about the future, difficulties to stay focused, anxiety, stress, agitation, withdrawal, and depression (Armitage and Nellums, 2020; Wang etal., 2020). Accordingly, a Consortium of universities, research centers, and clinical centers have joined forces to carry out research which seeks to know the emotional state of Latin American older adults during confinement by Coronavirus disease (COVID-19). The study included the following countries: Argentina, Bolivia, Chile, Colombia, Costa Rica, Ecuador, Guatemala, Honduras, Mexico, Nicaragua, Peru, Puerto Rico, Dominican Republic, and Venezuela. Between April and May, we carry out the piloting of the evaluation protocol, making cultural and linguistic adaptations. Later, between June and October, more than 7000 older adults were evaluated by telephone by an expert professional through filling out an online form. The protocol we used includes a sociodemographic and clinical questionnaire, information on confinement, lifestyles, and the abbreviated version of the Yesavage Geriatric Depression Scale (Martínez de la Iglesia etal., 2020). Sociodemographic characteristics of the final sample (n = 5245) show that 34% are men and 66% are women, with an average age of 69.61 years (SD = 7.28). Average schooling was 10.99 years (SD = 5.85) depending on the country, and 16.7% were illiterate. The major racial pattern of the population is Latin American mestizo (55.1%) followed by white (39.4%), South American indigenous (1.5%), and African American subjects (1.2%). Seventy-seven percentage of the participants have a monthly income, from retirement (45.9%) or independent work (26.4%), and 85% live with their spouses or relatives. Regarding quarantine, 86.7% of the respondents stated that they complied with the confinement measures, with an average of 123.15 days (SD = 42.43) of quarantine, which varies by country. Our data analysis has revealed that 30.27% of the older adults exhibit emotional disturbances. In Mexico and Peru, we have observed the highest levels of geriatric depression (38.9% and 38.1%, respectively) and in Venezuela the lowest (21.35%). Regression analysis shows that more years of schooling (OR = 0.943; IC95%: 0.93–0.95), having an economic income (OR = 0.764; IC95%: 0.64–0.90) and being a Latin American mestizo (OR = 0.832, IC95%: 0.71–0.98) are associated with reduced risk of geriatric depression. On the other hand, being widowed (OR = 1.428; IC95%: 1.10–1.85) or separated (OR = 1.352; IC95%: 1.01–1.82), lived in Bolivia (OR = 1.805; IC95%: 1.31–2.48), Mexico (OR = 2.320; IC95%: 1.70–3.16), and Peru (OR = 2.008; IC95%: 1.45–2.78) are associated with highest risk. This first multicenter study found that emotional status of older adults during the SARS-CoV-2 pandemic in Latin America varies depending on the country where they live and sociodemographic and socioeconomic factors. It is necessary for follow-up studies to validate diagnosis and analyze the greater risk of deterioration in the coming months

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Diretrizes Brasileiras de Medidas da Pressão Arterial Dentro e Fora do Consultório – 2023

Hypertension is one of the primary modifiable risk factors for morbidity and mortality worldwide, being a major risk factor for coronary artery disease, stroke, and kidney failure. Furthermore, it is highly prevalent, affecting more than one-third of the global population. Blood pressure measurement is a MANDATORY procedure in any medical care setting and is carried out by various healthcare professionals. However, it is still commonly performed without the necessary technical care. Since the diagnosis relies on blood pressure measurement, it is clear how important it is to handle the techniques, methods, and equipment used in its execution with care. It should be emphasized that once the diagnosis is made, all short-term, medium-term, and long-term investigations and treatments are based on the results of blood pressure measurement. Therefore, improper techniques and/or equipment can lead to incorrect diagnoses, either underestimating or overestimating values, resulting in inappropriate actions and significant health and economic losses for individuals and nations. Once the correct diagnosis is made, as knowledge of the importance of proper treatment advances, with the adoption of more detailed normal values and careful treatment objectives towards achieving stricter blood pressure goals, the importance of precision in blood pressure measurement is also reinforced. Blood pressure measurement (described below) is usually performed using the traditional method, the so-called casual or office measurement. Over time, alternatives have been added to it, through the use of semi-automatic or automatic devices by the patients themselves, in waiting rooms or outside the office, in their own homes, or in public spaces. A step further was taken with the use of semi-automatic devices equipped with memory that allow sequential measurements outside the office (ABPM; or HBPM) and other automatic devices that allow programmed measurements over longer periods (HBPM). Some aspects of blood pressure measurement can interfere with obtaining reliable results and, consequently, cause harm in decision-making. These include the importance of using average values, the variation in blood pressure during the day, and short-term variability. These aspects have encouraged the performance of a greater number of measurements in various situations, and different guidelines have advocated the use of equipment that promotes these actions. Devices that perform HBPM or ABPM, which, in addition to allowing greater precision, when used together, detect white coat hypertension (WCH), masked hypertension (MH), sleep blood pressure alterations, and resistant hypertension (RHT) (defined in Chapter 2 of this guideline), are gaining more and more importance. Taking these details into account, we must emphasize that information related to diagnosis, classification, and goal setting is still based on office blood pressure measurement, and for this reason, all attention must be given to the proper execution of this procedure.La hipertensión arterial (HTA) es uno de los principales factores de riesgo modificables para la morbilidad y mortalidad en todo el mundo, siendo uno de los mayores factores de riesgo para la enfermedad de las arterias coronarias, el accidente cerebrovascular (ACV) y la insuficiencia renal. Además, es altamente prevalente y afecta a más de un tercio de la población mundial. La medición de la presión arterial (PA) es un procedimiento OBLIGATORIO en cualquier atención médica o realizado por diferentes profesionales de la salud. Sin embargo, todavía se realiza comúnmente sin los cuidados técnicos necesarios. Dado que el diagnóstico se basa en la medición de la PA, es claro el cuidado que debe haber con las técnicas, los métodos y los equipos utilizados en su realización. Debemos enfatizar que una vez realizado el diagnóstico, todas las investigaciones y tratamientos a corto, mediano y largo plazo se basan en los resultados de la medición de la PA. Por lo tanto, las técnicas y/o equipos inadecuados pueden llevar a diagnósticos incorrectos, subestimando o sobreestimando valores y resultando en conductas inadecuadas y pérdidas significativas para la salud y la economía de las personas y las naciones. Una vez realizado el diagnóstico correcto, a medida que avanza el conocimiento sobre la importancia del tratamiento adecuado, con la adopción de valores de normalidad más detallados y objetivos de tratamiento más cuidadosos hacia metas de PA más estrictas, también se refuerza la importancia de la precisión en la medición de la PA. La medición de la PA (descrita a continuación) generalmente se realiza mediante el método tradicional, la llamada medición casual o de consultorio. Con el tiempo, se han agregado alternativas a través del uso de dispositivos semiautomáticos o automáticos por parte del propio paciente, en salas de espera o fuera del consultorio, en su propia residencia o en espacios públicos. Se dio un paso más con el uso de dispositivos semiautomáticos equipados con memoria que permiten mediciones secuenciales fuera del consultorio (AMPA; o MRPA) y otros automáticos que permiten mediciones programadas durante períodos más largos (MAPA). Algunos aspectos en la medición de la PA pueden interferir en la obtención de resultados confiables y, en consecuencia, causar daños en las decisiones a tomar. Estos incluyen la importancia de usar valores promedio, la variación de la PA durante el día y la variabilidad a corto plazo. Estos aspectos han alentado la realización de un mayor número de mediciones en diversas situaciones, y diferentes pautas han abogado por el uso de equipos que promuevan estas acciones. Los dispositivos que realizan MRPA o MAPA, que además de permitir una mayor precisión, cuando se usan juntos, detectan la hipertensión de bata blanca (HBB), la hipertensión enmascarada (HM), las alteraciones de la PA durante el sueño y la hipertensión resistente (HR) (definida en el Capítulo 2 de esta guía), están ganando cada vez más importancia. Teniendo en cuenta estos detalles, debemos enfatizar que la información relacionada con el diagnóstico, la clasificación y el establecimiento de objetivos todavía se basa en la medición de la presión arterial en el consultorio, y por esta razón, se debe prestar toda la atención a la ejecución adecuada de este procedimiento.A hipertensão arterial (HA) é um dos principais fatores de risco modificáveis para morbidade e mortalidade em todo o mundo, sendo um dos maiores fatores de risco para doença arterial coronária, acidente vascular cerebral (AVC) e insuficiência renal. Além disso, é altamente prevalente e atinge mais de um terço da população mundial. A medida da PA é procedimento OBRIGATÓRIO em qualquer atendimento médico ou realizado por diferentes profissionais de saúde. Contudo, ainda é comumente realizada sem os cuidados técnicos necessários. Como o diagnóstico se baseia na medida da PA, fica claro o cuidado que deve haver com as técnicas, os métodos e os equipamentos utilizados na sua realização. Deve-se reforçar que, feito o diagnóstico, toda a investigação e os tratamentos de curto, médio e longo prazos são feitos com base nos resultados da medida da PA. Assim, técnicas e/ou equipamentos inadequados podem levar a diagnósticos incorretos, tanto subestimando quanto superestimando valores e levando a condutas inadequadas e grandes prejuízos à saúde e à economia das pessoas e das nações. Uma vez feito o diagnóstico correto, na medida em que avança o conhecimento da importância do tratamento adequado, com a adoção de valores de normalidade mais detalhados e com objetivos de tratamento mais cuidadosos no sentido do alcance de metas de PA mais rigorosas, fica também reforçada a importância da precisão na medida da PA. A medida da PA (descrita a seguir) é habitualmente feita pelo método tradicional, a assim chamada medida casual ou de consultório. Ao longo do tempo, foram agregadas alternativas a ela, mediante o uso de equipamentos semiautomáticos ou automáticos pelo próprio paciente, nas salas de espera ou fora do consultório, em sua própria residência ou em espaços públicos. Um passo adiante foi dado com o uso de equipamentos semiautomáticos providos de memória que permitem medidas sequenciais fora do consultório (AMPA; ou MRPA) e outros automáticos que permitem medidas programadas por períodos mais prolongados (MAPA). Alguns aspectos na medida da PA podem interferir na obtenção de resultados fidedignos e, consequentemente, causar prejuízo nas condutas a serem tomadas. Entre eles, estão: a importância de serem utilizados valores médios, a variação da PA durante o dia e a variabilidade a curto prazo. Esses aspectos têm estimulado a realização de maior número de medidas em diversas situações, e as diferentes diretrizes têm preconizado o uso de equipamentos que favoreçam essas ações. Ganham cada vez mais espaço os equipamentos que realizam MRPA ou MAPA, que, além de permitirem maior precisão, se empregados em conjunto, detectam a HA do avental branco (HAB), HA mascarada (HM), alterações da PA no sono e HA resistente (HAR) (definidos no Capítulo 2 desta diretriz). Resguardados esses detalhes, devemos ressaltar que as informações relacionadas a diagnóstico, classificação e estabelecimento de metas ainda são baseadas na medida da PA de consultório e, por esse motivo, toda a atenção deve ser dada à realização desse procedimento