CHALLENGES FOR THE INTERGOVERNMENTAL COORDINATION OF THE BOLSA FAMILIA PROGRAM

The paper examines the intergovernmental coordination of the Bolsa Familia Program (PBF), given its goal to tackle poverty in a country with deep social and regional inequality. It seeks to qualify the debate on the centralization of cash transfer programs in Brazil through the analysis of intergovernmental relations adopted under the three main dimensions of the PBF - cash transfer, monitoring of conditionalities and articulation of complementary programs - considering the federative implications derived from the intersectoral perspective that drives the Program. Two categories of challenges are highlighted. The first one relates to the need for greater investment in space and opportunities for intergovernmental negotiation, especially in the dimension of income transfer, which initially was characterized by centralization. In the second, the intergovernmental matter demands the organization of a coordinated national strategy for the articulation of complementary programs, suggesting greater involvement of states in the regional coordination of the Program.51545847

Depression and anxiety in systemic lupus erythematosus: The crosstalk between immunological, clinical, and psychosocial factors

Depression and anxiety cause severe loss of quality of life for patients with systemic lupus erythematosus. The causes and factors that contribute to these psychological manifestations in lupus are difficult to disentangle. This study compared clinical, psychological, and demographic factors between lupus patients, depressed patients, and rheumatoid arthritis patients to discover lupus-specific contributors to depression. Lupus-specific manifestations of depression were also investigated. Physiological, clinical, and psychosocial data were collected from 77 patients. ELISA was used to measure cytokine levels. Univariate and Multivariate analyses were used to compare the patient populations and identify correlations between key physical and psychological indicators. The prevalence of depression in the SLE cohort was 6 times greater than the healthy control subjects. Pain, IL-6, and Pittsburgh Sleep Quality index values were all significantly higher in SLE patients compared with the healthy control group (P < .001, P = .038, and P = .005, respectively). Anxiety levels were significantly higher in SLE patients compared to healthy and RA control patients (P = .020 and .011, respectively). Serum IL-10 concentrations, relationship assessment scale, and fatigue severity scale values were found to be correlated with depression among the SLE patients (P = .036, P = .007, and P = .001, respectively). Relationship assessment and fatigue severity scale scores were found to be the best indicators of depression for the SLE patients (P = .042 and .028, respectively). Fatigue Severity, relationship satisfaction, and IL-10 concentrations are indicators of depression in lupus patients. Despite also suffering from the pain and disability that accompanies chronic autoimmune disease, the rheumatoid arthritis patients had less anxiety and better relationship scores.The authors thank the Portugal Fulbright Commission for funding Dr. Pool

Influence of Biological Therapeutics, Cytokines, and Disease Activity on Depression in Rheumatoid Arthritis

Purpose: Rheumatoid arthritis (RA) is an often debilitating autoinflammatory disease. Patients with rheumatoid arthritis are often troubled by co-occurring depression or other psychological manifestations. RA patients have a variety of treatment options available, including biologicals that inhibit cytokines or immune cells. If these cytokines influence the psychological symptoms, then the use of cytokine inhibitors should modulate these symptoms.Methods: A cohort of 209 individuals was recruited. This group included 82 RA patients, 22 healthy subjects, 32 depressed control subjects, and 73 subjects with systemic lupus erythematosus. Of the RA patients, 51% were on a biological therapeutic. ELISA was used to measure cytokine levels. A variety of psychological assessments were used to evaluate depression, anxiety, sleep, fatigue, and relationship status. Clinical values were obtained from medical records.Results: IL-10 concentration was associated with depressive symptoms in the RA patients, healthy controls, and the lupus patients. In the patients with primary depression, depressive symptoms were associated with IL-6 and TNF-alpha. In RA patients, Tocilizumab use was associated with decreased depressive symptoms. 14 RA patients who were not using biologicals began using them by a one-month follow-up. In these patients, there was no significant change to any value except for fatigue.Conclusions: A variety of both biological and social factors influences depressive symptoms in RA. IL-10 and IL-6 are likely to be involved, since IL-10 concentration was associated with depression and Tocilizumab decreased depressive symptoms in the RA patients. The roles of these cytokines are different in RA and lupus, as high IL-10 in RA is associated with increased depressive symptoms, but high IL-10 in the lupus patients is associated with decreased depression. IL-6 was also associated with depressive symptoms in the patients with primary depression. These results strongly indicate that disease activity, including cytokine levels, has a strong impact on depressive symptoms.This study was supported by Portugal Fulbright Commission (Dr. Brian D. Poole)

Efficacy, Stability, and Biosafety of Sifuvirtide Gel as a Microbicide Candidate against HIV-1

Sifuvirtide is a proven effective HIV-1 entry inhibitor and its safety profile has been established for systemic administration. The present study evaluated the potential of sifuvirtide formulated in a universal gel for topical use as a microbicide candidate for preventing sexual transmission of HIV. Our data showed that sifuvirtide formulated in HEC gel is effective against HIV-1 B, C subtypes, CRF07_BC and CRF01_AE, the latter two recombinants represents the most prevalent strains in China. In addition, we demonstrated that sifuvirtide in gel is stable for at least 8 weeks even at 40°C, and did not cause the disruption of integrity of mucosal epithelial surface, or the up-regulation of inflammatory cytokines both in vitro or in vivo. These results suggest that sifuvirtide gel is an effective, safe and stable product, and should be further tested as a vaginal or rectal microbicide in pre-clinical model or clinical trial for preventing HIV sexual transmission

Human Rights Shaming Through INGOs and Foreign Aid Delivery

Does the ``shaming" of human rights violations influence foreign aid delivery decisions across OECD donor countries? We examine the effect of shaming, defined as targeted negative attention by human rights international nongovernmental organizations (INGOs), on donor decisions about how to deliver bilateral aid. We argue that INGO shaming of recipient countries leads donor governments, on average, to ``bypass" the recipient government in favor of non-state aid delivery channels, including international and local NGOs and international organizations (IOs). However, we expect this relationship to be conditional on a donor country's position in the international system. Minor power countries have limited influence in global affairs and are therefore more able to centrally promote human rights in their foreign policy. Major power countries, on the other hand, shape world politics and often confront ``realpolitik" concerns that may require government-to-government aid relations in the presence of INGO shaming. We expect aid officials of minor donor countries to be more likely to condition aid delivery decisions on human rights shaming than their counterparts of major donor countries. Using compositional data analysis, we test our argument using originally collected data on human rights shaming events in a time-series cross-sectional framework from 2004 to 2010. We find support for our hypotheses: On average, OECD donor governments increase the proportion of bypass when INGOs shame the recipient government. When differentiating between donor types we find that this finding holds for minor but not for major powers. These results add to both our understanding of the influences of aid allocation decision-making and our understanding of the role of INGOs on foreign-policy