Challenges Regarding the Performance of Public Investment Projects

Investments, approached as a factor influencing the future, have an essential role in economic growth and development by stimulating the production process and by creating new, high-performing structures that are correlated with the specific needs of individuals and society. From the point of view of access to resources, but also of economic-social competition, economic development generates a higher level of performance, certified on the basis of qualitative and quantitative evaluation processes. In this context, the analysis system of investment projects must be based on operational principles and instruments with medium and long-term impact, capable of aligning with strategic visions. In this paper, based on the research carried out in the specialized literature and the analyzed studies regarding public investments, we identify the current challenges regarding the performance of public investment projects and propose a series of criteria for evaluating the performance of public investments and a sequence of stages to ensure the elimination of non-performing projects at the local, regional and national level. The results of the present research reveal the inadequate prioritization of public investments to ensure adequate sustainability and offer us the opportunity to develop new research directions in the following works in which we will analyze the impact that inadequate prioritization has on the sustainability of local, regional and national communities

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

O OR RI IG GI IN NA Immunohistochemical detection of p53 protein as a prognostic indicator in prostate carcinoma

Abstract The aim of our study was to evaluate the prognostic significance of p53 protein immunoreactivity for prostate cancer and to determine whether p53 immunoreactivity correlates with the Gleason tumor grade in primary adenocarcinoma. Prostate fragments were fixed in 10% formalin, paraffin-embedded, sectioned and standard Hematoxylin-Eosin stained, then examined using histological grade (Gleason system). P53 expression was studied using immunohistochemistry with monoclonal antibody anti-p53, 1 : 100 (BIOX) on tissue samples obtained during transurethral electroresection, adenomectomy or needle biopsy in 30 patients with prostate carcinoma: group 1 (n = 7) Gleason score 5, group 2 (n = 10) Gleason score 6, group 3 (n = 11) Gleason score 7, group 4 (n = 2) Gleason score 8. Also, we noted the cases with high grade prostatic intraepithelial neoplasia (high grade PIN). All specimens prior to initiation of any treatment were submitted for this study. Staining was defined as positive for p53 whenever any specific nuclear staining was detected. We considered tumors to overexpress p53 protein only when strong nuclear staining was present. Cases exhibiting weak or equivocal nuclear staining were classified as negative, as were cases with extremely rare isolated positive nuclei. A semiquantitative scoring system was employed to assess the level of p53 reactivity. Six of 17 (35.2%) moderately differentiated tumors (Gleason score 5-6) and five of 13 (38.4%) moderate to poorly differentiated (Gleason score 7 and above) revealed strong nuclear positivity for p53. In addition, we noted occasional p53 reactivity in high-grade PIN. Conclusions. We interpret these data to demonstrate a positive association between p53 reactivity and higher Gleason grade tumors; p53 might be an independent prognostic indicator among metastatic risk case

The association between chronic pancreatitis and the iNOS-2087A>G polymorphism

Introduction. Chronic pancreatitis is morphologically characterized by ductal dysplasia, breeding grounds for the proliferation of the ductal cells, the degenerative changes in pancreatic acinar cells and fibrosis, and it is defined on the basis of the clinical, morphological and functional criteria

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions