Regional disparities in infant mortality in Canada: a reversal of egalitarian trends

<p>Abstract</p> <p>Background</p> <p>Although national health insurance plans and social programs introduced in the 1960s led to reductions in regional disparities in infant mortality in Canada, it is unclear if such patterns prevailed in the 1990s when the health care and related systems were under fiscal duress. This study examined regional patterns of change in infant mortality in Canada in recent decades.</p> <p>Methods</p> <p>We analysed regional changes in crude infant mortality rates and in infant mortality rates among live births with a birth weight ≥ 500 g and ≥ 1,000 g in Canada from 1945 to 2002. Associations between baseline infant mortality rates in the provinces and territories (e.g., in 1985–89) and the change observed in infant mortality rates over the subsequent period (e.g., between 1985–89 and 1995–99) were assessed using Spearman's rank correlation coefficient. Trends in regional disparities were also assessed by calculating period-specific rate ratios between provinces/territories with the highest versus the lowest infant mortality.</p> <p>Results</p> <p>Provincial/territorial infant mortality rates in 1945–49 were not correlated with changes in infant mortality over the next 10 years (rho = 0.01, P = 0.99). However, there was a strong negative correlation between infant mortality rates in 1965–69 and the subsequent decline in infant mortality (rho = - 0.85, P = 0.002). Provinces/territories with higher infant mortality rates in 1965–69 (Northwest Territories 64.7 vs British Columbia 20.7 per 1,000 live births) experienced relatively larger reductions in infant mortality between 1965–69 and 1975–79 (53.7% decline in the Northwest Territories vs a 36.6% decline in British Columbia). This pattern was reversed in the more recent decades. Provinces/territories with higher infant mortality rates ≥ 500 g in 1985–89 experience relatively smaller reductions in infant mortality between 1985–89 and 2000–02 (rho = 0.82, P = 0.004). The infant mortality ≥ 500 g rate ratio (contrasting the province/territory with the highest versus lowest infant mortality) was 3.2 in 1965–69, 2.4 in 1975–79, 2.2 in 1985–89, 3.1 in 1995–99 and 4.1 in 2000–02.</p> <p>Conclusion</p> <p>Fiscal constraints in the 1990s led to a reversal of provincial/territorial patterns of change in infant mortality in Canada and to an increase in regional health disparities.</p

Selective loss of myelin-associated glycoprotein from myelin correlates with anti-MAG antibody titre in demyelinating paraproteinaemic polyneuropathy

Summary The IgM monoclonal autoantibodies of patients with demyelinating paraproteinaemic polyneuropathy recognize a carbohydrate structure present on both myelin-associated glycoprotein (MAG) and protein zero (Po). These autoantibodies are sufficient to cause the disease but the mechanism of demyelination remains unclear. We have analysed nerve biopsies from eight patients with polyneuropathy and anti-MAG antibodies by quantitative immunohistochemistry and find a concordant pattern of reduced expression of myelin markers with the loss of myelinated fibres. We report here novel features of this disease, in particular a selective lack of detectable MAG in a large proportion of myelinated fibres containing Po, myelin basic protein (MBP) and periaxin. There is also an inverse correlation of the distribution of MAG in peripheral never myelin with the serum anti-MAG antibody titres but no correlation of these titres with the loss of myelinated fibres. Double immunofluorescence staining of paraproteinaemic polyneuropathy (PPN) nerves shows anti-MAG IgM deposited on the periphery of myelinated fibres associated with or lacking MAG staining. These data suggest that the binding of anti-MAG antibodies to MAG and/or other myelin component(s) results in MAG downregulation and may have an essential role in the molecular mechanisms leading to demyelination and partial regeneration in this diseas

Transparência de tecnologia contextualizada: estudo de caso no Semiárido paraibano.

O artigo apresenta uma análise multidimensional sobre a estratégia de intervenção do Cooperar/PB-BIRD com o objetivo de reduzir a extrema pobreza no Estado da Paraíba. A partir da difusão de tecnologias adaptadas as reais necessidades e interesses das famílias rurais e as peculiaridades do semiárido, isto é, Transferência de Tecnologia Contextualizada (TTC), fundamentada na construção de um Índice de Sustentabilidade de Investimentos de Politicas Públicas (IPP), com a finalidade de monitorar e avaliar sua consecução. O IPP possibilitou que, associar-se a cada base municipal, o Acervo Tecnológico, hoje existente, voltado para a sustentabilidade dos Arranjos Produtivos Locais (APLs). O processo de TTC em marcha na Paraíba disciplina as atividades na esfera estadual, municipal e local, em base sustentável. Enquanto, o IPP pautado em valores adicionados brutos a preço corrente da agropecuária, torna possível mensurar para cada um dos 222 municípios, seus graus de sustentabilidade de aplicação de investimentos de políticas pública por habitante Rural, antes e posterior sua consecução

A graphical tool for eliciting knowledge of air pollution sources

With tens of thousands of air quality monitoring stations installed in the world, this source of information has become the standard in air quality measuring. Air pollution becoming a growing concern for decades now, the need for an easy way to visualise pollution data arose. Extensive maps have been created to represent air pollution using data collected from monitoring stations, as well as other sources of information, such as traffic density or weather forecasts. This paper introduces a complementary source: direct environmental expert knowledge. By using the developed tool, the goal is to allow experts to express their knowledge about air pollution emission and diffusion as a function of the presence of key topological elements in a map, such as buildings or roads. The results of the usability tests performed with a sample of 30 participants are promising. Participants provided useful feedback regarding key application features to be implemented in future iterations.info:eu-repo/semantics/acceptedVersio

Transpiration in mango using Granier method

Objetivou-se, com esse trabalho avaliar o método Granier (sonda de dissipação térmica) para a cultura da manga quanto à viabilidade de uso em condições de campo e ajustar a equação de determinação do fluxo de seiva com base em medidas lisimétricas, iniciando-se com três mudas da variedade Tommy Atkins, plantadas em vasos que, colocados sobre plataforma de pesagem, funcionaram como lisímetros. A área condutora do caule (AS) foi determinada por meio da aplicação de corantes. Medidas de transpiração por lisimetria nas plantas foram realizadas em vaso e estimativas do fluxo de seiva com sonda de dissipação térmica (SDT). Em um ramo de planta adulta foram instaladas uma sonda de dissipação térmica e um sensor de balanço de calor caulinar. Os resultados demonstraram que, usando os coeficientes originais da equação de Granier, o método subestima em 31% o fluxo de seiva (FS) diário em relação à transpiração medida pelos lisímetros; modificando os parâmetros empíricos da equação FS = 0,00017k1,231AS o desvio médio apresentado foi de -1,4%, com boa precisão (R² = 0,89). O método da SDT e balanço de calor caulinar apresentaram boa concordância entre os valores.The purpose of this study was to evaluate Granier's method (heat dissipation probe) for mango crop and to determine the viability of its use under field conditions and to adjust the equation of sap flow (SF) on the basis of lysimeter measurements. The work started with three seedlings of the variety Tommy Atkins cultivated in recipients that were placed on a weighing platforms which functioned as lysimeters. The sapwood area (SA) was determined through pigment application. Transpiration measurement by lysimeter were conducted in recipients and sap flow estimates with heat dissipation probe (HDP). This probe and a stem heat balance sensor were installed in one branch of the adult plant. The results showed that, using original coefficients of Granier's equation, the method underestimated sap flow by 31% daily in relation to the transpiration. Modifying empirical parameters of equation FS = 0,00017k1,231AS, the mean error was of -1.4% with good precision (R² = 0.89). HDP and stem heat balance method showed good agreement

Diversidade de espécies de aves em silvicultura de eucalipto.

Com a rápida e crescente expansão da silvicultura, especialmente no Estado de São Paulo, é comum o debate sobre os impactos e possíveis benefícios de tal prática, principalmente sobre a biodiversidade. Entretanto, levantamentos de indicadores de biodiversidade nessas áreas ainda são escassos e existe uma grande lacuna de conhecimento. Este trabalho apresenta resultados sobre a caracterização da avifauna encontrada em uma propriedade de silvicultura de Eucalyptus no Município de Brotas, SP. A amostragem da avifauna foi realizada usando a metodologia de contagem por pontos. Após seis campanhas de campo foram registradas 53 espécies de aves para a área de estudo, distribuídas em 23 famílias e 11 ordens. A ordem dos Passeriformes foi a que apresentou maior número de espécies (34) e de contatos (132). De acordo com a análise da frequência de ocorrência, poucas espécies mostraram-se frequentes na região e outras apareceram em um único ponto, fato que poderia ser indicativo de grande variedade de nichos ecológicos. Análises futuras avaliarão a diversidade da fauna em relação a indicadores de ecologia da paisagem e em relação à fitossociologia do sub-bosque nas áreas de cultivo de eucalipto.bitstream/item/56791/1/015-11.pd

A new classification system for degenerative spondylolisthesis of the lumbar spine

This is the author accepted manuscript. The final version is available from Springer Verlag via the DOI in this record.PURPOSE: There is no consensus for a comprehensive analysis of degenerative spondylolisthesis of the lumbar spine (DSLS). A new classification system for DSLS based on sagittal alignment was proposed. Its clinical relevance was explored. METHODS: Health-related quality-of-life scales (HRQOLs) and clinical parameters were collected: SF-12, ODI, and low back and leg pain visual analog scales (BP-VAS, LP-VAS). Radiographic analysis included Meyerding grading and sagittal parameters: segmental lordosis (SL), L1-S1 lumbar lordosis (LL), T1-T12 thoracic kyphosis (TK), pelvic incidence (PI), pelvic tilt (PT), and sagittal vertical axis (SVA). Patients were classified according to three main types-1A: preserved LL and SL; 1B: preserved LL and reduced SL (≤5°); 2A: PI-LL ≥10° without pelvic compensation (PT < 25°); 2B: PI-LL ≥10° with pelvic compensation (PT ≥ 25°); type 3: global sagittal malalignment (SVA ≥40 mm). RESULTS: 166 patients (119 F: 47 M) suffering from DSLS were included. Mean age was 67.1 ± 11 years. DSLS demographics were, respectively: type 1A: 73 patients, type 1B: 3, type 2A: 8, type 2B: 22, and type 3: 60. Meyerding grading was: grade 1 (n = 124); grade 2 (n = 24). Affected levels were: L4-L5 (n = 121), L3-L4 (n = 34), L2-L3 (n = 6), and L5-S1 (n = 5). Mean sagittal parameter values were: PI: 59.3° ± 11.9°; PT: 24.3° ± 7.6°; SVA: 29.1 ± 42.2 mm; SL: 18.2° ± 8.1°. DSLS types were correlated with age, ODI and SF-12 PCS (ρ = 0.34, p < 0.05; ρ = 0.33, p < 0.05; ρ = -0.20, and p = 0.01, respectively). CONCLUSION: This classification was consistent with age and HRQOLs and could be a preoperative assessment tool. Its therapeutic impact has yet to be validated. LEVEL OF EVIDENCE: 4.No funds were received in support of this work. No benefits in any forms have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript