Developing a provincial epidemiologic and demographic information system for health policy and planning in Kwazulu-Natal.

Thesis (M.Med.)-University of Natal, Durban, 2000.Since 1994, a turning point in the history of South Africa (SA), significant changes were made in the delivery of health services by the public sector, provincially and nationally. The process of change involved making important decisions about health services provision, often based on past experience but ideally requiring detailed information on health status and health services. For an example, Primary Health Care (PHC) was made freely accessible to all citizens of this country. Many studies on the impact of free PHC in the country have shown increased utilization of these services.40 In the context of HIV/AIDS and its complications and other emerging health conditions, reasons for this increased utilization may not be that simple. I17, II8. Parallel with increased utilisatIon has been uncontrollable escalation of costs in the Department of Health (DoH), often resulting in ad-hoc and ineffective measures of cost-containment.40. For these and many other reasons of critical importance to public health services management, the issue of health information generally, and epidemiological inforn1ation in particular, should be brought higher on the agenda of health management. Public health services management is about planning, organization, leading, monitoring and control of the same services.2 Any public health plan must have a scientific basis. In order to achieve rational planning of public health services in the province, adequate, up to date, accurate information must be available, as a planning tool. Health information is one of key resources and an essential element in health services management. It is a powerful tool by which to assess health needs, to measure health status of the population and most importantly, to decide how resources should be deployed.5 Trends in the health status of the population are suggested by the White Paper for transforn1ation of Health Services (White Paper), to be important indicators of the success of the Reconstruction and Development Programme (RDP), the country's programme of transformation. 37,39 It is within that context that the KwaZulu-Natal-Department of Health (KZN-DoH) resolved to establish an Epidemiology/Demographic Unit for the province, to assist management to achieve the department's objectives of providing equitable, effective, efficient and comprehensive health services. 37,89 Purpose: To develop a provincial Epidemiological-Demographic Inforn1ation System (EDIS) that will consistently inforn1 and support rational and realistic management decisions based on accurate, timely, current and comprehensive infom1ation, moving the DoH towards evidence based policy and planning. Objectives: To provide an ED IS framework to : .develop provincial health policy .assist management with health services planning and decision-making .ensure central co-ordination of health information in order to support delivery of services at all levels of the health system . . monitor implementation and evaluation of health programmes . ensure utilization of information at the point of collection, for local planning and interventlon. Methods: A rapid appraisal of the existing Health Information System (HIS) in the province was conducted from the sub-departments of the DoH and randomly selected institutions. A cross-sectional study involving retrospective review of records from selected hospitals, clinics and other sources, was conducted. The study period was the period between January 1998 to December 1998. Capacity at district and regional levels on managing health information and epidemiological information in particular, was reviewed and established through training progranmles. Results: The rapid appraisal of existing HIS in the province revealed a relatively electronically well resourced sub-department of Informatics within the KZN-DoH, with a potential to provide quality and timely data. However, a lot of data was collected from both clinics and hospitals but not analyzed nor utilized. Some critical data was captured and analyzed nationally. There was lack of clarity between the Informatics Department staff responsible for collecting and processing provincial data and top management with regards each other's needs. Demographics: The demographic composition and distribution profile of the KZN population showed features of a third world country for Blacks with the White population displaying contrasting first world characteristics. Socio-Economic Profile: The majority of the population was unemployed, poor, illiterate, economically inactive, and earning very low income. The water supply, housing and toilet facilities seemed adequate, but in the absence of data on urban/rural distinction, this finding needs to be interpreted with caution Epidemiology: All basic indicators of socio-economic status (infant, child, neonatal mortality rates) were high and this province had the second poorest of the same indicators in the country. Adult and child morbidity and mortality profiles of the province, both at clinics and district hospitals were mainly from preventable conditions. Indicators on women and maternal health were consistent with the socio-economic status of this province; and maternal mortality rate was high with causes of mortality that were mainly preventable. The issue of HIV / AIDS complications remains unquantifiable with the limited data available. HIV is a serious epidemic in KZN and this province continues to lead all the provinces in the country, a prevalence of 32 % in 1999.86 Health Services Provision: Inmmnization coverage was almost 50% below the national target and drop out rate was very high. Termlinations of Pregnancies (TOP) occurred mainly among adult, single women, and the procedure done within the first trimester and requested for social and economic reasons. Provincial clinics (mainly fixed) and hospitals provide family planning and Ante Natal Care (ANC) services to the majority of pregnant women in the province. Conclusion : KZN is a poor province with an epidemiological profile of a country in transition but predominantly preventable health conditions. The province has a potential for producing high quality health information required for management, planning and decision making. It is recommended that management redirects resources towards improving PHC services. Establishment of an Epidemiology Unit would facilitate the DoH's health services reforms, through provision of comprehensive, accurate, timely and relevant health information

Evaluation under long-day conditions of 4x-2x progenies from crosses between potato cultivars and haploid Tuberosum-solanum chacoense hybrids.

Twelve 4x families (obtained from a sub-set of crosses between seven 4x-potato cultivars and three 2x haploid Tuberosum-Solanum chacoense hybrids) were evaluated at Hancock, Wisconsin (USA). The 4x-parents were elite cultivars selected for adaptation in three continents (Europe, South America, and North America). The 2x male clones were able to produce 2n-pollen grains by a mechanism akin to first-division restitution with crossover (FDR-CO). The estimation of the degree of heterosis for total tuber yield (TTY) was obtained by comparing the field performance of the progenies with their respective 2x and 4x parents. Haulm maturity (HM) and general tuber appearance (GTA) were also evaluated. For TTY, the 4x-2x families (as a group) outyielded both the 4x and 2x parental groups by 10.6% and 42.5%, respectively. In addition, 5 out of 12 famiIies outyielded their corresponding 4x-parents. These best five families outyielded the group of 4x-parents by 40.6%. A considerable variability was observed for HM but, in general, the families were later maturing than the 4x cultivars. The identification of 4x-2x families with GTA within the range of the 4x commercial cultivars was another important observation. An overall lack of parent-offspring correlation was detected indicating that performance of the parents per se cannot provide a reliable prediction about the performance of the families. Therefore, progeny testing would be an imperative step for selection of parental clones at both ploidy levels. Our study indicated that haploid Tuberosum-S. chacoense hybrids are able to generate heterotic 4x-2x families for TTY in combination with good GTA. These results reinforce the view that selection of superior clones for the Northern Hemisphere can be feasible using germplasm with -25% genomic contribution of this wild South American species

Lipedema: A Call to Action!

Lipedema is a chronic progressive disease characterized by abnormal fat distribution resulting in disproportionate, painful limbs. It almost exclusively affects women, leading to considerable disability, daily functioning impairment, and psychosocial distress. Literature shows both scarce and conflicting data regarding its prevalence. Lipedema has been considered a rare entity by several authors, though it may be a far more frequent condition than thought. Despite the clinical impact on women's health, lipedema is in fact mostly unknown, underdiagnosed, and too often misdiagnosed with other similarly presenting diseases. Polygenic susceptibility combined with hormonal, microvascular, and lymphatic disorders may be partly responsible for its development. Furthermore, consistent information on lipedema pathophysiology is still lacking, and an etiological treatment is not yet available. Weight loss measures exhibit minimal effect on the abnormal body fat distribution, resulting in eating disorders, increased obesity risk, depression, and other psychological complaints. Surgical techniques, such as liposuction and excisional lipectomy, represent therapeutic options in selected cases. This review aims to outline current evidence regarding lipedema epidemiology, pathophysiology, clinical presentation, differential diagnosis, and management. Increased awareness and a better understanding of its clinical presentation and pathophysiology are warranted to enable clinicians to diagnose and treat affected patients at an earlier stage

Mating system and fine-scale spatial genetic structure of Solanum lycocarpum St. Hil. (Solanaceae) in the Brazilian cerrado.

Made available in DSpace on 2018-06-06T00:57:47Z (GMT). No. of bitstreams: 1 ID278381.pdf: 380211 bytes, checksum: cffbc302b71ded9ecd7d04a010c2e4b7 (MD5) Previous issue date: 2007-01-1

A situacao atual e perspectivas do melhoramento genetico de batata no Brasil.

A situação atual do melhoramento genético de batata no Brasil; Estratégias de melhoramento; Problemas relativos a produção de batata semente de novas cultivares no Brasil; Futuro.Palestra

Inferências sobre Vegetação e Clima no Holoceno a partir de Fitólitos e Pólen da Lagoa do Macuco, Litoral Norte do Estado do Espírito Santo (Brasil)

[EN] An interproxy approach focused on phytoliths and pollen, including radiocarbon dating and sediment particle-size analyses, has been carried out at Lagoa do Macuco, Linhares municipality, Espírito Santo State, Brazil. Three pollen zones were identified: the first one (MAC-C I) indicates the presence of mangrove vegetation between 7700 cal yr BP and 4396 cal yr BP; the second one a displacement of the vegetation from the lower areas to the more elevated margins of the valley (MAC-C II, from between 4396 to 1287 cal. yr BP) and third one (MAC-C III), representing the period of the current lake evolution, between 1287 cal. yr BP and the present day. The displacement of the mangrove seems to be connected to the landward migration of the palaeo-estuary and the flooding of the lower parts of the valley, reflecting the relative sea-level highstand, which occurred after 7000 cal yr BP. The phytolith analysis indicated four main zone. The phytolith zone I (7700-7100 cal yr BP) did not show the presence of phytoliths. The phytoliths zone II (7100-3400 cal yr BP) indicates the presence of an open vegetation predominantly of grasses while phytolith zone III (3400-400 cal yr BP) shows a phase with more forested vegetation. Finally, the phytolith zone IV (400 cal yr BP to modern) has a decrease in tree cover and the setting of vegetation with a strong grasses component. Phytoliths indices indicate trends of humidity and temperature at a more local scale, allowing understanding the environmental conditions during the formation of the current lake.[PT] Uma abordagem interproxy focada na análise de fitólitos e de grãos de pólen, também incluindo datação 14C e análise granulométrica de sedimentos, foi aplicada ao estudo da Lagoa do Macuco, em Linhares no Estado do Espírito Santo. Foram identificadas três zonas polínicas definidas com base nas mudanças do registro polínico, a primeira (MAC-C I) indicando a presença de uma vegetação de mangue entre 7700 anos cal AP e 4396 anos cal AP, a segunda (MAC-C II) que representa o deslocamento da vegetação das áreas mais baixas para as partes marginais mais elevadas do vale (4396 anos cal AP - 1287 anos cal AP) e a terceira (MAC-C III) que representa o período da instalação do atual lago, entre 1287 anos cal AP e os dias atuais. O deslocamento do mangue parece estar conectado a migração em direção ao paleo-estuário e o alagamento das partes baixas do vale, refletindo a elevação do nível relativo do mar depois de 7000 cal anos AP. A análise fitolítica indicou quatro zonas principais. A zona fitolítica I (7700-7100 anos cal AP), não apresentou fitólitos. A zona fitolítica II (7100-3400 anos cal AP) indica a presença de uma vegetação predominantemente composta por gramíneas, enquanto a zona fitolítica III (3400-400 anos cal AP) mostrou uma fase com uma vegetação mais florestada. Finalmente, a zona fitolítica IV, (400 anos cal AP até os dias atuais) apresentou decréscimo da cobertura arbórea e uma estrutura de vegetação com forte presença de gramíneas em sua composição. Os índices fitolíticos indicaram tendência de umidade e temperatura em escala local permitindo a compreensão das condições ambientais durante a formação do lago atual.The authors express their gratitude to Vale and Sooretama Nature Reserves (Linhares, ES, Brasil) for the field support. This work received financial support by the São Paulo Foundation for Research (FAPESP), grant 2011/00995-7, and CNPq (Universal), grant 470210/2012-5.Peer Reviewe

A new FSA approach for in situ γ\gamma-ray spectroscopy

An increasing demand of environmental radioactivity monitoring comes both from the scientific community and from the society. This requires accurate, reliable and fast response preferably from portable radiation detectors. Thanks to recent improvements in the technology, $\gamma$-spectroscopy with sodium iodide scintillators has been proved to be an excellent tool for in-situ measurements for the identification and quantitative determination of $\gamma$-ray emitting radioisotopes, reducing time and costs. Both for geological and civil purposes not only $^{40}$K, $^{238}$U, and $^{232}$Th have to be measured, but there is also a growing interest to determine the abundances of anthropic elements, like $^{137}$Cs and $^{131}$I, which are used to monitor the effect of nuclear accidents or other human activities. The Full Spectrum Analysis (FSA) approach has been chosen to analyze the $\gamma$-spectra. The Non Negative Least Square (NNLS) and the energy calibration adjustment have been implemented in this method for the first time in order to correct the intrinsic problem related with the $\chi ^2$ minimization which could lead to artifacts and non physical results in the analysis. A new calibration procedure has been developed for the FSA method by using in situ $\gamma$-spectra instead of calibration pad spectra. Finally, the new method has been validated by acquiring $\gamma$-spectra with a 10.16 cm x 10.16 cm sodium iodide detector in 80 different sites in the Ombrone basin, in Tuscany. The results from the FSA method have been compared with the laboratory measurements by using HPGe detectors on soil samples collected in the different sites, showing a satisfactory agreement between them. In particular, the $^{137}$Cs isotopes has been implemented in the analysis since it has been found not negligible during the in-situ measurements.Comment: accepted by Science of Total Environment: 8 pages, 10 figures, 3 table