ABSTRACT
Abstract Considering that the economic valuation of ecosystem services is a useful approach to support the conservation of natural areas, we aimed to estimate the monetary value of the benefits provided by a protected area in southeast Brazil, the Serra do Cipó National Park. We calculated the visitor's willingness to pay to conserve the ecosystems of the protected area using the contingent valuation method. Located in a region under intense anthropogenic pressure, the Serra do Cipó National Park is mostly composed of rupestrian grassland ecosystems, in addition to other Cerrado physiognomies. We conducted a survey consisting of 514 interviews with visitors of the region and found that the mean willingness to pay was R$ 7.16 year-1, which corresponds to a total of approximately R$ 716,000.00 year-1. We detected that per capita income, the household size, the level of interest in environmental issues and the place of origin influenced the likelihood that individuals are willing to contribute to the conservation of the park, as well as the value of the stated willingness to pay. This study conveys the importance of conserving rupestrian grassland and other Cerrado physiognomies to decision makers and society.
Resumo Dado que a valoração econômica de serviços ecossistêmicos é uma abordagem útil para incentivar a conservação de áreas naturais, tivemos como objetivo estimar o valor monetário dos benefícios fornecidos por uma área protegida no sudeste do Brasil, o Parque Nacional da Serra do Cipó. Calculamos a disposição a pagar dos visitantes pela conservação dos ecossistemas abrangidos pela área protegida, usando o método da valoração contingente. Localizado em uma região que sofre intensa pressão antrópica, o Parque Nacional da Serra do Cipó é composto majoritariamente por campos rupestres, além de outras fitofisionomias do Cerrado. Realizamos 514 entrevistas com os visitantes da região e encontramos uma disposição a pagar média de R$ 7,16 ano-1, o que corresponde ao total de aproximadamente R$ 716.000,00 ano-1. Detectamos que renda per capita, número de dependentes, nível de interesse por temas relacionados ao meio ambiente e local de origem influenciam a probabilidade de o indivíduo estar disposto a contribuir para a conservação do parque, assim como o valor da disposição a pagar declarada. Este estudo atrai atenção dos tomadores de decisão e da sociedade para a importância de se conservar os campos rupestres e outras fitofisionomias do Cerrado.
Subject(s)
Ecosystem , Conservation of Natural Resources/economics , Parks, Recreational/economics , BrazilABSTRACT
Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant.