Trends and inequities in amenable mortality between 1997 and 2012 in South Africa

Background. Amenable mortality comprises causes of death that should not occur with timely and effective healthcare. It is commonly used to assess healthcare performance. It could also be used to assess the effectiveness of the pending National Health Insurance (NHI) in South Africa (SA), but to do this, the level and distribution of amenable mortality are required using a local list of amenable causes. Objectives. To establish an amenable cause-of-death list appropriate for SA and to determine the levels, trends, geographical distribution, population group differences and international comparisons of mortality amenable to healthcare. Methods. A local list of amenable causes of death was developed with input from public health and disease-specific medical experts. The Second SA National Burden of Disease estimates were reclassified into amenable mortality. Analyses of age-standardised death rates (ASDRs) and amenable mortality proportions were conducted by province and population group between 1997 and 2012. Excess mortality in relation to the best- performing province and population group was also analysed. ASDRs for SA were compared with those of European Union (EU) and Organisation for Economic Co-operation and Development (OECD) countries. Results. The local list of amenable conditions contained 45 causes of death. There were large disparities in amenable mortality between provinces and population groups, which did not attenuate over time. There was an average annual percentage increase in amenable ASDRs, but when HIV/AIDS was excluded from the analysis there was an average annual decrease of 1.12%. In the post-peak HIV/AIDS period between 2008 and 2012, an annual average of 207 810 amenable deaths could have been saved if all provinces had the same ASDR as the Western Cape. SA's ASDR was 2.6 and 2.2 times higher than that of the worst-performing EU and OECD country, respectively. Conclusions. This is the first study known to the authors that has established a local amenable mortality list and described the epidemiology of amenable mortality in SA. Amenable mortality could be used as an indicator of the performance of the pending NHI over time and, in combination with other indicators, could identify areas of the health system that require improvement. Benchmarking could also quantify gaps in health system performance between geographical regions and indicate whether these are reduced with time

Population analysis of Scomberomorus cavalla (Cuvier, 1829) (Perciformes, Scombridae) from the Northern and Northeastern coast of Brazil

Scomberomorus cavalla is a pelagic fish species widely distributed on the Atlantic west coast, and a noticeable decrease in its capture level in the USA and Gulf of Mexico is occurring, compared to the levels reached by the species in the past. Likewise, in some areas of Brazil, there has been indication of over-harvesting. However, there are no molecular studies focusing on the management of such an important item. Thus, in the present study, 380 nucleotide base pairs of the mitochondrial DNA D-Loop region of samples from Macapá, Bragança, and Fortaleza were sequenced. Phylogenetic and population analyses revealed that there is only one panmitic population, and low levels of genetic variability were verified. These results, as well as the noticed over-harvesting of S. cavalla, represent very important data to determine the management of such stock in order to prevent a collapse or the risk of future extinction.

Scomberomorus cavalla é uma espécie de peixe pelágico amplamente distribuído na costa oeste do Atlântico, e uma diminuição no seu nível de captura tem sido verificada nos E.U.A e Golfo do México, comparada com os níveis alcançados pela espécie no passado. Da mesma forma, em algumas áreas do Brasil, há indícios de sobre-exploração. Entretanto, não existem estudos moleculares que visam o manejo deste importante item. Desta forma, no presente estudo, foram seqüenciados 380 pares de bases nucleotídicas da região da Alça-D do DNA mitocondrial de amostras provenientes de desembarque em Macapá, Bragança e Fortaleza. As análises filogenéticas e populacionais revelaram que há apenas uma população panmítica e baixos níveis de variabilidade genética foram observados. Estes resultados, assim como a observada sobre-exploração de S. cavala, representam dados muito importantes para o estabelecimento do manejo deste estoque a fim de prevenir um colapso ou risco de extinção no futuro.

Population analysis of Scomberomorus cavalla (Cuvier, 1829) (Perciformes, Scombridae) from the Northern and Northeastern coast of Brazil

Scomberomorus cavalla is a pelagic fish species widely distributed on the Atlantic west coast, and a noticeable decrease in its capture level in the USA and Gulf of Mexico is occurring, compared to the levels reached by the species in the past. Likewise, in some areas of Brazil, there has been indication of over-harvesting. However, there are no molecular studies focusing on the management of such an important item. Thus, in the present study, 380 nucleotide base pairs of the mitochondrial DNA D-Loop region of samples from Macapá, Bragança, and Fortaleza were sequenced. Phylogenetic and population analyses revealed that there is only one panmitic population, and low levels of genetic variability were verified. These results, as well as the noticed over-harvesting of S. cavalla, represent very important data to determine the management of such stock in order to prevent a collapse or the risk of future extinction.

Scomberomorus cavalla é uma espécie de peixe pelágico amplamente distribuído na costa oeste do Atlântico, e uma diminuição no seu nível de captura tem sido verificada nos E.U.A e Golfo do México, comparada com os níveis alcançados pela espécie no passado. Da mesma forma, em algumas áreas do Brasil, há indícios de sobre-exploração. Entretanto, não existem estudos moleculares que visam o manejo deste importante item. Desta forma, no presente estudo, foram seqüenciados 380 pares de bases nucleotídicas da região da Alça-D do DNA mitocondrial de amostras provenientes de desembarque em Macapá, Bragança e Fortaleza. As análises filogenéticas e populacionais revelaram que há apenas uma população panmítica e baixos níveis de variabilidade genética foram observados. Estes resultados, assim como a observada sobre-exploração de S. cavala, representam dados muito importantes para o estabelecimento do manejo deste estoque a fim de prevenir um colapso ou risco de extinção no futuro.

Es la etnia mapuche un factor de riesgo para padecer fractura de fémur proximal en adultos mayores? / Is Mapuche ethnicity a risk factor for hip fracture in aged?

BACKGROUND: Ethnic factors are involved in the risk for osteoporosis and hip fracture. AIM: To assess the effect of Mapuche ethnicity on the risk of hip fracture. PATIENTS AND METHODS: A case control study. Cases were subjects over 55 years of age admitted, during one year, for hip fracture not associated to major trauma or tumors. Controls were randomly chosen from other hospital services and paired for age with cases. The magnitude of the association between ethnicity and hip fracture was expressed as odds ratio in a logistic regression model. RESULTS: In the study period, 156 cases with hip fracture were admitted. The proportion of subjects with Mapuche origin was significantly lower among cases than controls (11.8 and 26.5 per cent respectively, p < 0.001). In the logistic regression model, Mapuche ethnicity was associated with hip fracture with an odds radio of 0.14 (p = 0.03, 95 per cent CI 0.03-0.8). CONCLUSIONS: In this sample, Mapuche ethnicity is a protective factor for hip fracture.

Advertisement calls of two anuran amphibians, Rana tigrina and Tomopterna breviceps.

Rana tigrina and Tomopterna breviceps occur as sympatric species at Dharwad, India. Sexually mature males produce advertisement calls. The advertisement call of both the species consist of a number of calls produced in series forming a call group· Each call group of Rana tigrina comprises 10-40 calls, whereas that of Tomopterna breviceps consists 13-141 calls. Each call consists of a pulse group with variable number of pulses which lack pulse interval. Calls of both the species exhibit similarities in (i) call consisting of series of calls with a pulse group in each call, (ii) absence of pulse interval within the pulse group, (iii) the amplitude of the first pulse being always small, and (iv) the frequency spectrum beginning from 200 Hz. Based on the similarities in the spectral features of the calls, it is suggested that the two species may be closely related to each other.

Vocalization of the tree frog Polypedates maculatus (Rhacophoridae).

The period of calling activity of Polypedates maculatus lies between April and October. Males possess an indistinct subgular vocal sac which turns yellow during the breeding season. Mating calls type I, type II and distress calls have been identified. Mating calls type I and type II consist of a single pulse group. Type I call comprises of 7-22 pulses, whereas type II call consists of 4-6 pulses. Pulses are short. The frequency spectrum is broad and continuous. Distress calls, with 6 hormonics, are given by the females with their mouth open.

Terapia tópica em lesoes esportivas: estudo comparativo do diclofenato dietilamônio e um preparado de controle / Local treatment in sport injuries: a comparative study of diclofenac diethylamonium and a reference preparation

Em um estudo controlado, simples-cego, multicêntrico, foram testadas a eficácia e a tolerabilidade do tratamento local com Cataflam Emulgel em 69 pacientes com lesöes dolorosas, tais como entorses e contusöes. Um segundo grupos de pacientes foi tratado com um gel de referência contendo 2,0% de ácido salicílico, 0,2% de polissulfato mucopolissacarídeo (MPSS) e extrato adrenocortical, correspondendo à atividade de 0,02% de prednisolona. Em ambos os grupos de pacientes, a dor e o edema diminuíram rapidamente com o tratamento. Com respeito à eficácia terapêutica e à observância dos pacientes, Cataflam Emulgel provou ser superior ao gel de referência. Ambos os preparados foram bem tolerados. Efeitos adversos puderam ser observados apenas uma vez em cada grupo

Genetic variability in a natural population of Cebus apella paraguayanus (Cebidae, primates)

Foram estudadas 17 proteínas séricas e eritrocitárias em uma populaçäo natural de Cebus apella paraguayanus. Apenas o locus da GPI mostrou poliformismo (GPI*1 = 89% and GPI*2 = 11%). Uma análise comparativa das estimativas de variabilidade genética dentre os primatas mostrou que C. a paraguayanus (P = 5.9%; H = 1.1%) apresenta níveis de variaçäo genética comparáveis a Alouatta palliata e Leontopithecus rosalia, duas outras espécies do Novo Mundo

Isolate breakdown in Amazonia: the blacks of the Trombetas river

Um total de 201 indivíduos, descendentes de escravos africanos que fugiram e formaram um comunidade independente às margens dos rios Trombetas e Cuminá, foi estudada com relaçäo a 16 sistemas genéticos (dois grupos sangüíneos, hemoglobina, oito sistemas eritrocitários e cinco proteínas séricas). Dezesseis (59 por cento) dos 27 marcadores genéticos estudados apresentaram freqüências que säo típicas de populaçöes com ancestralidade africana e alguma mistura. A presença de HB*S, CA2*2, ACP*R, GD*A, GD*A- e HP*2M também indicou um conjunto gênico em grande parte africano. A estimativa quantitativa da mistura, usando 11 dos sistemas que apresentaram menos heterogeneidade, forneceu as seguintes percentagens, quanto aos componentes raciais: 62 por cento de negro, 11 por cento de indígena e 27 por cento de branco. Estimativas prévias de miscigenaçäo africana em populaçöes da regiäo amazônica resultaram em números muito menores (13 por cento a 24 por cento). Conclui-se que esta comunidade ainda mantém muito das suas características ancestrais, apesar do processo de mistura racial que está ocorrendo lá e praticamente em todo Brasil

Changes in hypothalamic catechol-0-methyl-transferase during sexual differentiation of the brain

1. An assay using [14 C-methyl]-S-adenosyl-L-methionine was used to measure catecholamine-O-methyl-transferase (COMT) activity in the hypothalamus of newborn male and female rats from day 1 to day 12 and in adult animals after day 60. 2. There was no difference in COMT activity between sexes until day 8, when it became significantly higher in females. 3. Administration of 200 microng testosterone propionate to female rats at birth reduced the hypothalamic COMT level of the adult to that observed for male littermates. The response was dose-dependent in the range 50 to 200 microng. The hypothalamic contnet of COMT after puberty of male rats castrated ar birth was comparable to that of post-pubertal females. 4. These results show that COMT, one of the enzymes involved in the control of brain biogenic amines, is also affected by the process of sexual differentiation of the brain

Governmental Relationships and HIV/AIDs Service Delivery

This research project examined inter-governmental relations in the health sector in South Africa. It focused on HIV/AIDS services but the intention was to use HIV/AIDS as a tracer or probe of broader health system functioning. The main objectives of the research were to describe what HIV/AIDS services are provided; how the different functions are allocated between government actors; and how they are then coordinated. The study was conducted in two parts. Phase 1 was completed in the second half of 2002 and provided a broad National Overview of HIV/AIDS activities in the national; provincial and local spheres of government. Phase 2 was done in early 2003 and consisted of detailed Case Studies from three different tracer municipalities. The research methodology was mainly qualitative and exploratory and included literature review; document analysis and key informant interviews