Challenges In Brazil Research Articles

A multicentric evaluation of the recombinant Leishmania infantum antigen-based immunochromatographic assay for the serodiagnosis of canine visceral leishmaniasis

BackgroundVisceral leishmaniasis (VL) is a serious public health challenge in Brazil and dogs are considered to be the main urban reservoir of the causative agent. The culling of animals to control VL in some countries makes the accurate diagnosis of canine VL (CVL) essential. Recombinant antigens rLci1A and rLci2B were selected from a cDNA library of Leishmania infantum amastigotes due to their strong potential as candidates in diagnostic testing for CVL. The present multicentric study aimed to evaluate the sensitivity of a prototype test using these antigens (DPP rLci1A/rLci2B) against 154 sera obtained from symptomatic dogs within three endemic areas of VL in Brazil. The specificity was evaluated using 40 serum samples from negative dogs and dogs infected with other pathogens. Sensitivity and specificity rates of DPP rLci1A/rLci2B prototype were compared to rates from other diagnostic tests currently in use by the Brazilian Ministry of Health, including DPP®LVC, EIE®LVC.FindingsDPP rLci1A/rLci2B prototype offered similar performance to that offered by DPP®LVC rapid test, as follows: sensitivity of 87% (CI 81–91) and 88% (CI 82–93) and specificity of 100% (CI 91–100) and 97% (CI 87–100), respectively for DPP rLci1A/rLci2B and DPP®LVC. When results of these two tests were considered concomitantly, sensitivity increased to 93.5% (CI 89–96).ConclusionsThe recombinant antigens rLci1A and rLci2B represent promising candidates for use in a multi-antigen rapid test for CVL. The inclusion of novel antigens to the DPP rLci1A/rLci2B prototype model could offer additionally enhanced sensitivity to detect animals infected by L. infantum.

Anti-poverty and progressive social change in Brazil: lessons for other emerging economies

This article examines Brazil’s experiences with anti-poverty and progressive social change, and spells out possible lessons for emerging economies with similar challenges. It draws on the Bolsa Familia conditional cash transfers (CCT) and the continuous cash benefits programmes and discusses important aspects of programme leadership, management and coordination. After a brief discussion of poverty, it presents a framework synthesizing key success factors for effective and sustaining programme implementation. Brazil does not offer a ‘blueprint’ for other countries to copy; only lessons from experience. Therefore the article concludes by discussing key ongoing challenges and suggests areas for future research, focusing on comparative studies across countries. Points for practitioners Progress has been made against global poverty, notably in countries experiencing sustained economic growth like Brazil. In spite of these remarkable efforts, challenges remain especially for countries which focus only on macroeconomic growth but not equity or inclusive development. Growth without equity does not eradicate poverty. Accordingly, emerging economies are being urged to pursue multipronged strategies: crafting innovative public policies, reshaping institutions for macroeconomic management, reaching out and engaging target communities, democratization, legislated and constitutionally mandated progressive social change. This article provides practical lessons from experience from Brazil, which practitioners from other emerging economies can adapt to their own circumstances for the effective and sustaining implementation of anti-poverty and progressive social change. It also provides a holistic framework for better understanding the institutional context, leadership, management, inter-government and cross-sectoral coordination and private sector participation. Finally, it identifies some of the key ongoing challenges in Brazil, and suggests areas for applied comparative research.

Expansion Pressure: Energy Challenges in Brazil and Chile

In Latin America, primary energy demand is projected to grow on average by 1.7% per year and to reach 830 million tons of oil equivalent (mtoe) by 2035, according to the International Energy Agency's 2011 World Energy Outlook. Demand for renewables in the power generation sector in the region will double over that period, reaching nearly 140 mtoe in 2035. Furthermore, the IEA projects that biofuels use in road transport will increase by more than 4% per year, reaching 1 million barrels per day (mb/d) by 2035, representing around 25% of fuel consumption in the sector. The economic giant in the region, Brazil, will increase its primary energy consumption to 420 mtoe in 2035, representing more than half of the regional total.

The Challenges of Incorporating Genetic Testing in the Unified National Health System in Brazil

Genetic diseases and congenital anomalies are the second most common cause of infant mortality in Brazil. In 2009, the Ministry of Health established the National Policy for Integral Attention in Clinical Genetics in the Brazilian Unified National Health System (UNHS). This policy is not yet regulated, and there is a fear that, in the name of the comprehensiveness of health care, genetic testing might be carried out without due care and criteria, increasing costs to the UNHS. Currently, only a small population has access to genetic testing, through teaching hospitals or private health care. The biggest challenge in Brazil, in this area, is to be able to set the right standards and assessment processes about clinical utility, testing priorities, dispersal of resources, and distribution of skilled professionals. Expanding access to users of the Brazilian UNHS will mean mining the technical, social, and ethical aspects about medical genetics services.

PHP51 Patient-Centered Care: Challenges for Brazil, Lessons for United States

PHP51 Patient-Centered Care: Challenges for Brazil, Lessons for United States

Interactive Tele-Education Applied to a Distant Clinical Microbiology Specialization University Course

The microbiology laboratory provides a strategic support for infectious disease diagnosis and also alerts the medical community about bacterial resistance to antibiotics. The microbiologists' training is a challenge in Brazil, a country with an extensive territory, a diverse population, and disparity of resource allocation. The aim of this study was to implement an interactive tele-educational course in clinical microbiology to reach distant laboratory workers and to improve their professional skills. The course scientific content was defined according to competences associated, distributed in 560 h, with laboratory practices (knowledge matrix-contextual education). The 11-module course structure comprised 70% distance learning, 22% on campus (integrated modules), and 8% monographs. The group included 7 physicians and 21 microbiologists from 20 different Brazilian cities. The time flexibility and location were the two main reasons for student participation, thus decreasing absences to the workplace, different from the traditional teaching methodologies. The group performance was measured by monthly evaluations, and 1 year postcourse, the researcher visited their workplace. There was significant improvement in microbiological practices performed before compared with after group participation. Therefore, 76.9% of laboratory practices were modified because of the knowledge acquired in the course. Students showed behavioral changes in relation to performance in infection control as well as on the dissemination of their knowledge. This specialization course using distance education did not compromise the quality. This educational methodology represents an alternative to teach clinical microbiology to laboratory workers from remote hospitals, as a nationwide continuing educational strategy.

Sandflies (Psychodidae: Phlebotominae) survey in an urban transmission area of visceral leishmaniasis, Northeastern Brazil

Visceral leishmaniasis (VL) is a major public health challenge in Brazil, especially in states where it is endemic. The aim of this study was to investigate the relationship of sand fly population density with environmental variables (temperature, rainfall and relative humidity) in urban areas of the city of Mossoró, Rio Grande do Norte, Northeastern Brazil. Sand flies were captured with Center Disease Control (CDC) traps installed monthly in the intra and peridomicile of three houses. Data analysis was based on the chi-square test and linear regression. A total of 7,347 sand flies were captured, being 93.85% Lutzomyia longipalpis and 6.15% Lutzomyia evandroi. Sand flies were more commonly found in the peridomicile and there was no difference between the number of males and females. The variables rainy season as well as relative humidity and rainfall, alone or together, did not have an effect on sand fly population density. However, high temperatures had a negative effect. The study of the behavior of sand flies in specific units of endemic areas can provide input to public health authorities for planning appropriate VL vector control measures.

Use And Knowledge Concerning Anabolic-androgenic Steroids (AAS) Among Male Brazilian Bodybuilders

Athletes, especially bodybuilders, have recognized for several decades that use of AAS can promote muscle growth. More recently, AAS use by non-athletes has also become popular simply as an easy way to "look good". The use of AAS is a serious problem in general. In Brazil, use represents a public health concern. Unfortunately, the risk factors for this type of drug abuse are little studied. PURPOSE: To analyze the use and knowledge concerning AAS among male bodybuilders in a fitness center in Recife, City of Pernambuco, State of Northeast Brazil. METHODS: An anonymous questionnaire with 13 objective questions and 2 open-ended questions was distributed to male members of the fitness center. Twenty-seven volunteers, between the ages of 18 and 50, completed the questionnaire. The questionnaire included a general information section, which ended with the question, 'What is your opinion of AAS?'. Another section asked about patterns of use, effects of AAS use, and reasons leading to initial use of AAS. RESULTS: 85.2% of the participants had a basic knowledge of AAS; 33.3% related AAS to various adverse health problems, and 29.6% to the potential for death; 25.9% learned about AAS from health professionals, 18.5% from a fitness center member, and 22.2% from TV; 30% had used AAS in pursuit of the "perfect body" and to increase muscle mass; 11% decided to use AAS to enhance appearance and to boost self-esteem; AAS were administered by a friend in 11% of cases and by a pharmacist in 4% of the cases. Regarding adverse health effects following AAS use, 11% reported increased acne and 4% lower libido. Eleven percent purchased AAS without a prescription and 4% from a fitness friend. Thirty-seven percent didn't know how nutritional supplements differed from AAS. CONCLUSION: Although, AAS are illegal, use appears to have increased significantly over the past three decades among recreational athletes. The use of AAS is a growing concern that presents an interesting public health challenge in Brazil. AAS are being used, with associated risk factors, to achieve what many consider socially desirable outcomes: being physically fit, healthy, and attractive. Our research emphasizes the necessity for an effective prevention and education campaign that addresses the problems related to the misuse of AAS.

Interactive Digital Terrestrial Television: The Interoperability Challenge in Brazil

This paper introduces different standards implemented in existing Digital Terrestrial Television Broadcasting systems to allow the fruition of interactive services and applications through digital Set Top Boxes. It focuses on the interoperability issue between the Brazilian and the European architectures. In fact, despite in Brazil the GEM specification has been designed to foster wide content compatibility across a range of interactive platforms, it has never come to a final implementation and deployment. As a result the interoperability issue has been deeply explored in the BEACON project and an innovative system architecture has been developed to deploy t-learning services across Europe and Brazil, providing integration of those systems that were not able to interoperate until nowadays. This work is an important step in the direction of standards' interoperability. As a result, MHP and Ginga NCL-Lua implementation appeared to be the very best choice to deliver interactive services in an interoperable mode between European and Brazilian digital television.

U.S. – Brazil Student Exchange Program: Perspectives of Brazilian Professors

This article discusses the perspectives of the Brazilian professors who are participating in the Consortia para a Liderança Futura e Recursos Humanos para o Suporte à Inclusão Social de Pessoas com Necessidades Especiais. Ongoing activities to conduct the Consortia's student exchange at the Universidade Federal Fluminense and Universidade de São Paulo are described. Information about the impact of the Consortia and its continuing challenges in Brazil is presented. Commentary on the Consortia's implications for international rehabilitation counseling and education is also provided.

Studies on lignocellulosic fibers of Brazil. Part I: Source, production, morphology, properties and applications

Among the main contributors to the gross domestic product of all countries are their natural resources, whose improper utilization adds problems to the lack of proper data on their availability and structure/property correlations. If these data were made available, they would help in achieving objectives of value addition and employment generation. This paper describes the availability of some of the Brazilian lignocellulosic fibers, their market, extraction methods, reported morphology, properties and their present applications. Some perspectives for these fibers are also presented, considering their growing importance and their whole spectrum of promising opportunities and challenges for Brazil and other developing countries.

Retraction of the paper "Forensic entomology and main challenges in Brazil"

Apart from an early case report from China (13th century), the first observations on insects and other arthropods as forensic indicators were documented in Germany and France during mass exhumations in the 1880s by Reinhard, who is considered a co-founder of the discipline. After the French publication of Mégnin's popular book on the applied aspects of forensic entomology, the concept quickly spread to Canada and United States. At that time, researchers recognized that the lack of systematic observations of insects of forensic importance jeopardized their use as indicators of postmortem interval. General advances in insect taxonomy and ecology helped to fill this gap over the following decades. After World Wars, few forensic entomology cases were reported in the scientific literature. From 1960s to the 1980s, Leclercq and Nuorteva were primarily responsible for maintaining the method in Central Europe, reporting isolated cases. Since then, basic research in the USA, Russia and Canada opened the way to the routine use of Entomology in forensic investigations. Identifications of insects associated with human cadavers are relatively few in the literature of the Neotropical region and have received little attention in Brazil. This article brings an overview of historic developments in this field, the recent studies and the main problems and challenges in South America and mainly in Brazil.

Factors associated with institutionalization of children orphaned by AIDS in a population-based survey in Porto Alegre, Brazil

There are increasing numbers of children orphaned by AIDS, especially in countries without universal free AIDS treatment. As institutionalization is associated with bad health and developmental outcomes, we have identified the factors associated with the institutionalization of AIDS orphans in a population-based survey in a city in southern Brazil. Using AIDS mortality and healthcare registries from 1998 to 2001, a cross-sectional study was conducted among the caregivers of children aged 0-14 years who were the survivors of parents dying of AIDS in Porto Alegre. Data were collected by a household survey using a structured questionnaire. Out of 1131 orphans identified, 75.4% of their caregivers participated. Among participants, 70% had lost their father and 50% their mother, and 21% had lost both parents. At the time of the survey, 41% of the children lived with the mother, 25% lived with grandparents and 5% lived in institutions. In multivariate analysis, HIV positivity multiplied the child's chances of living in an institution by a factor of 4.6, losing its mother by 5.9, losing both parents by 3.7, and having a non-white mother by 4.0. This study provides population-based data on what has become of the children of individuals dying of AIDS. Improving the quality of life and averting the institutionalization of AIDS orphans requires interventions to promote the survival of mothers living with AIDS, as well as specific interventions for child family placement. Reducing the stigma of HIV infection in children and racial discrimination present challenges in Brazil.

Challenges for Brazil’s food industry in the context of globalization and Mercosur consolidation

This paper examines how the Brazilian food industry has been heavily affected by several recent institutional and economic changes. The food industry, including the processing and retail sectors, is part of a broader agribusiness system that conditions corporations’ strategies, performance, and adoption of adequate governance structures. The Brazilian agroindustrialization process that preceded the formation of the sub-regional free-trade area (Mercosur) and economic liberalization influenced subsequent development of the agribusiness and food system in the Mercosur countries and their investment and trade links to countries outside Mercosur. The article emphasizes business strategies for coping with challenges and opportunities that have arisen from Mercosur integration, from economic stabilization programs and, more importantly, from a broad range of institutional changes such as trade liberalization, deregulation, and the friendlier treatment of foreign capital. These changes have together fostered the globalization process in the region and have stimulated different responses from large and small firms, all threatened by the new, competitive environment.