Monday, September 20, 2010

Addiction by Prescription

The New Drug Crisis: Addiction by Prescription

By JEFFREY KLUGER Monday, Sep. 13, 2010

Stephen Lewis for TIME

It's not easy to find a mother who would look back fondly on the time her son had cancer. But Penny (not her real name) does. Penny lives in Boston, and her son got sick when he was just 13. He struggled with the disease for several years — through the battery of tests and the horror of the diagnosis and, worst of all, through the pain that came from the treatment. For that last one, at least, there was help — Oxycontin, a time-released opioid that works for up to 12 hours. It did the job, and more.

The brain loves Oxycontin — the way the drug lights up the limbic system, with cascading effects through the ventral striatum, midbrain, amygdala, orbitofrontal cortex and prefrontal cortex, leaving pure pleasure in its wake. What the brain loves, it learns to crave. That's especially so when the alternative is the cruel pain of cancer therapy. By the time Penny's son was 17, his cancer was licked — but his taste for Oxy wasn't. When his doctor quit prescribing him the stuff, the boy found the next best — or next available — thing: heroin. Penny soon began spending her Monday nights at meetings of the support group Learn to Cope, a Boston-based organization that counsels families of addicts, particularly those hooked on opioids or heroin./.../

FEATURE-Ancient seeds in Mexico help fight warming effects

17 Sep 2010 15:02:48 GMT

Source: Reuters

* Climate change could bring lower yields, food crisis
* Crossing plant varieties to fight drought, heat
By Mica Rosenberg
EL BATAN, Mexico, Sept 17 (Reuters) - More than 500 years after Spanish priests brought wheat seeds to Mexico to make wafers for the Catholic Mass, those seeds may bring a new kind of salvation to farmers hit by global warming.
Scientists working in the farming hills outside Mexico City found the ancient wheat varieties have particular drought- and heat-resistant traits, like longer roots that suck up water and a capacity to store more nutrients in their stalks.
They are crossing the plants with other strains developed at the International Maize and Wheat Improvement Center (CIMMYT) in El Batan to grow types of wheat that can fight off the ill effects of rising temperatures around the world.
"It's like putting money in the bank to use, in this case, for a not rainy day," scientist Matthew Reynolds said of the resilient Mexican wheats his team collected./.../

Saturday, September 18, 2010

A Internet morreu?

Thursday, September 16, 2010

POA: indicadores relacionados à área de saúde

Cai Coeficiente de Mortalidade Infantil em Porto Alegre - veja esse indicador e outros relacionados à área de saúde

Em 2009, Porto Alegre atingiu o menor Coeficiente de Mortalidade Infantil dos últimos dez anos, relativo a crianças com menos de um ano de idade. OCoeficiente de Mortalidade Infantil na Capital passou de 14,84 óbitos por mil nascidos vivos, em 2000, para 9,75 registrados no ano passado. Os dados foram divulgados pela Secretaria Municipal de Saúde, através da Coordenadoria Geral de Vigilância em Saúde.

No Banco Estatístico estão atualizados os principais indicadores relacionados à vigilância epidemiológica da cidade e Regiões do Orçamento Participativo, ressaltamos que os dados relativos ao ano de 2009 são preliminares. Um desses indicadores diz respeito ao percentual de crianças que nascem de mães jovens (menos de 20 anos), que caiu 16,2%, entre 2005 e 2009, passando de 17,6% para 14,8%. As Regiões Cruzeiro, Leste e Eixo-Baltazar foram as que mais contribuíram para esse declínio.

Também está disponível no banco estatístico o Coeficiente de Mortalidade Materna, indicador inédito para os anos de 2004 a 2008. Esse coeficiente reflete o número de mulheres que morrem por causas maternas em relação ao número de nascidos vivos. Houve um decréscimo de 40% entre 2004 e 2008, passando de 71,64 (2004) para 43,12 em 2008.

Acesse aqui o banco de dados.

MDG poverty commitments

World Bank: MDG poverty commitments unlikely to change

World leaders will reaffirm their commitment to halve the number of people living in poverty by 2015 in line with the Millennium Development Goals, but the effects of the global economic crisis are likely to keep them from promising to set any additional targets, the World Bank says in a report. The Bank backed efforts to help poor countries accelerate development within already existing funding commitments such as trade benefits and infrastructure capacity building.AlertNet.org/Reuters (9/16)

Wednesday, September 15, 2010

Uma proposta para o Museu das Águas de Porto Alegre

Publicado em 20 20UTC julho 20UTC 2010 por Museu das Águas de Porto Alegre

from

L.A.T.Grassi

1. Justificativa

A água é uma substância essencial e indispensável para todos os seres vivos e para todas as atividades da sociedade humana. Como componente do ambiente natural da Terra, tem um papel fundamental no equilíbrio ecológico e na preservação das condições ambientais que permitem a nosso planeta gerar e manter a vida como a conhecemos./.../

ECG screening criteria for young athletes

European ECG screening criteria for young athletes need review

SEPTEMBER 13, 2010 | Sue Hughes

Stockholm, Sweden - The European ECG-based screening process for hypertrophic cardiomyopathy (HCM) in young athletes needs to be reviewed, and the criteria for further evaluation should be recalculated according to the type and intensity of the exercise performed, a new study suggests.

"Training-related changes on the ECG are different for individuals participating in different sports. We should not be using the same screening criteria for a whole range of sports. As well as the type and intensity of sport, other factors that can influence ECG changes are gender and race. Therefore, we need a whole set of different individual guidelines for each group," study author Dr José Angel Cabrera (Hospital Quiron, Madrid, Spain) told heartwire.

Cabrera explained that the European ECG screening criteria for young athletes are associated with a very high rate of false positives, meaning that many individuals are referred on unnecessarily for further tests. "The guidelines have changed recently, and the situation has improved. We used to see a rate of about 70% false positives, but this has now been reduced to about 50%. But we can improve the ECG criteria even more if we factor in type of sport, race, and gender. We can then really refine what we are looking for as a sign of structural heart disease." Several groups are working on producing such guidelines, he added./.../

Smoking cessation treatments cost-effective: study

By JULIE STEENHUYSEN, REUTERS

Last Updated: September 14, 2010 4:32pm

CHICAGO – Investing in smoking cessation treatments saves lives and it may be sound fiscal policy, U.S. researchers said Tuesday.

They said for every $1 spent on smoking cessation treatments, states will get back $1.26, amounting to a 26 % return on their investment.

The study, done by researchers at Penn State University, compared the costs of drug treatments and counseling programs aimed at helping people quit smoking with the cost of premature deaths, lost productivity and the health costs of smoking, which increases the risk of cancers and heart disease.

It was funded by a grant from Pfizer Inc, maker of the smoking cessation drug Chantix, known generically as varenicline.

“Smoking results in costs to the United States of more than $300 billion a year,” Paul Billings of the American Lung Association told reporters in a news briefing.

That includes $67.5 billion in lost workplace productivity; $117 billion from the cost of people dying prematurely; and $116 billion in direct medical expenditures.

“Sadly, smoking continues to kill 393,000 people in the United States each year,” Billings told the briefing.

Although the average cost of a pack of cigarettes nationwide is $5.61, the real cost in terms of lost lives and productivity is $18.05 per pack./.../

Tuesday, September 14, 2010

Funding for global tobacco control

Polluter pays – increasing funding for global tobacco control

14 Sep, 10 | by Becky Freeman, Web Editor

In the August 2010 issue of Tobacco Control, Cynthia Callard wrote an enlightening article on just how uneven the playing field is in tobacco control. She compared the 2008 total revenues of

the five major tobacco companies that control 90% of the global market as compared to the total amount spent on global tobacco control. The results show just how much the deck is stacked against effective tobacco control, especially in low and middle income countries. The revenues of these five companies exceeded $300 billion ($160 billion of that is provided to governments as tax) and the corporate earnings of the four publicly traded companies were over $25 billion, of which $14 billion was retained after corporate income taxes were paid. In comparison, funding for global tobacco control was a paltry $240 million. That would be less than 2% of the retained earnings of the four public companies alone
.

Fome no mundo

Fome no mundo diminui pela primeira vez em 15 anos, diz FAO

Assimina Vlahou

De Roma para a BBC Brasil

Menino paquistanês espera distribuição de alimentos em campo de refugiados

Segundo a FAO, 7 países na Ásia e na África concentram 2/3 dos subnutridos

O número de pessoas subnutridas no mundo teve a primeira queda em 15 anos no último ano, de 1,023 bilhão para 925 milhões, segundo um relatório divulgado nesta terça-feira pela Organização das Nações Unidas para Alimentação e Agricultura (FAO).

Segundo a organização, a queda nos números absolutos de subnutridos em 2010 é consequência, em grande parte, da expectativa de retomada do crescimento da economia, particularmente em países em desenvolvimento, e da queda no preço de alimentos desde meados de 2008./.../

Monday, September 13, 2010

education does not always correlate with less CVD

REACH: More education does not always correlate with less CVD

SEPTEMBER 10, 2010 | Reed Miller

Atlanta, GA - Men with more education have fewer cardiovascular events than less educated men in relatively wealthy countries, but this relationship does not hold in less developed countries and is reversed among women, new research from the Reduction of Atherothrombosis for Continued Health (REACH) registry shows [1].

REACH is an ongoing prospective study of 67 888 subjects with either established atherothrombotic disease or multiple atherothrombotic risk factors in 44 countries. Dr Abhinav Goyal (Emory School of Medicine, Atlanta, GA) and colleagues categorized 61 332 REACH subjects into four classes based on self-reported attained education level: zero to eight years, nine to 12 years, trade or technical school, and university. The researchers stratified 23-month follow-up outcomes by gender and world region, either low- to middle-income nations (Latin America, Eastern Europe, Middle East, and most of Asia) or high-income nations (US, Canada, Western Europe, Japan, and Australia). Results of the study are published online September 7, 2010 in Circulation.

Goyal told heartwire, "Most of the studies that have been conducted in the past 20 years have been conducted in the developed world and Western countries. We got good information from those studies, indicating that higher education protects against cardiovascular events [in the developed world], but the scope of cardiovascular disease on a global scale has shifted such that over 80% of the burden in the world from cardiovascular disease is happening in developing economies or low- and middle-income countries."/.../

Drugmakers: influence doctors' decisions

Drugmakers hold too much influence over doctors' decisions, public says

Particularly alarming to patients are physicians who get paid to pitch drugs in ads.

By KEVIN B. O'REILLY, amednews staff. Posted Sept. 13, 2010.

How relationships with industry may influence physician decisions is not just a concern limited to Capitol Hill or medical ethics committees. A new poll found that 69% of patients say they believe drugmakers hold too much sway over doctors' prescribing.

Nearly half of the 1,154 adults surveyed nationwide said physicians' prescribing decisions are influenced by gifts from drugmakers, according to poll results released in August. A third of patients were so worried about pharmaceutical marketing that they felt they could not rely on their doctors' medication advice.

"Physicians should know that most patients now are concerned about the drug companies influencing them," said John Santa, MD, MPH, director of the Consumer ReportsNational Research Center, which conducted the poll in May. "When they're on the phone with a patient, when they have a patient in their office -- the patient may not say it -- but they are concerned ... and they're disturbed by it."

Means of influence

A new poll says patients think drugmakers have too much impact on how physicians decide which drugs to prescribe. Patients were most concerned about companies rewarding doctors for a high prescribing percentage. Less than a third cared that doctors got free pens from drug firms.

Here are various pharmaceutical marketing techniques aimed at doctors that patients find objectionable:

81% Rewarding doctors who write a lot of prescriptions for a company's drugs

72% Paying doctors to provide testimonials or pitch for a drug

61% Paying doctors to speak at conferences

58% Buying meals for doctors and their staff

41% Providing free samples of drugs to doctors

40% Providing doctors with posters or literature featuring a company's drugs

32% Providing doctors with items such as pens or pads with a company logo

Source: "Best Buy Drugs Prescription Drug Tracking Poll 2," Consumer ReportsNational Research Center, released Aug. 24 /.../

Saturday, September 11, 2010

Social Determrinants of Health: Canada

Social Determinants of Health:
The Canadian Facts
Juha Mikkonen and Dennis Raphael
Foreword by Hon. Monique Bégin (Former Minister of National Health & Welfare of Canada)
Published in May 2010. ISBN 978-0-9683484-1-3 – 62 pp

[Download the Press Release, April 28 2010]

Summary
The primary factors that shape the health of Canadians are not medical treatments or lifestyle choices but rather the living conditions they experience. These conditions have come to be known as the social determinants of health. This information – based on decades of research and hundreds of studies in Canada and elsewhere – is unfamiliar to most Canadians. Canadians are largely unaware that our health is shaped by how income and wealth is distributed, whether or not we are employed and if so, the working conditions we experience.

Our health is also determined by the health and social services we receive, and our ability to obtain quality education, food and housing, among other factors. And contrary to the assumption that Canadians have personal control over these factors, in most cases these living conditions are – for better or worse – imposed upon us by the quality of the communities, housing situations, work settings, health and social service agencies, and educational institutions with which we interact.

Improving the health of Canadians requires we think about health and its determinants in a more sophisticated manner than has been the case to date. Social Determinants of Health: The Canadian Facts considers 14 social determinants of health:

1. Income and Income Distribution
2. Education
3. Unemployment and Job Security
4. Employment and Working Conditions
5. Early Childhood Development
6. Food Insecurity
7. Housing
8. Social Exclusion
9. Social Safety Network
10. Health Services
11. Aboriginal Status
12. Gender
13. Race
14. Disability

The publication outlines why they are important; how Canada is doing in addressing them; and what can be done to improve their quality. The purpose of the document is to provide promote greater awareness of the social determinants of health and the development and implementation of public policies that improve their quality.

[Download - PDF, 4Mb]

Friday, September 10, 2010

O futuro das drogas

Mídia do Dia: 03/09/2010
Data de Veiculação: 02/09/2010

O futuro das drogas por Carlos Salgado, psiquiatra, presidente da ABEAD

Olhar para o futuro com o foco nas drogas de abuso é, há um, tempo assustador e instigante.

Emergem algumas possibilidades: disponibilidade de mais drogas, tragédias na forma de epidemias de uso de drogas desorganizadoras, fracasso da repressão, ocupação de espaços de poder por parte dos negociantes de drogas, legitimação ampla e irrestrita da produção e consumo, seleção natural dos mais hábeis diante da grande disponibilidade e uso massivo, mudanças conceituais sociais com ritualização do uso, avanços médicos e biológicos no controle do abuso (genética, imunologia e farmacologia).

O horizonte imaginário é amplo. Nos tempos correntes, mais e mais substâncias vão ficando disponíveis, ampliando o repertório dos usuários. Relatórios internacionais de agências observadoras do fenômeno da drogas, como o UNODC, mostram uma tendência geral de restrição do uso de substâncias mais naturais e ampliação da produção e uso de substâncias, digamos, laboratoriais. Elas têm se mostrado atraentes e trazem certo charme de benignidade e confiabilidade. Lobos em peles de cordeiros rapidamente mostram sua face cruel e desorganizadora, mesmo em uso recreacional.

Mas, seguindo com os olhos no futuro, parece fazer sentido acreditar numa certa industrialização franca das drogas de abuso. Assim como ocorre na indústria farmacêutica, a produção de drogas vai introduzindo opções em número sempre crescente. A busca por drogas de uso recreacional seguro seguirá em pauta. Preservar o usuário e ao mesmo tempo mantê-lo fiel é um dos desafios objeto de ficção, como mostrado no livro O Admirável Mundo Novo, escrito por Aldous Huxley em 1931, onde o Soma trazia recreação segura para qualquer usuário.

What Is 'Reality'?

Stephen Hawking Asks, What Is 'Reality'?

By STEPHEN HAWKING Friday, Sep. 10, 2010

Stephen Hawking, co-author of The Grand Design

David Parry / PA / Landov

EmailA few years ago the city council of Monza, Italy, barred pet owners from keeping goldfish in curved bowls. The measure's sponsor explained the measure in part by saying that it is cruel to keep a fish in a bowl with curved sides because, gazing out, the fish would have a distorted view of reality. But how do we know we have the true, undistorted picture of reality?/.../

Saúde Urbana

Ciência & Saúde Coletiva

Print version ISSN 1413-8123

Ciênc. saúde coletiva vol.13 no.6 Rio de Janeiro Nov./Dec. 2008

doi: 10.1590/S1413-81232008000600013

Artigo indicado pela AMICOR Maria Inês Reinert Azambuja

Saúde urbana: "a cidade é uma estranha senhora, que hoje sorri e amanhã te devora"^*

Urban health: "the city is a strange lady, smiling today, devouring you tomorrow"

Waleska Teixeira Caiaffa^{I, II}; Fabiane Ribeiro Ferreira^I; Aline Dayrell Ferreira^{I, III}; Claúdia Di Lorenzo Oliveira^{I, IV}; Vitor Passos Camargos^I; Fernando Augusto Proietti^{I, II}
^IObservatório de Saúde Urbana, Faculdade de Medicina, UFMG. Av. Alfredo Balena 190/625, Santa Efigênia. 30130-100 Belo Horizonte MG. wcaiaffa@medicina.ufmg.br ^IIDepartamento de Medicina Preventiva e Social, Faculdade de Medicina, UFMG ^IIIDepartamento Materno-Infantil e Saúde Coletiva, Escola de Enfermagem, UFMG ^IVFundação Hemominas, Belo Horizonte, MG

RESUMO

Mais da metade dos habitantes da terra está vivendo nas cidades, e o mundo está se tornando mais e mais urbano. Este artigo considera, a partir de revisão bibliográfica, que o ambiente urbano influencia a saúde e os comportamentos humanos, apontando para a necessidade do melhor entendimento dos determinantes da saúde das populações vivendo nas cidades. Explora as transformações urbanas oferecendo uma visão sobre a conformação das cidades contemporâneas e os impactos sobre a saúde humana. Sugere que, enquanto as cidades podem representar oportunidades positivas, impactos desiguais negativos relacionados à falta de organização social, precárias condições urbanas e de trabalho, falta de governança, de oportunidades, e de capacidade de desenvolver políticas para ações tendem a ampliar os efeitos adversos sobre a saúde das pessoas. Discute a saúde urbana como um ramo de conhecimento aninhado na saúde pública, possibilitando re-pensar avaliações de impacto à saúde a partir de intervenções não necessariamente originadas da saúde. Propõe arcabouço de um modelo conceitual, além de uma taxonomia comum para a saúde urbana. Apresenta direções futuras de investigação e prática, contemplando especificidades analíticas, sob a luz de alguns exemplos da literatura científica brasileira./.../

Wednesday, September 08, 2010

PNAD 2010

08/09/2010 - 10h00

Pnad: Um em cada cinco brasileiros é analfabeto funcional

Rafael Targino
Do UOL Educação
Em São Paulo

Um em cada cinco brasileiros (20,3%) é analfabeto funcional, de acordo com a Pnad (Pesquisa Nacional por Amostra de Domicílios) 2009, divulgada nesta quarta-feira (8) pelo IBGE (Instituto Brasileiro de Geografia e Estatística). É considerada analfabeta funcional a pessoa com 15 ou mais anos de idade e com menos de quatro anos de estudo completo. Em geral, ele lê e escreve frases simples, mas não consegue, por exemplo, interpretar textos.

Segundo a pesquisa, o problema é maior na região Nordeste, na qual a taxa de analfabetismo funcional chega a 30,8%. Na região Sudeste, onde esse índice é menor, a taxa ainda supera os 15%.

No entanto, o número vem caindo desde 2004, quando, segundo o IBGE, o país tinha 24,4% de analfabetos funcionais. Em 2008, o total era de 21%. Em comparação com 2009, a taxa caiu 0,7 pontos percentuais.

Analfabetismo total
A taxa de analfabetismo no Brasil entre pessoas com 15 anos ou mais caiu 0,3 pontos percentuais entre 2008 e o ano passado, de acordo com a Pnad. O índice saiu de 10% há dois anos para 9,7% em 2009. Segundo o órgão, o isso representa 14,1 milhões de analfabetos –em 2008, eram 14,2 milhões.

De acordo com o IBGE, a maioria dos analfabetos (92,6%) está concentrada no grupo com mais de 25 anos de idade. No Nordeste, a taxa de analfabetismo entre a população com 50 anos ou mais chega a 40,1%, enquanto que no Sul, esse número é de 12,2%. Os nordestinos têm as maiores taxas em todas as faixas de idade.

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