The Role of Exotic Species in Traditional Pharmacopeias of the Cerrado: a Case Study in Southeast Brazil

The “diversification hypothesis” proposes that exotic species are incorporated into plant pharmacopeias to broaden the range of treatments and meet therapeutic demands unattended by native species. The “versatility hypothesis” suggests that the wider range of uses of exotic species explains their selection in traditional pharmacopeias. This study was conducted with experts in medicinal plants in the Cerrado (Brazilian savanna), selected through the “snowball” technique, to test if the versatility and diversity hypotheses explain the incorporation of exotic species in the popular pharmacopeia. Relative importance (RI) index was calculated for each species, as a measure of versatility. A variance analysis was performed to compare RI of native and exotic species. An analysis of similarity (ANOSIM) was used to test the differences among the types of therapeutic indication and the ICD-10 body systems, by native and exotic species. The local pharmacopeia has 108 native and 32 exotic species for the treatment of 52 health issues. The results do not support the versatility hypothesis, since native and exotic species have similar RI. However, the repertoire of native species tends to be more versatile, being suitable for treating a wider range of disorders. In spite of the overlap of native and exotic species in therapeutic indications, some exotic species are unique to the treatment of certain diseases, effectively strengthening the local pharmacopeia and thus supporting the diversification hypothesis.     

A Support Tool for Air Pollution Health Risk Management in Emerging Countries: A Case in Brazil

This study evaluated the health risk due to air pollution in São Paulo State, Brazil, comparing Brazil's standards and the World Health Organization (WHO) air quality guidelines. New methodology was applied considering, as hazard parameters, the maximum average concentrations of SO₂, NO₂, O₃, CO, and PM₁₀ from 2007 to 2011. As exposure parameters, population density and location sensitivity were considered. A health risk index based on fuzzy logic was performed to integrate the selected parameters, giving the likelihood of reaching different risk levels. Data gathering and spatial representation of parameters and risk scores were performed by means of geographic information system (GIS). Highest values of risk were observed in the Metropolitan Area of São Paulo and near the cities of Cubatão and Piracicaba, associated to vehicular and industrial emissions and sugar cane burning. Discussions about the need to revise national air quality standards have intensified over the past years. Generally, indices used for air quality do not consider the population exposed. This study showed the integration of GIS with fuzzy logic methodology to be a useful tool for health risk assessment. When evaluating the risk, exposure parameters must be intrinsically considered to enhance the importance of population vulnerability when assessing environmental problems, especially in emerging economies.     

Caesarean Delivery and Postpartum Maternal Mortality: A Population-Based Case Control Study in Brazil

BackgroundCesarean delivery rates continue to increase worldwide and reached 57% in Brazil in 2014. Although the safety of this surgery has improved in the last decades, this trend is a concern because it carries potential risks to women’s health and may be a modifiable risk factor of maternal mortality. This paper aims to investigate the risk of postpartum maternal death directly associated with cesarean delivery in comparison to vaginal delivery in Brazil.MethodsThis was a population-based case—control study performed in eight Brazilian states. To control for indication bias, deaths due to antenatal morbidity were excluded. We included 73 cases of postpartum maternal deaths from 2009–2012. Controls were selected from the Birth in Brazil Study, a 2011 nationwide survey including 9,221 postpartum women. We examined the association of cesarean section and postpartum maternal death by multivariate logistic regression, adjusting for confounders.ResultsAfter controlling for indication bias and confounders, the risk of postpartum maternal death was almost three-fold higher with cesarean than vaginal delivery (OR 2.87, 95% CI 1.63–5.06), mainly due to deaths from postpartum hemorrhage and complications of anesthesia.ConclusionCesarean delivery is an independent risk factor of postpartum maternal death. Clinicians and patients should consider this fact in balancing the benefits and risks of the procedure.     

A Case Study in Serendipity: Environmental Researchers Use of Traditional and Social Media for Dissemination

In the face of demands for researchers to engage more actively with a wider range of publics and to capture different kinds of research impacts and engagements, we explored the ways a small number of environmental researchers use traditional and social media to disseminate research. A questionnaire was developed to investigate the impact of different media as a tool to broker contact between researchers and a variety of different stakeholders (for example, publics, other researchers, policymakers, journalists) as well as how researchers perceive that their use of these media has changed over the past five years. The questionnaire was sent to 504 researchers whose work had featured in a policy-oriented e-news service. 149 valid responses were received (29%). Coverage in traditional media (newspapers, broadcast) not only brokers contact with other journalists, but is a good source of contact from other researchers (n=47, 62%) and members of the public (n=36, 26%). Although the use of social media was limited amongst our sample, it did broker contact with other researchers (n=17, 47%) and the public (n=10, 28%). Nevertheless, few environmental researchers were actively using social media to disseminate their research findings, with many continuing to rely on academic journals and face-to-face communication to reach both academic and public audiences.     

传统农业生态系统的实态分析：以松江县华阳镇为例

自闻大中先生首先利用中国的古农书《补农书》分析嘉兴地区17世纪传统农业生态系统以来[1],中国传统农业生态系统的高效性和持续性,受到了国际有关专家的重视。前几年,Ｃｏｒｎｅｌｌ大学的艾尔青博士在中国做博士后期间,曾以太湖地区传统农业为课题进行研究工作。但就目前来看,太湖地区传统农业生态系统的分析研究仍处于初步阶段。因为一批民国时期的调查资料尚未利用,特别是日伪时期满铁上海事务所在这一地区所做的调查非常详实具体,是研究传统农业生态系统极好的材料。本文的研究主要就是在满铁30年代末关于松江县华阳镇四个村庄63家农户…     

Traditional anti-malarial medicine in Roraima, Brazil

Malaria is probably the most serious health problem facing northern Amazonia, and isolated populations can benefit greatly from the knowledge of local resources which may effectively be used to control it. The results of an ethnobotanical survey of the plant species used in the treatment of malaria in the Brazilian State of Roraima are presented. Fieldwork was carried out amongst seven savanna-and forest-dwelling indigenous groups, and among the Luso-Brazilian population. Ninety-nine species, of 82 genera and 41 families, were identified as having been used for this purpose in the region. The results are discussed in the context of previously published information on anti-malarial plants of northern Latin America, which was analysed by a broad literature survey whose overall results are also presented here. Of the species collected in Roraima, only 24 appear previously to have been reported as anti-malarials, although 49% of the represented genera are known to be used in this way elsewhere. The plants are currently undergoing laboratory screening for anti-malarial activity and toxicity.     

The Role of Local Knowledge and Traditional Extraction Practices in the Management of Giant Earthworms in Brazil

The giant earthworm, Rhinodrilus alatus (Righi 1971), has been captured in the southeastern Brazilian Cerrado biome for approximately 80 years and used as bait for amateur fishing throughout Brazil. Local knowledge and traditional extraction practices are crucial for the establishment of management strategies for the species because, although its extraction involves conflicts and social and environmental impacts, the species is one of the major sources of income for approximately 3,000 people, especially for members of an Afro-descendant community that has approximately 2,000 inhabitants. Participatory tools, such as seasonal calendar, transect walks and participatory maps, were individually or collectively used with extractors and traders (former extractors), and 129 semi-structured and unstructured interviews were conducted with the same individuals between 2005 and 2012. The capture of Rhinodrilus alatus was observed in different seasons and areas of occurrence of the species in 17 municipalities, where this giant earthworm is the only species extracted for trade. All information obtained was verified by community members in 17 meetings. The extractors have an extensive knowledge of the life history, behavior, distribution, and possible impacts of climate change on the species. Different capture techniques, which have different impacts, are used during the dry and rainy seasons and are passed by the extractors through the generations. Local knowledge contributed to the establishment of agreements for the use of capture techniques that have less impact, to the expansion of scientific knowledge and the reassessment of the conservation status of Rhinodrilus alatus. The present study may serve as an example for management projects for other giant earthworm species in other regions of Brazil and in other countries.     

传统山地村落的生态适应性研究—以京西黄岭西村为例

生态适应性研究是剖析传统村落生态理念的重要角度。本文介绍了生态适应性的概念及研究进展,传统村落生态适应性研究包含2个部分：自然生态适应性和人文生态适应性。构建了传统山地村落生态适应性的研究体系。以北京市门头沟区斋堂镇黄岭西村为例,立足于5个研究视角分析其自然及人文生态适应性,引入软件模拟分析的研究方法,对中国传统山地村落的生态适应理念予以总结,以期对中国今后的山地村镇规划与发展提供经验与借鉴。     

Enabling Policy Planning and Innovation Management through Patent Information and Co-Authorship Network Analyses: A Study of Tuberculosis in Brazil

Introduction

New tools and approaches are necessary to facilitate public policy planning and foster the management of innovation in countries'' public health systems. To this end, an understanding of the integrated way in which the various actors who produce scientific knowledge and inventions in technological areas of interest operate, where they are located and how they relate to one another is of great relevance. Tuberculosis has been chosen as a model for the present study as it is a current challenge for Brazilian research and innovation.

Methodology

Publications about tuberculosis written by Brazilian authors were accessed from international databases, analyzed, processed with text searching tools and networks of coauthors were constructed and visualized. Patent applications about tuberculosis in Brazil were retrieved from the Brazilian National Institute of Industrial Property (INPI) and the European Patent Office databases, through the use of International Patent Classification and keywords and then categorized and analyzed.

Results/Conclusions

Brazilian authorship of articles about tuberculosis jumped from 1% in 1995 to 5% in 2010. Article production and patent filings of national origin have been concentrated in public universities and research institutions while the participation of private industry in the filing of Brazilian patents has remained limited. The goals of national patenting efforts have still not been reached, as up to the present none of the applications filed have been granted a patent. The analysis of all this data about TB publishing and patents clearly demonstrates the importance of maintaining the continuity of Brazil''s production development policies as well as government support for infrastructure projects to be employed in transforming the potential of research. This policy, which already exists for the promotion of new products and processes that, in addition to bringing diverse economic benefits to the country, will also contribute to effective dealing with public health problems affecting Brazil and the World.     

Maintaining Resources for Traditional Medicine: A Global Overview and a Case Study from Buganda (Uganda)

 Presentations at a session of the 13th Congress of the International Society for Ethnobiology (ISE, May 2012) provided a global overview of ‘maintaining resources for traditional medicine’. Two themes received special attention, transmission of traditional medical knowledge and conservation of medicinal plants. The consensus at the well attended session was that traditional medicine can play a useful role in primary healthcare, including for chronic complaints and spiritual problems. However, the use of traditional medicine is declining in many places. Some practical efforts at maintaining resources for traditional medicine are described. A case study for Buganda (Uganda), given in greater detail, shows that progress in maintaining resources for traditional medicine can be impeded by forces not directly related to its intrinsic merits. The value of making efforts to maintain resources for traditional medicine is discussed in relation to its contribution to biocultural conservation, much needed today to counter balance the homogenising and ecologically destabilising influences of globalisation.     

病种质量管理方式探讨 ——以剖宫产为例

目的 以剖宫产为例研究病种管理方式,探讨病种纳入标准。方法 采用统计学分析法,对不同指征剖宫产按照住院天数、住院费用进行分组,并对其住院费用的影响因素进行分析。结果 5组不同指征剖宫产数据根据住院费用指标可分为3组,按照住院天数指标分类则可归纳为2组,并且经分析发现,影响不同指征剖宫产术住院总费用的因素主要为药费、住院天数。结论 可以依据医疗资源消耗的相似性制定病种纳入标准,扩大病种质量控制体系范围;此外,通过控制关键影响因素来加强病种质量管理,降低患者医疗费用。     

Assessing the Quality of Care for Pneumonia in Integrated Community Case Management: A Cross-Sectional Mixed Methods Study

Background

Pneumonia is the leading infectious cause of mortality in children under five worldwide. Community-level interventions, such as integrated community case management, have great potential to reduce the burden of pneumonia, as well as other diseases, especially in remote populations. However, there are still questions as to whether community health workers (CHW) are able to accurately assess symptoms of pneumonia and prescribe appropriate treatment. This research addresses limitations of previous studies using innovative methodology to assess the accuracy of respiratory rate measurement by CHWs and provides new evidence on the quality of care given for children with symptoms of pneumonia. It is one of few that assesses CHW performance in their usual setting, with independent re-examination by experts, following a considerable period of time post-training of CHWs.

Methods

In this cross-sectional mixed methods study, 1,497 CHW consultations, conducted by 90 CHWs in two districts of Luapula province, Zambia, were directly observed, with measurement of respiratory rate for children with suspected pneumonia recorded by video. Using the video footage, a retrospective reference standard assessment of respiratory rate was conducted by experts. Counts taken by CHWs were compared against the reference standard and appropriateness of the treatment prescribed by CHWs was assessed. To supplement observational findings, three focus group discussions and nine in depth interviews with CHWs were conducted.

Results and Conclusion

The findings support existing literature that CHWs are capable of measuring respiratory rates and providing appropriate treatment, with 81% and 78% agreement, respectively, between CHWs and experts. Accuracy in diagnosis could be strengthened through further training and the development of improved diagnostic tools appropriate for resource-poor settings.     

Livestock Management Within a Traditional Agrosilvopastoral System in Northern Minas Gerais,Brazil: A Model for Reconciling Livelihoods and Conservation at a Time of Environmental Change

Human Ecology - We examine the ongoing transformation of the livestock raising component of a complex agrosilvopastoral management system associated with the Geraizeiro of northern Minas Gerais...