Relates the debate on Structural Adjustment Programmes (SAPs) to the latest cycle of globalisation, and their impact on human development. Uses sub-Saharan Africa as a case study for the difficulties of integration in world economic trends. Presents the historical background of SAPs; explores the effectiveness of the SAPs' prescriptions and questions the so-called shining examples of SAPs. Also compares the differences between the Washington and the emerging Copenhagen consensus and examines the way SAPs have been adopted and advocated. (Original abstract - amended)
In: Ecotoxicology and environmental safety: EES ; official journal of the International Society of Ecotoxicology and Environmental safety, Band 81, S. 17-26
In: Alcohol and alcoholism: the international journal of the Medical Council on Alcoholism (MCA) and the journal of the European Society for Biomedical Research on Alcoholism (ESBRA), Band 45, Heft 2, S. 119-125
In: Alcohol and alcoholism: the international journal of the Medical Council on Alcoholism (MCA) and the journal of the European Society for Biomedical Research on Alcoholism (ESBRA), Band 43, Heft 2, S. 215-222
The present work reports on the development of piezoresistive TixCuy thin films, deposited on polymeric substrates (PET). The general idea was to analyse the influence of the Cu concentration on the signal response of the Ti-based transducers, exploring the possibility to use this thin film system as force and deformation sensors in biomedical sensing devices. The GLancing Angle Deposition, GLAD, technique was used to change the typical normal columnar growth microstructure into inclined (zigzag-like) architectures, aiming to tune the mechanical and electrical responses of the thin films, which may offer unique opportunities for several sensing devices. Inclined (zigzag grown) thin films were prepared with increasing amounts of Cu and characterized in terms of the most relevant properties for sensing applications. The piezoresistive response was analyzed trough the evaluation of the Gauge Factor, K. The incident angles of the particle flux = 45º were used to prepare the nano-architectured zigzag TixCuy thin films. The Gauge factor ranges from 1.24 ± 0.03 to 16.34±0.43 for intermetallic Ti0.92Cu0.08 and pure Cu thin films, respectively. For the deposited thin films small voids are formed and the voids density decreases considerably with increasing Cu content. Taking in account the: electrical resistance linearity, low noise and the highest K value found for TixCuy films (K= 3.6±0.1), the most promising results were obtained when the polymer was coated with a stoichiometry ofTi0.37Cu0.63. The overall set of results also show the viability of these materials to be used as piezoresistive sensors, namely in biological environments, such as catheters, needles or endoscopes with sensing capabilities. ; The authors also thank FCT for financial support: A. Ferreira and C. Lopes thanks the FCT for grant SFRH/BPD/102402/2014 and SFRH/BD/103373/2014. The authors thank financial support from the Basque Government Industry Department under the ELKARTEK Program. SLM thanks the Diputación de Bizkaia for financial support ...
Ti1−xCux thin films were produced by the glancing angle deposition technique (GLAD) for resistance temperature measurements. The deposition angle was fixed at α = 0° to growth columnar structures and α = 45° to growth zigzag structures. The Ti-to-Cu atomic concentration was tuned from 0 to 100 at.% of Cu in order to optimize the temperature coefficient of resistance (TCR) value. Increasing the amount of Cu in the Ti1−xCux thin films, the electrical conductivity was gradually changed from 4.35 to 7.87 × 105 Ω−1 m−1. After thermal "stabilization," the zigzag structures of Ti1−xCux films induce strong variation of the thermosensitive response of the materials and exhibited a reversible resistivity versus temperature between 35 and 200 °C. The results reveal that the microstructure has an evident influence on the overall response of the films, leading to values of TCR of 8.73 × 10−3 °C−1 for pure copper films and of 4.38 × 10−3 °C−1 for a films of composition Ti0.49Cu0.51. These values are very close to the ones reported for the bulk platinum (3.93 × 10−3 °C−1), which is known to be one of the best material available for these kind of temperature-related applications. The non-existence of hysteresis in the electrical response of consecutive heating and cooling steps indicates the viability of these nanostructured zigzag materials to be used as thermosensitive sensors. ; Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Funding UID/FIS/04650/2013 and Project PTDC/EEI-SII/5582/2014. A. Ferreira and C. Lopes thanks the FCT for Grant SFRH/BPD/102402/2014 and SFRH/BD/103373/2014. The authors thank financial support from the Basque Government Industry Department under the ELKARTEK Program ...
Objective: To model the reduction in premature deaths attributed to noncommunicable diseases if targets for reformulation of processed food agreed between the Portuguese health ministry and the food industry were met. Methods: The 2015 co-regulation agreement sets voluntary targets for reducing sugar, salt and trans-fatty acids in a range of products by 2021. We obtained government data on dietary intake in 2015-2016 and on population structure and deaths from four major noncommunicable diseases over 1990-2016. We used the Preventable Risk Integrated ModEl tool to estimate the deaths averted if reformulation targets were met in full. We projected future trends in noncommunicable disease deaths using regression modelling and assessed whether Portugal was on track to reduce baseline premature deaths from noncommunicable diseases in the year 2010 by 25% by 2025, and by 30% before 2030. Findings: If reformulation targets were met, we projected reductions in intake in 2015-2016 for salt from 7.6 g/day to 7.1 g/day; in total energy from 1911 kcal/day to 1897 kcal/day due to reduced sugar intake; and in total fat (% total energy) from 30.4% to 30.3% due to reduced trans-fat intake. This consumption profile would result in 248 fewer premature noncommunicable disease deaths (95% CI: 178 to 318) in 2016. We projected that full implementation of the industry agreement would reduce the risk of premature death from 11.0% in 2016 to 10.7% by 2021. Conclusion: The co-regulation agreement could save lives and reduce the risk of premature death in Portugal. Nevertheless, the projected impact on mortality was insufficient to meet international targets.
Objective To model the reduction in premature deaths attributed to noncommunicable diseases if targets for reformulation of processed food agreed between the Portuguese health ministry and the food industry were met. Methods The 2015 co-regulation agreement sets voluntary targets for reducing sugar, salt and trans-fatty acids in a range of products by 2021. We obtained government data on dietary intake in 2015–2016 and on population structure and deaths from four major noncommunicable diseases over 1990–2016. We used the Preventable Risk Integrated ModEl tool to estimate the deaths averted if reformulation targets were met in full. We projected future trends in noncommunicable disease deaths using regression modelling and assessed whether Portugal was on track to reduce baseline premature deaths from noncommunicable diseases in the year 2010 by 25% by 2025, and by 30% before 2030. Findings If reformulation targets were met, we projected reductions in intake in 2015–2016 for salt from 7.6 g/day to 7.1 g/day; in total energy from 1911 kcal/day to 1897 kcal/day due to reduced sugar intake; and in total fat (% total energy) from 30.4% to 30.3% due to reduced trans-fat intake. This consumption profile would result in 248 fewer premature noncommunicable disease deaths (95% CI: 178 to 318) in 2016. We projected that full implementation of the industry agreement would reduce the risk of premature death from 11.0% in 2016 to 10.7% by 2021. Conclusion The co-regulation agreement could save lives and reduce the risk of premature death in Portugal. Nevertheless, the projected impact on mortality was insufficient to meet international targets.
Background Excessive consumption of sugar has a well-established link with obesity. Preliminary results show that a tax levied on sugar-sweetened beverages (SSBs) by the Portuguese government in 2017 led to a drop in sales and reformulation of these products. This study models the impact the market changes triggered by the tax levied on SSBs had on obesity incidence across various age groups in Portugal. Methods and findings We performed a national market analysis and population-wide modelling study using market data for the years 2014-2018 from the Portuguese Association of Non-Alcoholic Drinks (GlobalData and Nielsen Consumer Panel), dietary data from a national survey (IAN-AF 2015-2016), and obesity incidence data from several cohort studies. Dietary energy density from SSBs was calculated by dividing the energy content (kcal/gram) of all SSBs by the total food consumption (in grams). We used the potential impact fraction (PIF) equation to model the projected impact of the tax-triggered change in sugar consumption on obesity incidence, through both volume reduction and reformulation. Results showed a reduction of 6.6 million litres of SSBs sold per year. Product reformulation led to a decrease in the average energy density of SSBs by 3.1 kcal/100 ml. This is estimated to have prevented around 40-78 cases of obesity per year between 2016 and 2018, with the biggest projected impact observed in adolescents 10 to <18 years old. The model shows that the implementation of this tax allowed for a 4 to 8 times larger projected impact against obesity than would be achieved though reformulation alone. The main limitation of this study is that the model we used includes data from various sources, which can result in biases-despite our efforts to mitigate them-related to the methodological differences between these sources. Conclusions The tax triggered both a reduction in demand and product reformulation. These, together, can reduce obesity levels among frequent consumers of SSBs. Such taxation is an effective population-wide intervention. Reformulation alone, without the decrease in sales, would have had a far smaller effect on obesity incidence in the Portuguese population.
Objective To model the reduction in premature deaths attributed to noncommunicable diseases if targets for reformulation of processed food agreed between the Portuguese health ministry and the food industry were met. Methods The 2015 co-regulation agreement sets voluntary targets for reducing sugar, salt and trans-fatty acids in a range of products by 2021. We obtained government data on dietary intake in 2015-2016 and on population structure and deaths from four major noncommunicable diseases over 1990-2016. We used the Preventable Risk Integrated ModEl tool to estimate the deaths averted if reformulation targets were met in full. We projected future trends in noncommunicable disease deaths using regression modelling and assessed whether Portugal was on track to reduce baseline premature deaths from noncommunicable diseases in the year 2010 by 25% by 2025, and by 30% before 2030. Findings If reformulation targets were met, we projected reductions in intake in 2015-2016 for salt from 7.6 g/day to 7.1 g/day; in total energy from 1911 kcal/day to 1897 kcal/day due to reduced sugar intake; and in total fat (% total energy) from 30.4% to 30.3% due to reduced trans-fat intake. This consumption profile would result in 248 fewer premature noncommunicable disease deaths (95% CI: 178 to 318) in 2016. We projected that full implementation of the industry agreement would reduce the risk of premature death from 11.0% in 2016 to 10.7% by 2021. Conclusion The co-regulation agreement could save lives and reduce the risk of premature death in Portugal. Nevertheless, the projected impact on mortality was insufficient to meet international targets.
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.