Data and the process of formulating health policies

OBJECTIVE: To evaluate the use of the available information systems in decision-making process involving municipalities' health services, since technical scientific information is becoming an important tool for managers' decision-making both in the private and public sectors. METHODS: Four case studies were undertaken in the state of Sao Paulo between 1998 and 2000. The municipalities included in this study varied in size and in terms of the of complexity of their health systems. Research involved the use of both quantitative (survey of epidemic, demographic, economic-financial and social indicators) and qualitative methods (interviews with key actors and focus group). "Triangulation" was adopted in the analysis in order to establish an articulation among the diverse sources of data and methodological procedures utilized. RESULTS: The strategy of implementation of the Unified Health System (SUS) in itself implies in a pattern of consumption of information already available in large data banks within public institutions and local production of information concerning, primarily, the financial dimension of the city or district, whatever its size, the complexity of the local health system and the type of health administration. CONCLUSIONS: The information available on the data banks are, in general, considered outdated with respect to the immediate needs of local health managers. The equipment infrastructure and training of human resources in health data management were considered precarious for use in the decision-making process.     

The urban environment from the health perspective: the case of Belo Horizonte, Minas Gerais, Brazil

This study aims to determine spatial patterns of mortality and morbidity for five health problems in an urban environment: homicides, adolescent pregnancy, asthma hospitalization, and two vector-borne diseases, dengue and visceral leishmaniasis. All events were obtained through the city health database and geoprocessed using residential addresses and 80 planning units consisting of census tracts. We used thematic maps, proportionate mortality/morbidity ratios by planning unit, and the overlapped rank of the 20th worse planning unit rates for each event. A spatial pattern of high rates of homicides, proportion of young mothers, and hospitalization due to asthma overlapped in socially and economically disadvantaged areas. For the two vector-borne diseases, high rates with great dispersion were found in underprivileged areas, in contrast with very low rates among higher income areas. The results indicated the coexistence of heavier disease burden for residents of urban areas where poverty and lack of effective public health policies may be modulating social health problems. For the two vector-borne diseases, an environmental intervention in one mosquito-borne disease might be playing a role in the other's incidence.     

Behavioral and genoprotective effects of Vaccinium berries intake in mice

Studies have shown that supplementation with berries rich in anthocyanins are effective in reducing oxidative stress associated with aging, and are beneficial in reversing age-related neuronal and behavioral changes. However, there are few reports on other biological activities of these polyphenols, such as genoprotective effects. The present experiments were performed to study the possible effects of 30-day administration of a lyophilized extract of Vaccinium ashei berries on cognitive performance using step-down inhibitory avoidance, open-field habituation and elevated plus-maze tasks, as well as on DNA damage in the hippocampus and cerebral cortex. The present study showed that the extract significantly enhanced long-term memory in the inhibitory avoidance task, induced an increase in the number of crossings during open-field habituation and had an anxiolytic effect in the elevated plus-maze task. Moreover, the extract reduced oxidative DNA damage in brain tissue in vitro. These results suggest that supplementation with V. ashei berries to mice improves performance on memory tasks and has a protective effect on DNA damage, possibly due to the antioxidant activity of polyphenols, including anthocyanins.     

Role of glutamate and dopamine receptors in the psychopharmacological profile of the indole alkaloid psychollatine

Psychollatine (1), a new glycoside indole monoterpene alkaloid isolated from Psychotria umbellata, has shown an interesting psychopharmacological profile. This study aimed to investigate the role of NMDA glutamate and dopamine receptors in mediating the properties of 1. Psychollatine (1) was assessed for NMDA-induced seizures, MK-801-induced hyperlocomotion, amphetamine-induced lethality, and apomorphine-induced climbing behavior in mice. Psychollatine (1) (100 mg/kg) and MK-801 (0.3 mg/kg) prevented NMDA-induced seizures (P < 0.01), while 1 (100 mg/kg) attenuated the MK-801-induced hyperlocomotion (P < 0.05). Compound 1 (3 and 10 mg/kg), as well as chlorpromazine (4 mg/kg), prevented amphetamine-induced lethality (P < 0.05). Finally, 1 (10 mg/kg) (P < 0.05), MK-801 (0.2 mg/kg) (P < 0.01), and chlorpromazine (4 mg/kg) (P < 0.01) attenuated apomorphine-induced climbing behavior. The present results strongly support the involvement of NMDA glutamate receptors in the mode of action of psychollatine (1).