OBJECTIVE To describe the focalization and coverage of Bolsa Família Program among the families of children who are part of the 2004 Pelotas birth cohort (2004 cohort).METHODS The data used derives from the integration of information from the 2004 cohort and the Cadastro Único para Programas Sociais do Governo Federal (CadÚnico – Register for Social Programs of the Federal Government), in the 2004-2010 period. We estimated the program coverage (percentage of eligible people who receive the benefit) and its focus (proportion of eligible people among the beneficiaries). We used two criteria to define eligibility: the per capita household income reported in the cohort follow-ups and belonging to the 20% poorest families according to the National Economic Indicator (IEN), an asset index.RESULTS Between 2004 and 2010, the proportion of families in the cohort that received the benefit increased from 11% to 34%. We observed an increase in all wealth quintiles. In 2010, by income and wealth quintiles (IEN), 62%-72% of the families were beneficiaries among the 20% poorest people, 2%-5% among the 20% richest people, and about 30% of families of the intermediate quintile. According to household income (minus the benefit) 29% of families were eligible in 2004 and 16% in 2010. By the same criteria, the coverage of the program increased from 43% in 2004 to 71% in 2010. In the same period, by the wealth criterion (IEN), coverage increased from 29% to 63%. The focalization of the program decreased from 78% in 2004 to 32% in 2010 according to income, and remained constant (37%) according to the IEN.CONCLUSIONS Among the families of the 2004 cohort, there was a significant increase in the program coverage, from its inception until 2010, when it was near 70%. The focus of the program was below 40% in 2010, indicating that more than half of the beneficiaries did not belong to the target population.
Depression and anxiety play an important role in decreasing quality of life worldwide. Since tryptophan is a serotonin precursor and low levels of serotonin seems to be related to depression, the effect of oral tryptophan has been investigated for possible potentiation of the action of antidepressant drugs. We investigated the effects of chronically administered tryptophan (50mg/kg/day, p.o.) with or without concomitant fluoxetine (10mg/kg/day, s.c.) on adult rats regarding depression-related and anxiety-like behaviors. Tryptophan levels in cerebrospinal fluid (CSF) were measured 4h after a single administration of daily dosages of chronic treatments. We found that tryptophan increased depressive-related behavior, but did not alter anxiety-like behavior. However, fluoxetine decreased depression-related behavior and was anxiogenic. Tryptophan with concomitant fluoxetine did not alter anxiety-like behavior. Moreover, our data suggests that the antidepressant effect of fluoxetine was not enhanced by concomitant administration of tryptophan, which could be associated with increased levels of tryptophan in CSF. Further investigations are needed to elucidate the related mechanisms.
To retrieve and assess the available data in the literature about the safety and efficacy of baroreflex activation therapy (BAT) in heart failure with reduced ejection fraction (HFrEF) patients, through a rapid systematic review of clinical studies. Rapid systematic review of literature. Searched electronic databases included PubMed, EMBASE, CENTRAL, Scopus, and Web of Science using Mesh and free terms for heart failure and BAT. No language restriction was used for the searches. We included full peer reviewed publications of clinical studies (randomized or not), including patients with HFrEF undergoing BAT, with or without control group, assessing safety and efficacy outcomes. One reviewer conducted the analysis of the selected abstracts and the full‐text articles, performed data extraction, and evaluated the methodological quality of the selected articles. The methodological quality was assessed according to the Cochrane Collaboration instruments. A descriptive summary of the results is provided. Of the 441 citations screened, 10 publications were included (three were only conference abstracts), reporting data from three studies. Only one study was a randomized clinical trial. Two studies reported a 6 month following, and the other study analysed outcomes up to 41 months. The procedure seems to be safe when performed by a well‐trained multi‐professional team. An 86% rate of system and procedure‐related complication‐free was reported, with no cranial nerve injuries. Improvements in New York Heart Association class of heart failure, quality of life, 6 min walk test, and hospitalization rates, as well as in muscle sympathetic nerve activity. No meta‐analysis was conducted because of the lack of homogeneity across studies; the results from each study are reported individually. BAT procedure seems to be safe if appropriate training is provided. Improvements in clinical outcomes were described in all included studies. However, several limitations do not allow us to make conclusive statements on the efficacy of BAT for HFrEF. New well‐designed trials are still needed.
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