There is an increase in the consideration of ecosystem services (ES) within the planning, policy, and research sectors. The increase in sectors working with ES is leading to an increase in scale mismatches, where ecosystem services are being mismanaged, leading to problems. Using a combination of methods these scale issues were investigated. A systematic review of both scientific and grey literature was undertaken which analysed 112 documents and led to a survey of 72 subjects who were working with ES across different sectors, and finally 19 in-depth interviews were undertaken, in order to understand fully the scale issues, and potential solutions being used. The systematic review found that a lot of ecosystem service scientific literature was based on, or had connections with, the global issue of climate change, this was in contrast to the survey that found that both researchers and those in policy are working at a regional spatial scale or below. The in-depth interviews attributed this to many factors including the pressure to publish in high-impact journals, and applying for funding. The survey found that the different sectors are working at different scales, and where they do work at the same scale, the definition they place on that scale term is different. The survey and in-depth interviews found that funding can influence the extent of a project and funding timelines lead into the temporal scale of a project. Funding can encourage collaboration with stakeholders and between sectors in order to pool resources and expertise. Alongside clarity of terms used and expectations for the project, collaboration was also put forward as one of the methods which can alleviate scale mismatches.

Magister Curationis - MCur / Pregnancy induced hypertension is one of the causes of maternal, fetus and neonatal morbidity and mortality. It is the condition in which a pregnant woman develops hypertension because of physiological changes that result during pregnancy and both mother and fetus can be affected. According to the World Health Organization (WHO), the first target of the third United Nations Sustainable Development Goals (SDG-3) is to reduce the maternal mortality rate (MMR) to less than 10 per 100.000 live births by 2030 (WHO, 2017). This is because globally, about 350 000 women die every year from pregnancy related causes (Hogan, Foreman, & Naghavi, 2010). According to the WHO (2015), these conditions namely post-partum hemorrhage, hypertension in pregnancy, infections, unsafe abortion and other delivery-related complications cause three quarters of all maternal deaths in the World. Hence the needs to prevent or successfully treat conditions that contribute to this scourge (WHO, 2011). The two main interventions that are used to prevent or treat hypertension in pregnancy are medication and lifestyle adjustment. However, it is important to understand the intervention that is most suited to a context and its patient and compare the effects of these interventions on management of hypertension in pregnant women as a patient outcome.

Background The burden of non-communicable diseases (NCDs) is rapidly increasing globally, and particularly in Africa, where the health focus, until recently, has been on infectious diseases. The response to this growing burden of NCDs in Africa has been affected owing to a poor understanding of the burden of NCDs, and the relative lack of data and low level of research on NCDs in the continent. Recent estimates on the burden of NCDs in Africa have been mostly derived from modelling based on data from other countries imputed into African countries, and not usually based on data originating from Africa itself. In instances where few data were available, estimates have been characterized by extrapolation and over-modelling of the scarce data. It is therefore believed that underestimation of NCDs burden in many parts of Africa cannot be unexpected. With a gradual increase in average life expectancy across Africa, the region now experiencing the fastest rate of urbanization globally, and an increase adoption of unhealthy lifestyles, the burden of NCDs is expected to rise. This thesis will, therefore, be focussing on understanding the prevalence, and/or where there are available data, the incidence, of four major NCDs in Africa, which have contributed highly to the burden of NCDs, not only in Africa, but also globally. Methods I conducted a systematic search of the literature on three main databases (Medline, EMBASE and Global Health) for epidemiological studies on NCDs conducted in Africa. I retained and extracted data from original population-based (cohort or cross sectional), and/or health service records (hospital or registry-based studies) on prevalence and/or incidence rates of four major NCDs in Africa. These include: cardiovascular diseases (hypertension and stroke), diabetes, major cancer types (cervical, breast, prostate, ovary, oesophagus, bladder, Kaposi, liver, stomach, colorectal, lung and non-Hodgkin lymphoma), and chronic respiratory diseases (chronic obstructive pulmonary disease (COPD) and asthma). From extracted crude prevalence and incidence rates, a random effect meta-analysis was conducted and reported for each NCD. An epidemiological model was applied on all extracted data points. The fitted curve explaining the largest proportion of variance (best fit) from the model was further applied. The equation generated from the fitted curve was used to determine the prevalence and cases of the specific NCD in Africa at midpoints of the United Nations (UN) population 5-year age-group population estimates for Africa. Results From the literature search, studies on hypertension had the highest publication output at 7680, 92 of which were selected, spreading across 31 African countries. Cancer had 9762 publications and 39 were selected across 20 countries; diabetes had 3701 publications and 48 were selected across 28 countries; stroke had 1227 publications and 19 were selected across 10 countries; asthma had 790 publications and 45 were selected across 24 countries; and COPD had the lowest output with 243 publications and 13 were selected across 8 countries. From studies reporting prevalence rates, hypertension, with a total sample size of 197734, accounted for 130.2 million cases and a prevalence of 25.9% (23.5, 34.0) in Africa in 2010. This is followed by asthma, with a sample size of 187904, accounting for 58.2 million cases and a prevalence of 6.6% (2.4, 7.9); COPD, with a sample size of 24747, accounting for 26.3 million cases and a prevalence of 13.4% (9.4, 22.1); diabetes, with a sample size of 102517, accounting for 24.5 million cases and a prevalence of 4.0% (2.7, 6.4); and stroke, with a sample size of about 6.3 million, accounting for 1.94 million cases and a prevalence of 317.3 per 100000 population (314.0, 748.2). From studies reporting incidence rates, stroke accounted for 496 thousand new cases in Africa in 2010, with a prevalence of 81.3 per 100000 person years (13.2, 94.9). For the 12 cancer types reviewed, a total of 775 thousand new cases were estimated in Africa in 2010 from registry-based data covering a total population of about 33 million. Among women, cervical cancer and breast cancer had 129 thousand and 81 thousand new cases, with incidence rates of 28.2 (22.1, 34.3) and 17.7 (13.0, 22.4) per 100000 person years, respectively. Among men, prostate cancer and Kaposi sarcoma closely follows with 75 thousand and 74 thousand new cases, with incidence rates of 14.5 (10.9, 18.0) and 14.3 (11.9, 16.7) per 100000 person years, respectively. Conclusion This study suggests the prevalence rates of the four major NCDs reviewed (cardiovascular diseases (hypertension and stroke), diabetes, major cancer types, and chronic respiratory diseases (COPD and asthma) in Africa are high relative to global estimates. Due to the lack of data on many NCDs across the continent, there are still doubts on the true prevalence of these diseases relative to the current African population. There is need for improvement in health information system and overall data management, especially at country level in Africa. Governments of African nations, international organizations, experts and other stakeholders need to invest more on NCDs research, particularly mortality, risk factors, and health determinants to have evidenced-based facts on the drivers of this epidemic in the continent, and prompt better, effective and overall public health response to NCDs in Africa.

O século XX foi marcado por significativa transformação social, que se refletiu em rápido aumento da expectativa de vida da população mundial. Nesse contexto, é cada vez mais significativa a parcela de mulheres que atingem a menopausa. Doenças cardiovasculares, que representam a principal causa de morte entre os adultos, e a osteoporose, apresentam uma relação nítida com a antecipação da menopausa, isto é, aquela que ocorre abaixo da média esperada para uma população. As pesquisas na área, antes praticamente relacionadas ao tratamento dos efeitos causados pelo climatério, se voltam cada vez mais para entender como os hábitos ou estilos de vida podem influenciar a fisiologia ovariana e, conseqüentemente, alterar o momento da menopausa. A relação com alguns destes hábitos, como o fumo, já apresenta forte embasamento na literatura. Entretanto, a correlação com o nível socioeconômico, seja pelas dificuldades de se medir adequadamente esse constructo, ou talvez pela quantidade insuficiente de trabalhos de qualidade, não se apresenta de forma tão evidente. O nível de escolaridade, considerado um dos melhores indicadores do nível socioeconômico, tanto pela maior facilidade de obtenção da informação, como pelo já demonstrado grau de associação com diversos desfechos em saúde, foi avaliado nesta revisão sistemática como fator de exposição para a antecipação da idade da menopausa. Este trabalho se alinha com a crescente tendência de se entender como os determinantes sociais podem influenciar nos desfechos em saúde, e de se buscar estratégias eficazes em prol da diminuição das desigualdades em saúde. A estratégia de busca eletrônica foi desenvolvida de forma específica para as diferentes bases (MEDLINE [PubMed] e LILACS) e através de consulta a referências cruzadas. Somente foram incluídos estudos observacionais pela natureza da questão, já que não seria possível, neste caso, a realização de estudos experimentais. Após a identificação inicial de 776 artigos, 40 deles foram selecionados para apreciação do texto completo. No final, esta revisão sistemática englobou 30 artigos, relatando resultados de 32 estudos. Como resultado, verificou-se que estudos que não demonstram associação significativa do nível de educação com a idade da menopausa formaram a maioria da amostra. A forma como nível de escolaridade foi medida e a metodologia para comparação entre os estratos se mostraram largamente heterogêneas. Não se encontraram evidências inequívocas sobre a existência de associação entre o nível de escolaridade e a idade da menopausa através desta revisão. / The 20th century was marked by significant social changes that reflected on a fast increase of life expectancy of the worldwide population. In this context, the portion of women that attain menopause is increasingly more significant. Cardiovascular diseases, that represent the main cause of death among adults, and osteoporosis, present a clear relation with the anticipation of menopause, that is, that one that occurs below the expected average to a certain population. Initially, studies in this area were practically restricted to treatment of effects caused by the climateric period. Currently, they are more and more concerned to understand how habits or life styles can influence the ovarian physiology and, consequently, how they can alter the age at menopause. Association with some of these habits, such as smoking tobacco, already presents a strong foundation in the literature. However, the correlation with socioeconomic level, maybe due to difficulties concerning how to measure this concept properly or to the insufficient amount of qualified papers, is not so clearly presented. Educational level, considered as one of the best socioeconomic indicators, both due to the greater facility to obtain information and already the demonstrated degree of association with several outcomes in health, was evaluated in this systematic review as an exposure factor to the anticipation of the age at menopause. This work is lined up an increasing tendency to understand how social determinants can influence health outcomes and how effective strategies could be built to decrease health inequalities. The strategy of electronic search was developed in a specific way to different basis considered (Medline [PubMed] and Lilacs) and complemented with cross-reference search. Only observational studies were included by the nature of the question, since it would not be possible, in this case, to perform experimental studies. After initial identification of 776 articles, in which 40 out of them were selected for evaluation of the complete text. In the end, our systematic review included 30 articles, giving an account of 32 studies. As a result of the review, it was noticed that studies not showing a significant association between educational level and the age at menopause formed the most part of the sample. The way by which the educational level was measured as well as the methods used for comparing strata, were largely heterogeneous, This review did not find strong evidences about the existence of an association between educational level and age at menopause.

O século XX foi marcado por significativa transformação social, que se refletiu em rápido aumento da expectativa de vida da população mundial. Nesse contexto, é cada vez mais significativa a parcela de mulheres que atingem a menopausa. Doenças cardiovasculares, que representam a principal causa de morte entre os adultos, e a osteoporose, apresentam uma relação nítida com a antecipação da menopausa, isto é, aquela que ocorre abaixo da média esperada para uma população. As pesquisas na área, antes praticamente relacionadas ao tratamento dos efeitos causados pelo climatério, se voltam cada vez mais para entender como os hábitos ou estilos de vida podem influenciar a fisiologia ovariana e, conseqüentemente, alterar o momento da menopausa. A relação com alguns destes hábitos, como o fumo, já apresenta forte embasamento na literatura. Entretanto, a correlação com o nível socioeconômico, seja pelas dificuldades de se medir adequadamente esse constructo, ou talvez pela quantidade insuficiente de trabalhos de qualidade, não se apresenta de forma tão evidente. O nível de escolaridade, considerado um dos melhores indicadores do nível socioeconômico, tanto pela maior facilidade de obtenção da informação, como pelo já demonstrado grau de associação com diversos desfechos em saúde, foi avaliado nesta revisão sistemática como fator de exposição para a antecipação da idade da menopausa. Este trabalho se alinha com a crescente tendência de se entender como os determinantes sociais podem influenciar nos desfechos em saúde, e de se buscar estratégias eficazes em prol da diminuição das desigualdades em saúde. A estratégia de busca eletrônica foi desenvolvida de forma específica para as diferentes bases (MEDLINE [PubMed] e LILACS) e através de consulta a referências cruzadas. Somente foram incluídos estudos observacionais pela natureza da questão, já que não seria possível, neste caso, a realização de estudos experimentais. Após a identificação inicial de 776 artigos, 40 deles foram selecionados para apreciação do texto completo. No final, esta revisão sistemática englobou 30 artigos, relatando resultados de 32 estudos. Como resultado, verificou-se que estudos que não demonstram associação significativa do nível de educação com a idade da menopausa formaram a maioria da amostra. A forma como nível de escolaridade foi medida e a metodologia para comparação entre os estratos se mostraram largamente heterogêneas. Não se encontraram evidências inequívocas sobre a existência de associação entre o nível de escolaridade e a idade da menopausa através desta revisão. / The 20th century was marked by significant social changes that reflected on a fast increase of life expectancy of the worldwide population. In this context, the portion of women that attain menopause is increasingly more significant. Cardiovascular diseases, that represent the main cause of death among adults, and osteoporosis, present a clear relation with the anticipation of menopause, that is, that one that occurs below the expected average to a certain population. Initially, studies in this area were practically restricted to treatment of effects caused by the climateric period. Currently, they are more and more concerned to understand how habits or life styles can influence the ovarian physiology and, consequently, how they can alter the age at menopause. Association with some of these habits, such as smoking tobacco, already presents a strong foundation in the literature. However, the correlation with socioeconomic level, maybe due to difficulties concerning how to measure this concept properly or to the insufficient amount of qualified papers, is not so clearly presented. Educational level, considered as one of the best socioeconomic indicators, both due to the greater facility to obtain information and already the demonstrated degree of association with several outcomes in health, was evaluated in this systematic review as an exposure factor to the anticipation of the age at menopause. This work is lined up an increasing tendency to understand how social determinants can influence health outcomes and how effective strategies could be built to decrease health inequalities. The strategy of electronic search was developed in a specific way to different basis considered (Medline [PubMed] and Lilacs) and complemented with cross-reference search. Only observational studies were included by the nature of the question, since it would not be possible, in this case, to perform experimental studies. After initial identification of 776 articles, in which 40 out of them were selected for evaluation of the complete text. In the end, our systematic review included 30 articles, giving an account of 32 studies. As a result of the review, it was noticed that studies not showing a significant association between educational level and the age at menopause formed the most part of the sample. The way by which the educational level was measured as well as the methods used for comparing strata, were largely heterogeneous, This review did not find strong evidences about the existence of an association between educational level and age at menopause.

Background: Addressing the growing burden of mental diseases is a public health priority. Nevertheless, many countries lack reliable estimates of the proportion of the population affected, which are crucial for health and social policy planning. This study aimed to collect existing evidence on the prevalence of mental diseases in Austria. Methods: A systematic review was conducted using MeSH, EMTREE and free-text terms in seven bibliographic databases. In addition, the references of included papers and relevant Austria-specific websites were searched. Articles published after 1996 pertaining to the Austrian adult population and presenting prevalence data for mental diseases were included in the analysis. Results: A total of 2612 records were identified in the database search, 19 of which were included in the analysis, 13 were community-based studies and 6 examined institutionalized populations. Sample sizes ranged from 200 to 15,474. The evidence was centered around depression (n= 6, 32%), eating disorders (n= 4, 21%) and alcohol dependence (n= 3, 16%). While most studies (n= 10, 53%) used questionnaires and scales to identify mental diseases, seven studies used structured clinical interviews, and two studies examined use of psychotropic drugs. Due to the diversity of methodologies, no statistical pooling of prevalence estimates was possible. Conclusion: Information on the prevalence of mental diseases in Austria is limited and comparability between studies is restricted. A variety of diagnostic instruments, targeted populations and investigated diseases contribute to discrepancies in the prevalence rates. A systematic, large-scale study on the prevalence of mental diseases in Austria is needed for comprehensive and robust epidemiological evidence.

O gênero Celeus compreende um número variável de espécies distribuídas por toda a região Neotropical. No que diz respeito à sistemática do gênero, poucas modificações taxonômicas foram feitas desde sua última grande revisão em 1982. Em relação às hipóteses de relacionamento das espécies incluídas no gênero, as poucas propostas disponíveis baseiam-se em dados moleculares, não existindo nenhuma baseada em dados morfológicos e bioacústicos. Dessa forma, os objetivos do presente estudo foram revisar a taxonomia do gênero Celeus, definir o número de espécies que o compõem, descrever eventuais variações morfológicas existentes nos táxons analisados e propor uma hipótese de relacionamento entre suas espécies, por meio da análise de caracteres morfológicos (plumagem, morfometria e osteologia) e vocais. Para isso foram analisados 1998 espécimes taxidermizados, 92 esqueletos e 200 arquivos sonoros testando sua aplicabilidade na sistemática do grupo, sob a ótica do conceito de espécie filogenética. Foi constatada a existência de uma grande variação individual nos caracteres de plumagem em praticamente todos os táxons analisados, o que provavelmente levou a descrições de várias espécies e subespécies, que demonstraram não ser válidas. Ao contrário dos caracteres de plumagem, os caracteres vocais demonstraram uma grande estabilidade, variando apenas entre as espécies. Os caracteres osteológicos também se mostraram úteis na sistemática de Celeus, apesar da grande variação individual observada. Ao final, C. obrieni, C. subflavus, C. tinnunculus, C. ochraceus e C. multifasciatus, antes tratadas como subespécies, foram validadas como espécies, além da inclusão de C. galeatus. O monofiletismo do gênero foi recuperado, corroborando estudos moleculares recentes, diferindo quanto ao posicionamento de C. galeatus em relação às demais espécies do gênero. Dentre os doze clados fortemente suportados, alguns corroboram os resultados das propostas moleculares disponíveis, como a relação de espécies-irmãs entre C. spectabilis e C. obrieni. Com a validação dessas cinco espécies e a confirmação do posicionamento de C. galeatus no gênero, Celeus passa a contar com 16 espécies (C. galeatus, C. spectabilis, C. obrieni, C. flavus, C. subflavus, C. loricatus, C. torquatus, C. tinnunculus, C. lugubris, C. flavescens, C. ochraceus, C. elegans, C. castaneus, C. grammicus, C. undatus e C. multifasciatus), o que representa um aumento de 62,5% no número de espécies segundo a última grande revisão taxonômica do gênero. / The genus Celeus encompasses a variable number of species distributed throughout the Neotropics. Regarding its systematic arrangement, few changes have been made since its lastest major review in 1982. As to its phylogenetic relationships, the few proposals available are based on molecular data, lacking a morphological and bioacustic hypothesis. Thus, the goals of this study were to conduct a taxonomic review of the genus Celeus, establish the number of species within it, describe any existing morphological variation in these taxa and propose a hypothesis of relationship among its species through the analysis of morphological characters (plumage, morphometry and osteology) and bioacustics. A total of 1998 study skins, 92 skeletons and 200 sound files were analyzed, testing its applicability in the systematics of the genus, under the perspective of the phylogenetic species concept. A great individual variation in plumage characters in almost all analyzed taxa has been verified. This variation may be seen as the reason that led former authors to describe many of the taxa here considered invalid. Unlike plumage, the vocal characters demonstrated a great stability, varying only between species. The osteological characters also proved its usefulness in the systematics of Celeus, despite its individual variation. Ultimately, C. obrieni, C. subflavus, C. tinnunculus, C. ochraceus and C. multifasciatus, taxa previously treated as subspecies, have been proved to be valid species. The monophyly of Celeus was recovered, as well as the placement of C. galeatus as a member of this genus, agreeing with recent molecular studies, but differing, as already remarked, in the placement of C. galeatus in respect to other species of the genus. Among the twelve strongly supported clades, some corroborate the results of the molecular studies available, such as the sister relationship between C. spectabilis and C. obrieni. The validation of these five taxa and the placement of C. galeatus in the genus, Celeus which now has 16 species (C. galeatus, C. spectabilis, C. obrieni, C. flavus, C. subflavus, C. loricatus, C. torquatus, C. tinnunculus, C. lugubris, C. flavescens, C. ochraceus, C. elegans, C. castaneus C. grammicus, C. undatus and C. multifasciatus), representing an increase of 62.5% in species number according to the latest major revision of the genus.

O grupo de onicóforos \"caraíbas\" apresenta grande diversidade de espécies, mas também gêneros fracamente delimitados. Epiperipatus Clark, 1913 é o maior dos gêneros neotropicais de Onychophora, mas ainda não sofreu revisão taxanômica. Este gênero foi incorporado no presente estudo, que contemplou o mais abrangente conjunto de dados moleculares, assistido por dados morfológicos. Quatro marcadores moleculares foram utilizados: cytochrome c oxidase subunit I (COI), 12S rRNA, 16S rRNA (mitochondriais) e 18S rRNA (nuclear). Além disso, trinta e três caracteres morfológicos foram levantados. A base de dados foi submetida a duas análises de Máxima Parcimônia (MP) e uma de Máxima Verossimilhança (ML). No total foram examinados 175 espécimes, cobrindo nove gêneros e vinte e nove espécies, dezoito delas pertencentes a Epiperipatus. Foi adotado como hipótese de trabalho o cladograma resultante da análise de evidência total que contemplou os dados moleculares e morfológicos. O resultado mostrou que os dados morfológicos não são capazes de resolver por si só as relações internas de Peripatidae, pois o número de caracteres morfológicos é menor que o número de terminais examinados. Peripatidae é suportado por dados moleculares e isso é conflitante com a delimitação morfológica tradicional dos gêneros da família. Isso demonstra que clados suportados por dados moleculares mostram elevada disparidade morfológica, que pode estar relacionada a adaptação a diferentes ambientes do clado Neotropical. Além disso, o resultado também sugeriu Epiperipatus como parafilético, pois engloba outros gêneros que devem ser sinonimizados. Epiperipatus apresentou estabilidade em três clados neotropicais, apesar de que Epiperipatus edwardsii (Blanchard, 1847) e outros quatro grupos mostraram posição instável. Para reconciliar a sistemática e a filogenia de Epiperipatus, os gêneros monotípicos Principapillatus Oliveira et al., 2014 e Cerradopatus Oliveira et al., 2015 devem ser considerados sinônimo-junior de Epiperipatus. Consequentemente, as novas combinações foram propostas: Epiperipatus hitoyensis (Oliveira et al., 2012) n. comb. e Epiperipatus sucuriuensis (Oliveira et al., 2015) n. comb.. Além disso, foram apresentadas e descritas as espécies novas Epiperipatus [sp1] n. sp., Epiperipatus [sp2] n. sp., Epiperipatus [sp10] n. sp., Epiperipatus [sp16] n. sp. e Epiperipatus [sp17] n. sp.. O enraizamento da filogenia de Onychophora em Peripatopsidae resultou no grupo Neotropical como grupo-irmão do grupo africano, e um aparente ancestral Asiático. A demonstrada monofilia de Epiperipatus confirmou sua larga distribuição, da mesma forma que Peripatus. Ambos os gêneros ocorrem da América Central ao Brasil. Entretanto, no Brasil enquanto Peripatus ocorre apenas no centro-oeste desse país, Epiperipatus é encontrado em quase todo o território desse país, com exceção da região sul / The \"caraibes\" onychophorans present both a large diversity and weakly defined genera. Epiperipatus Clark, 1913 is the largest genus, but it has not been revised so far. This genus is herein incorporated into the currently most comprehensive molecular phylogenetic analysis of Peripatidae, assisted by morphology. Four markers were used: cytochrome c oxidase subunit I (COI), 12S rRNA, 16S rRNA (mitochondrial) and 18S rRNA (nuclear). Moreover, 33 morphological characters were obtained. The dataset was used in two Maximum Parsimony (MP) and one Maximum Likelihood (ML) analyses. In a total of 175 specimens of Onychophora, nine genera and twenty-nine species were examined, eighteen of them belonging to Epiperipatus. We adopted as work hypothesis the MP based on total evidence. The result showed that morphological by itself cannot be used to resolve the phylogenetic relationships of this group, because the number of characters is smaller than the number of terminals examined. Here, Peripatidae was based on molecular data and this conflicts with the characters traditionally used to define genera in the family. It means that clades supported by molecular data shows high morphological disparity which might be reflected on the adaptation to different environments in the Caribbean clade. Also, the result suggests that Epiperipatus seems to be not monophyletic, as it includes others genera and these genera should be synonymized. Epiperipatus presented stable relationships across three clades of Neotropical onychophorans, but it was observed the unstable position of Epiperipatus edwardsii (Blanchard, 1847) and four groups also. To reconcile Epiperipatus systematics with the phylogeny, the monotypic genera Principapillatus Oliveira et al., 2014 and Cerradopatus Oliveira et al., 2015 should be considered as junior synonyms of Epiperipatus. Hence, the new combinations were proposed: Epiperipatus hitoyensis (Oliveira et al., 2012) n. comb. and Epiperipatus sucuriuensis (Oliveira et al., 2015) n. comb.. Moreover, the new species Epiperipatus [sp1] n. sp., Epiperipatus [sp2] n. sp., Epiperipatus [sp10] n. sp., Epiperipatus [sp16] n. sp. and Epiperipatus [sp17] n. sp. were presented and described here. Rooting the Onychophora phylogeny in Peripatopsidae resulted in the Neotropical group as the sister group relationship to the African species, and an apparently ancestral group from Asia. The demonstrated Epiperipatus monophily confirmed its widespread distribution, in the same way as Peripatus. Both are recorded from Central America to Brazil. However, in Brazil, while Peripatus occurs only until the Central-West region, Epiperipatus is found in all Brazilian territories, except in the South region

Submitted by Biblioteca da Faculdade de Farmácia (bff@ndc.uff.br) on 2017-03-21T18:41:19Z No. of bitstreams: 1 Andrade, Thays Santos de [Dissertação, 2014].pdf: 467886 bytes, checksum: 9f9c6acd0d2516bb655fb10868b2db29 (MD5) / Made available in DSpace on 2017-03-21T18:41:19Z (GMT). No. of bitstreams: 1 Andrade, Thays Santos de [Dissertação, 2014].pdf: 467886 bytes, checksum: 9f9c6acd0d2516bb655fb10868b2db29 (MD5) / O câncer de mama é o tipo que mais acomete as mulheres em todo o mundo. Aproximadamente 30-50% dos pacientes diagnosticados nos estágios iniciais desenvolverão doença metastática, considerada incurável. Nesta fase da doença, as terapias objetivam prolongar a sobrevida e proporcionar controle paliativo dos sintomas. O trastuzumabe, um anticorpo monoclonal dirigido contra o receptor do fator de crescimento epidérmico humano (HER2), vem aumentando as taxas de respostas, sobrevida livre de progressão e/ou sobrevida global no câncer de mama, tendo sido recentemente incorporado pelo Sistema Único de Saúde (SUS) para tratamento de câncer de mama inicial e localmente avançado. O objetivo deste trabalho foi realizar uma revisão sistemática de avaliações de custo-efetividade do trastuzumabe em pacientes com câncer de mama metastático com superexpressão de HER2. Foram realizadas buscas, entre o período de 1998 a 2013, em seis bases de dados eletrônicas, duas ferramentas de busca na internet, além de pesquisa manual de referências. Foram considerados artigos em inglês, espanhol e português, sendo excluídos comentários, editoriais, cartas, estudos de caso, artigos de revisão, revisões sistemáticas e metanálises. As etapas de seleção dos estudos e extração dos dados foram realizadas por dois revisores independentes, e dúvidas foram resolvidas por um terceiro revisor. Os estudos foram avaliados em relação à qualidade seguindo abordagens empregadas por Teerawattananon et al. (2007). A análise dos dados foi realizada a partir da conversão dos custos e de observações das razões incrementais de custo-efetividade do trastuzumabe. Foram identificados 521 estudos, todos em inglês. Destes, descartou-se 455 (294 por não atenderem os critérios da revisão e 161 duplicatas). Sessenta e seis estudos foram incluídos para leitura dos resumos, resultando em 24 para leitura completa do texto. No total, 13 estudos compuseram esta revisão. Os esquemas terapêuticos adotados nas análises de custo-efetividade foram variados. Oito estudos compararam o tratamento do trastuzumabe como 1ª linha para doença metastática e cinco estudos como 2ª linha, sendo que três destes utilizaram o trastuzumabe como comparador na avaliação econômica e não como intervenção. Todos os estudos que utilizaram o trastuzumabe como 2ª linha de tratamento, não consideraram a intervenção custo-efetiva. Em relação à qualidade dos estudos incluídos, estes apresentaram uma boa qualidade, visto que a maioria cumpriu as diretrizes metodológicas de avaliação de custo-efetividade e utilizaram boas evidências na estimativa dos parâmetros. Finalmente, as análises utilizaram diferentes limiares para determinar se o tratamento com o trastuzumabe foi custo-efetivo, bem como diferenças na modelagem dos custos, desfechos e padrões de tratamento. O uso de trastuzumabe, associado ou não, foi custo-efetivo como tratamento de 1ª linha, diferentemente de quando usado como 2ª linha. Foram encontradas diferenças quanto à qualidade dos estudos incluídos. É necessária a realização de novas avaliações de custo-efetividade do trastuzumabe no câncer de mama metastático que, aliadas a fatores administrativos, sociais e políticos, embasem os gestores na tomada de decisão quanto à sua incorporação / Breast cancer is the type that affects more women worldwide. Approximately 30-50 % of patients diagnosed in the early stages will develop metastatic disease, which is considered incurable. At this stage of the disease, therapies aimed prolong survival and provide palliative symptom control. Trastuzumab, a monoclonal antibody targeted to the receptor of the human epidermal growth factor (HER2), has increased response rates, progression-free survival and/or overall survival in breast cancer and has recently been incorporated by the Sistema Único de Saúde (SUS) for treatment of early and locally advanced breast cancer. The aim of this study was to conduct a systematic review of the cost-effectiveness analyses of trastuzumab in patients with metastatic breast cancer overexpressing HER2. Searches were conducted between the period 1998-2013, on six electronic databases, two generic searches on the Internet, as well as manual search of references. We considered articles in English, Spanish and Portuguese, being excluded reviews, editorials, letters, case studies, review articles, systematic reviews and meta-analyses. The stages of study selection and data extraction were performed by two independent reviewers, and doubts were resolved by one third reviewer. Studies were assessed for quality according to approaches employed by Teerawattananon et al (2007). Data analysis was performed from the conversion of the costs and comments of the incremental cost-effectiveness ratios of trastuzumab were made. A quantity of 521 studies, all in English, was identified. Of these, we discarded 455 (294 did not meet the criteria for review and 161 duplicates). Sixty-six studies were included for reading the abstracts, resulting in 24 to read the full text. In total, 13 studies composed this review. The treatment regimens adopted on cost-effectiveness evaluations were varied. Eight studies compared the treatment of trastuzumab as 1st line for metastatic disease and five studies as 2nd line, which three of these used trastuzumab as comparator in the economic evaluation and not as an intervention. All studies using trastuzumab as 2nd line treatment did not consider it as a cost-effective intervention. Regarding the quality of the included studies, they showed a good quality, since most fulfilled the methodological guidelines for assessing costeffectiveness and used good evidence in the estimation of parameters. Finally, the evaluations used different thresholds to determine whether treatment with trastuzumab was cost-effective as well as differences in modeling costs, outcomes and treatment regimens. The use of trastuzumab, alone or associated, was cost-effective as treatment of 1st line, unlike when used as 2nd line. Differences were found in the quality of the included studies. Conducting new cost-effectiveness analyses of trastuzumab in metastatic breast cancer, allied to political, social and administrative factors, which helps decision makers about its incorporation, is required

Submitted by Biblioteca da Faculdade de Farmácia (bff@ndc.uff.br) on 2017-03-28T17:15:31Z No. of bitstreams: 1 Andrade, Thays Santos de [Dissertação, 2014].pdf: 467886 bytes, checksum: 9f9c6acd0d2516bb655fb10868b2db29 (MD5) / Made available in DSpace on 2017-03-28T17:15:31Z (GMT). No. of bitstreams: 1 Andrade, Thays Santos de [Dissertação, 2014].pdf: 467886 bytes, checksum: 9f9c6acd0d2516bb655fb10868b2db29 (MD5) / O câncer de mama é o tipo que mais acomete as mulheres em todo o mundo. Aproximadamente 30-50% dos pacientes diagnosticados nos estágios iniciais desenvolverão doença metastática, considerada incurável. Nesta fase da doença, as terapias objetivam prolongar a sobrevida e proporcionar controle paliativo dos sintomas. O trastuzumabe, um anticorpo monoclonal dirigido contra o receptor do fator de crescimento epidérmico humano (HER2), vem aumentando as taxas de respostas, sobrevida livre de progressão e/ou sobrevida global no câncer de mama, tendo sido recentemente incorporado pelo Sistema Único de Saúde (SUS) para tratamento de câncer de mama inicial e localmente avançado. O objetivo deste trabalho foi realizar uma revisão sistemática de avaliações de custo-efetividade do trastuzumabe em pacientes com câncer de mama metastático com superexpressão de HER2. Foram realizadas buscas, entre o período de 1998 a 2013, em seis bases de dados eletrônicas, duas ferramentas de busca na internet, além de pesquisa manual de referências. Foram considerados artigos em inglês, espanhol e português, sendo excluídos comentários, editoriais, cartas, estudos de caso, artigos de revisão, revisões sistemáticas e metanálises. As etapas de seleção dos estudos e extração dos dados foram realizadas por dois revisores independentes, e dúvidas foram resolvidas por um terceiro revisor. Os estudos foram avaliados em relação à qualidade seguindo abordagens empregadas por Teerawattananon et al. (2007). A análise dos dados foi realizada a partir da conversão dos custos e de observações das razões incrementais de custo-efetividade do trastuzumabe. Foram identificados 521 estudos, todos em inglês. Destes, descartou-se 455 (294 por não atenderem os critérios da revisão e 161 duplicatas). Sessenta e seis estudos foram incluídos para leitura dos resumos, resultando em 24 para leitura completa do texto. No total, 13 estudos compuseram esta revisão. Os esquemas terapêuticos adotados nas análises de custo-efetividade foram variados. Oito estudos compararam o tratamento do trastuzumabe como 1ª linha para doença metastática e cinco estudos como 2ª linha, sendo que três destes utilizaram o trastuzumabe como comparador na avaliação econômica e não como intervenção. Todos os estudos que utilizaram o trastuzumabe como 2ª linha de tratamento, não consideraram a intervenção custo-efetiva. Em relação à qualidade dos estudos incluídos, estes apresentaram uma boa qualidade, visto que a maioria cumpriu as diretrizes metodológicas de avaliação de custo-efetividade e utilizaram boas evidências na estimativa dos parâmetros. Finalmente, as análises utilizaram diferentes limiares para determinar se o tratamento com o trastuzumabe foi custo-efetivo, bem como diferenças na modelagem dos custos, desfechos e padrões de tratamento. O uso de trastuzumabe, associado ou não, foi custo-efetivo como tratamento de 1ª linha, diferentemente de quando usado como 2ª linha. Foram encontradas diferenças quanto à qualidade dos estudos incluídos. É necessária a realização de novas avaliações de custo-efetividade do trastuzumabe no câncer de mama metastático que, aliadas a fatores administrativos, sociais e políticos, embasem os gestores na tomada de decisão quanto à sua incorporação / Breast cancer is the type that affects more women worldwide. Approximately 30-50 % of patients diagnosed in the early stages will develop metastatic disease, which is considered incurable. At this stage of the disease, therapies aimed prolong survival and provide palliative symptom control. Trastuzumab, a monoclonal antibody targeted to the receptor of the human epidermal growth factor (HER2), has increased response rates, progression-free survival and/or overall survival in breast cancer and has recently been incorporated by the Sistema Único de Saúde (SUS) for treatment of early and locally advanced breast cancer. The aim of this study was to conduct a systematic review of the cost-effectiveness analyses of trastuzumab in patients with metastatic breast cancer overexpressing HER2. Searches were conducted between the period 1998-2013, on six electronic databases, two generic searches on the Internet, as well as manual search of references. We considered articles in English, Spanish and Portuguese, being excluded reviews, editorials, letters, case studies, review articles, systematic reviews and meta-analyses. The stages of study selection and data extraction were performed by two independent reviewers, and doubts were resolved by one third reviewer. Studies were assessed for quality according to approaches employed by Teerawattananon et al (2007). Data analysis was performed from the conversion of the costs and comments of the incremental cost-effectiveness ratios of trastuzumab were made. A quantity of 521 studies, all in English, was identified. Of these, we discarded 455 (294 did not meet the criteria for review and 161 duplicates). Sixty-six studies were included for reading the abstracts, resulting in 24 to read the full text. In total, 13 studies composed this review. The treatment regimens adopted on cost-effectiveness evaluations were varied. Eight studies compared the treatment of trastuzumab as 1st line for metastatic disease and five studies as 2nd line, which three of these used trastuzumab as comparator in the economic evaluation and not as an intervention. All studies using trastuzumab as 2nd line treatment did not consider it as a cost-effective intervention. Regarding the quality of the included studies, they showed a good quality, since most fulfilled the methodological guidelines for assessing costeffectiveness and used good evidence in the estimation of parameters. Finally, the evaluations used different thresholds to determine whether treatment with trastuzumab was cost-effective as well as differences in modeling costs, outcomes and treatment regimens. The use of trastuzumab, alone or associated, was cost-effective as treatment of 1st line, unlike when used as 2nd line. Differences were found in the quality of the included studies. Conducting new cost-effectiveness analyses of trastuzumab in metastatic breast cancer, allied to political, social and administrative factors, which helps decision makers about its incorporation, is required