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Objective. To describe the medicine procurement activities of the PAHO Strategic Fund. Method. This is a retrospective study covering the period from 2004 to 2007, based on a bibliographic and document survey of Pan American Health Organization (PAHO) archives in the United States, El Salvador, Guatemala, Honduras, and Brazil. The volume of resources and the types of drugs procured by the fund were determined for the years 2004, 2005, and 2006 and for the period of January to September 2007. Results. The survey revealed a well-structured fund handling increasing resources, from US$ 3 475 043.00 in 2004 to US$ 19 646 634.00 in 2007 (January to September). The participation of antiretroviral drugs in this expenditure has grown from less than 8% of the total in 2004 to 57.89% in 2007. Still, in 2007, 66.63% of the financial resources managed by the Strategic Fund were allocated to the purchase of antiretroviral drugs for nine countries (Brazil, Guatemala, El Salvador, Ecuador, Honduras, Haiti, Belize, Nicaragua, and Bolivia) out of a total of 17 participating countries. Brazil was the country using the most resources through the Strategic Fund, accounting for 63% of the expenditure for the purchase of strategic supplies between January and September 2007. Conclusion. The proposal to unify the purchase of medications for all participating countries to improve pricing and purchasing management will result in large-scale savings. The Strategic Fund can contribute to increasing access to medicines and improving the management of the public health care system in Latin America. [ABSTRACT FROM AUTHOR]

Objective. To survey the literature regarding climate-sensitive diseases (CSD) and the impacts of climate changes on health. Method. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The Lilacs, SciELO, Scopus, and PubMed databases were searched in July 2017 without temporal restrictions for articles published in in Portuguese, English and Spanish. The following search strategy was used in all databases: (climate) AND (disease) AND (sensitive). Results. The systematic review included 106 articles, most of which focused on dengue, malaria, and respiratory and cardiovascular diseases. The most commonly studied climate variables were temperature and precipitation. The studies revealed a relationship between the incidence of certain diseases, especially cardiovascular and respiratory diseases, dengue, malaria, and arboviral diseases, and climate conditions in different regions of the world. This relationship was analyzed considering both past data on the incidence of diseases and climate variables and projections regarding the future incidence of diseases according to expected climate variations. A greater number of studies was performed by authors originating from developed countries. The world regions most often studied were China, the United States, Australia, and Brazil. Conclusions. Despite the increase in the number of published articles on this theme, a greater number of climate and environmental variables must be studied, with expansion of studies to additional regions in the world. [ABSTRACT FROM AUTHOR]

Objective. To synthesize and critically review the literature on interventions aimed at decreasing the burden of stroke survivor caregivers and other associated factors. Method. The literature search for the present systematic review was performed in PubMed, SciELO, Coordination for the Improvement of Higher Education Personnel (CAPES) website, and the Virtual Health Library using the following search terms: Stroke AND Caregivers AND Intervention; and Stroke AND Caregivers AND clinical trial. Eight randomized controlled clinical trials (RCT) published between 2008 and 2017 were selected. Results. The selected studies were performed in Sweden, Taiwan, Germany, China, India, and the United States. Psychoeducational, support, and skill acquisition interventions produced positive results for caregivers -- in the psychological, physical, and social domains, in the quality of the care provided, and in the acquisition of knowledge by caregivers -- and for stroke survivors -- for example, decreased use of health care services and improved capacity for self-care. The critical evaluation of the studies showed that none met all the methodological requirements for RCTs. The main limitations were missing data and the heterogeneity of interventions. Conclusion. The interventions had positive results for caregivers and survivors. However, future studies should consider long term assessments of the outcomes, with detailed description of the baseline needs that guided the study and the sharing of the support materials used to allow the intervention to be reproduced. [ABSTRACT FROM AUTHOR]