Questões de Inglês

TEXT 

 

  The global mortality rate for children younger than 5 has dropped by nearly half since 1990, the United Nations said Tuesday in an annual report on progress aimed at ensuring child survival, but the decline still falls short of meeting the organization’s goal of a two-thirds reduction by next year. Without accelerated improvements in reducing health risks to young children, the report said, that goal will not be reached until 2026, 11 years behind schedule. 

  Nearly all of the countries with the highest mortality rates are in Africa, the report said, and two countries that are among the world’s most populous — India and Nigeria — account for nearly a third of all deaths among children younger than 5.

  A collaboration of Unicef, other United Nations agencies and the World Bank, the report provides a barometer of health care and nutrition in every country. A child mortality rate can be a potent indicator of other elements in a country’s basic quality of life.

  The report showed that the mortality rate for children younger than 5, the most vulnerable period, fell to 46 deaths per 1,000 live births last year, from 90 per 1,000 births in 1990. It also showed that the gap in mortality rates between the richest and poorest households had fallen in all regions over most of the past two decades, except for sub-Saharan Africa.

The report attributed much of the progress to broad interventions over the years against leading infectious diseases in some of the most impoverished regions, including immunizations and the use of insecticide-treated mosquito nets, as well improvements in health care to expectant mothers and in battling the effects of diarrhea and other dehydrating maladies that pose acute risks to the young.

  “There has been dramatic and accelerating progress in reducing mortality among children, and the data prove that success is possible even for poorly resourced countries,” Dr. Mickey Chopra, the head of global health programs for Unicef, said in a statement about the report’s conclusions.

  Geeta Rao Gupta, Unicef’s deputy executive director, said, “The data clearly demonstrate that an infant’s chances of survival increase dramatically when their mother has sustained access to quality health care during pregnancy and delivery.” 

  Despite the advances, from 1990 and 2013, 223 million children worldwide died before their fifth birthday, a number that the report called “staggering.” In 2013, the report said, 6.3 million children younger than 5 died, 200,000 fewer than the year before. Nonetheless, that is still the equivalent of about 17,000 child deaths a day, largely attributable to preventable causes that include insufficient nutrition; complications during pregnancy, labor and delivery; pneumonia; diarrhea; and malaria.

  While sub-Saharan Africa has reduced the under-5 mortality rate by 48 percent since 1990, the report said, the region still has the world’s highest rate: 92 deaths per 1,000 live births, nearly 15 times the average in the most affluent countries. Put another way, the report said, children born in Angola, which has the world’s highest rate — 167 deaths per 1,000 live births — are 84 times as likely to die before they turn 5 as children born in Luxembourg, with the lowest rate — two per 1,000.

  The report noted that “a child’s risk of dying increases if she or he is born in a remote rural area, into a poor household or to a mother with no education.”

From: www.nytimes.com Sept. 16, 2014

 

Although the United Nations annual report shows mortality rate for children under 5 has dropped considerably worldwide, it is crucial to note that 

TEXT:

 

Responding to Ebola: The View From the FDA

Laurie Scudder, DNP, NP, Luciana Borio, MD

Disclosures August 20, 2014 

WHO Backs Use of Experimental Treatments for Ebola

U.S. Emergency Labs Ready to Work on Ebola Drugs If Asked

Keeping Ebola in Check: Advice From the CDC

 

DRUG & REFERENCE INFORMATION

 

Editor's Note: The issue of compassionate use of unapproved therapies has been brought to the attention of all healthcare providers recently after the decision to treat 2 Americans infected with the Ebola virus with an experimental serum never before used in humans. With the Ebola epidemic deemed to be out of control by the World Health Organization (WHO), the need for effective treatments has researchers and regulators scrambling to find, test, and potentially approve previously untested therapies.

 

In a press release in August, WHO discussed the ethics of using Ebola drugs that have never been cleared for human use, wary of a long history of medicines being tested on people who were never properly informed of the risks. In the countries hardest hit by Ebola, suspicion of foreign medical workers is already widespread.

 

Medscape spoke with Luciana Borio, MD, at the US Food and Drug Administration (FDA) about the issue of compassionate use and their efforts to respond to this crisis. Dr. Borio serves as the Acting Deputy Chief Scientist and Assistant Commissioner for Counterterrorism Policy in the Office of Counterterrorism and Emerging Threats at the FDA. In this capacity, Dr. Borio is responsible for providing leadership, coordination, and oversight for FDA's national and global health security, counterterrorism, and emerging threat portfolios. 

 

She serves as FDA's point of entry on policy and planning matters concerning counterterrorism and emerging threats, and collaborates across the US government and internationally on actions to advance global health security and US national security. 

 

Medscape: Can you define "compassionate use" as a regulatory and legal concept?

Luciana Borio, MD:  I'd like to begin by taking a step back. Ultimately, the goal for the FDA is to have products that are approved, licensed, or cleared to prevent or treat diseases. However, during a public health emergency, such as the one we are currently facing with Ebola, we don't always have these approved products available, and the best way for us to meet patients' needs might be the use of an unapproved product. 

 

FDA has mechanisms that we can use to facilitate patient access to investigational products; one of these is the Emergency Investigational New Drug (IND) application, often referred to as "compassionate use." It is one of a number of mechanisms under our expanded access program. 

 

Through this emergency IND mechanism, we can allow the use of an investigational product outside of a clinical trial being conducted to develop the product toward approval, in order to treat a patient with a serious or immediately life-threatening disease when the patient has no comparable or satisfactory alternative treatment option.

 

To evaluate a request for an emergency IND, we have to assess whether the benefits outweigh the risks on the basis of the best available scientific evidence that we have because, clearly, the data package at this point is often quite incomplete. The product may be effective or may not, and we also may see sometimes unexpected serious side effects. Sometimes we don't know exactly what is the most appropriate dose, for example, to give to a sick patient. We have only incomplete information about the use of these products, but we do the best we can to conduct a proper benefit/risk assessment with the available scientific data.

 

Under this mechanism, it is usually the patient's clinician who contacts the FDA requesting the emergency IND or compassionate use exemption. If, after an evaluation of the application, FDA believes the use is appropriate, the doctor will then make arrangements directly with the product developer to obtain the product. The manufacturer may or may not be willing to make the product available outside of the clinical trial, and FDA cannot compel the company to do so. So when the company provides expanded access to its product, it is doing so voluntarily.

http://www.medscape.com/viewarticle/829611 (Accessed on August 25th, 2014, edited) 

 

The discussion in the present text was triggered by the

Hillary Clinton set to announce presidential run this weekend

Fri, Apr 10, 2015

 

Latest poll shows Clinton is only slightly ahead of some Republican contenders

Hillary Clinton’s campaign is expected to concentrate on making the 67-year-old former first lady relatable to ordinary Americans.

 

Hillary Clinton is expected to announce her campaign for the Democratic US presidential nomination in 2016 as early as this weekend, facing no substantial competition but needing to get her organisation in place for the long battle to come.

 

A variety of sources in the Clinton orbit said they were anticipating an imminent announcement but would not confirm a report in the New York Daily News that the announcement was expected on Sunday.

 

Ms Clinton is likely to make her intentions known through a social media announcement followed by campaign travel. This focus on digital communications is an attempt to connect with young voters, who Ms Clinton needs to become American’s first woman president.

 

In her previous presidential run in 2008, Ms Clinton lost to the current president, Barack Obama, in part because of the Obama campaign’s clever use of social media to draw attention to his candidacy and raise huge sums through small donations.

 

Her campaign is expected to concentrate on making the 67-year-old former first lady relatable to ordinary Americans. Ms Clinton spent four years jetting to foreign capitals as Obama’s first-term secretary of state but has had limited day-to-day contact with everyday Americans.

 

Ms Clinton, the wife of former president Bill Clinton, is the overwhelming favourite for the Democratic nomination and no other major Democratic figure has stepped forward to challenge her, although former Maryland Governor Martin O’Malley has made moves toward a possible campaign.

 

But Ms Clinton’s biggest obstacle may be overcoming her own image.

 

She has struggled to get past accusations that she might be too secretive based on the revelation earlier this year that she had gone against federal recommendations to use an official email account while at the State Department and instead used her own private server.

 

A Quinnipiac University poll released this week had the surprising result that she was even or only slightly ahead of some Republican contenders like libertarian Senator Rand Paul of Kentucky.

 

Most polls in recent months have shown her with a substantial lead over the Republican 2016 field.

THE IRISH TIMES. Available on: http://www.irishtimes.com/ news/world/us/hillary-clinton-set-to-announce-presidential-runthis-weekend-1.2171301. Access on: May 15 2015.

According to the polls,  

Hillary Clinton set to announce presidential run this weekend

Fri, Apr 10, 2015

 

Latest poll shows Clinton is only slightly ahead of some Republican contenders

Hillary Clinton’s campaign is expected to concentrate on making the 67-year-old former first lady relatable to ordinary Americans.

 

Hillary Clinton is expected to announce her campaign for the Democratic US presidential nomination in 2016 as early as this weekend, facing no substantial competition but needing to get her organisation in place for the long battle to come.

 

A variety of sources in the Clinton orbit said they were anticipating an imminent announcement but would not confirm a report in the New York Daily News that the announcement was expected on Sunday.

 

Ms Clinton is likely to make her intentions known through a social media announcement followed by campaign travel. This focus on digital communications is an attempt to connect with young voters, who Ms Clinton needs to become American’s first woman president.

 

In her previous presidential run in 2008, Ms Clinton lost to the current president, Barack Obama, in part because of the Obama campaign’s clever use of social media to draw attention to his candidacy and raise huge sums through small donations.

 

Her campaign is expected to concentrate on making the 67-year-old former first lady relatable to ordinary Americans. Ms Clinton spent four years jetting to foreign capitals as Obama’s first-term secretary of state but has had limited day-to-day contact with everyday Americans.

 

Ms Clinton, the wife of former president Bill Clinton, is the overwhelming favourite for the Democratic nomination and no other major Democratic figure has stepped forward to challenge her, although former Maryland Governor Martin O’Malley has made moves toward a possible campaign.

 

But Ms Clinton’s biggest obstacle may be overcoming her own image.

 

She has struggled to get past accusations that she might be too secretive based on the revelation earlier this year that she had gone against federal recommendations to use an official email account while at the State Department and instead used her own private server.

 

A Quinnipiac University poll released this week had the surprising result that she was even or only slightly ahead of some Republican contenders like libertarian Senator Rand Paul of Kentucky.

 

Most polls in recent months have shown her with a substantial lead over the Republican 2016 field.

THE IRISH TIMES. Available on: http://www.irishtimes.com/ news/world/us/hillary-clinton-set-to-announce-presidential-runthis-weekend-1.2171301. Access on: May 15 2015.

The text shows that in a former campaign Hillary Clinton lost the candidacy to the current president partly because

Hillary Clinton set to announce presidential run this weekend

Fri, Apr 10, 2015

 

Latest poll shows Clinton is only slightly ahead of some Republican contenders

Hillary Clinton’s campaign is expected to concentrate on making the 67-year-old former first lady relatable to ordinary Americans.

 

Hillary Clinton is expected to announce her campaign for the Democratic US presidential nomination in 2016 as early as this weekend, facing no substantial competition but needing to get her organisation in place for the long battle to come.

 

A variety of sources in the Clinton orbit said they were anticipating an imminent announcement but would not confirm a report in the New York Daily News that the announcement was expected on Sunday.

 

Ms Clinton is likely to make her intentions known through a social media announcement followed by campaign travel. This focus on digital communications is an attempt to connect with young voters, who Ms Clinton needs to become American’s first woman president.

 

In her previous presidential run in 2008, Ms Clinton lost to the current president, Barack Obama, in part because of the Obama campaign’s clever use of social media to draw attention to his candidacy and raise huge sums through small donations.

 

Her campaign is expected to concentrate on making the 67-year-old former first lady relatable to ordinary Americans. Ms Clinton spent four years jetting to foreign capitals as Obama’s first-term secretary of state but has had limited day-to-day contact with everyday Americans.

 

Ms Clinton, the wife of former president Bill Clinton, is the overwhelming favourite for the Democratic nomination and no other major Democratic figure has stepped forward to challenge her, although former Maryland Governor Martin O’Malley has made moves toward a possible campaign.

 

But Ms Clinton’s biggest obstacle may be overcoming her own image.

 

She has struggled to get past accusations that she might be too secretive based on the revelation earlier this year that she had gone against federal recommendations to use an official email account while at the State Department and instead used her own private server.

 

A Quinnipiac University poll released this week had the surprising result that she was even or only slightly ahead of some Republican contenders like libertarian Senator Rand Paul of Kentucky.

 

Most polls in recent months have shown her with a substantial lead over the Republican 2016 field.

THE IRISH TIMES. Available on: http://www.irishtimes.com/ news/world/us/hillary-clinton-set-to-announce-presidential-runthis-weekend-1.2171301. Access on: May 15 2015.

The text states that Hillary Clinton

STICKERNOMICS

Football albums

Got, got, got, got, got, need  

 

[1]   THE World Cup is still two weeks away, but for children worldwide (plus disturbing numbers of adults)  

the race to complete the Brazil 2014 sticker book started long ago. Panini, an Italian firm, has produced  

sticker albums for World Cups since Mexico 1970; this year’s version has 640 stickers to collect. Collecting  

them is no idle pursuit, however. Getting every slot filled delivers an early lesson in probability, the value of  

[5] statistical tests and the importance of liquidity.  

  When you start an album, your first sticker (in Britain, they come in packs of five) has a 640/640  

probability of being needed. As the spaces get filled, the odds of opening a pack and finding a sticker you  

want fall. According to Sylvain Sardy and Yvan Velenik, two mathematicians at the University of Geneva, the  

number of sticker packs that you would have to buy on average to fill the album by mechanically buying pack  

[10] after pack would be 899. That assumes there is no supply shock to the market (the theft of hundreds of 

thousands of stickers in Brazil in April left many fearful that Panini would run short of cards).  

  It also assumes that the market is not being rigged. Panini says that each sticker is printed in the same  

volumes and randomly distributed. In a 2010 paper Messrs Sardy and Velenik gamely played the role of  

“regulator” by checking the distribution of stickers for a 660-sticker album sold in Switzerland for that year’s  

[15] World Cup. Out of their sample of 6,000 stickers, they expected to see each sticker 9.09 times on average  

(6,000/660), which was broadly borne out in practice.  

  Even in a fair market, it is inefficient to buy endless packs as an individual (not to mention bloody  

expensive for the parents). The answer is to create a market for collectors to swap their unwanted stickers.  

The playground is one version of this market, where a child who has a card prized by many suddenly  

[20] understands the power of limited supply. Sticker fairs are another. As with any market, liquidity counts. The  

more people who can be attracted into the market with their duplicate cards, the better the chances of finding  

the sticker you want.  

  Messrs Sardy and Velenik reckon that a group of ten astute sticker-swappers would need a mere  

1,435 packs between them to complete all ten albums, if they take advantage of Panini’s practice of selling  

[25] the final 50 missing stickers to order. Internet forums, where potentially unlimited numbers of people can  

swap stickers, make this number fall even further. The idea of a totally efficient market should dismay Panini,  

which will sell fewer packs as a result. But as in all markets, behaviour is not strictly rational. Despite  

entreaties, your correspondent’s son is prepared to tear out most of his stickers to get hold of Lionel Messi.  

Fonte: http://www.economist.com/news/finance-and-economics/21603019-got-got-got-got-got-need-stickernomics Acesso: 13/ago/2014 

 

Em “Despite entreaties, your correspondent’s son is prepared to tear out most of his stickers to get hold of Lionel Messi” (linhas 27 e 28), depreende-se que o autor