This critical review of the literature assembles and compares available data on breast cancer clinical stage, time intervals to care, and access barriers in different countries. It provides evidence that while more th...This critical review of the literature assembles and compares available data on breast cancer clinical stage, time intervals to care, and access barriers in different countries. It provides evidence that while more than 70% of breast cancer patients in most high-income countries are diagnosed in stages Ⅰ and Ⅱ, only 20%-50% patients in the majority of low- and middleincome countries are diagnosed in these earlier stages. Most studies in the developed world show an association between an advanced clinical stage of breast cancer and delays greater than three months between symptom discovery and treatment start. The evidence assembled in this review shows that the median of this interval is 30-48 d in high-income countries but 3-8 mo in low- and middle-income countries. The longest delays occur between the first medical consultation and the beginning of treatment, known as the provider interval. The little available evidence suggests that access barriers and quality deficiencies in cancer care are determinants of provider delay in low- and middle-income countries. Research on specific access barriers and deficiencies in quality of care for the early diagnosis and treatment of breast cancer is practically non-existentin these countries, where it is the most needed for the design of cost-effective public policies that strengthen health systems to tackle this expensive and deadly disease.展开更多
Forest managers and policy makers increasingly demand to have access to estimates of forest fragmentation, human accessibility to forest areas and levels of anthropogenic pressure on the remaining forests to integrate...Forest managers and policy makers increasingly demand to have access to estimates of forest fragmentation, human accessibility to forest areas and levels of anthropogenic pressure on the remaining forests to integrate them into monitoring systems, management and conservation plans. Forest fragmentation is defined as the breaking up of a forest unit, where the number of patches and the amount of expose edge increase while the amount of core area decreases. Forest fragmentation studies in Mexico have been limited to local or regional levels and have concen- trated only on specific forest types. This paper presents an assessment of the fragmentation of all forest types at the national level, their effective proximity to anthropogenic influences, and the development of an indica- tor of anthropogenic pressure on the forests areas. Broadleaf forests, tropical evergreen forests and tropical dry deciduous forests show the greatest fragmentation. Almost half （47%） of the tropical forests are in close effective proximity to anthropogenic influences and only 12% of their area can be considered isolated from anthropogenic influences. The values for the temperate forests are 23% and 29% respectively. Anthro- pogenic pressure in the immediate vicinity of anthropogenic activities is much higher in the tropical forests （75 in a scale 0-100） than in the tem- perate forests （30）. When considering these results jointly, the tropical forests, and more specifically, the tropical evergreen forests and tropical dry deciduous forests are under the greatest pressure and risks of degra- dation.展开更多
This paper presents assessments of the fragmentation of the temperate and tropical forests in Mexico at the national level for two dates 1993 and 2002.The study was based on land use and vegetation cover data sets sca...This paper presents assessments of the fragmentation of the temperate and tropical forests in Mexico at the national level for two dates 1993 and 2002.The study was based on land use and vegetation cover data sets scale 1：250,000.Two broad forest types（Temperate Forests and Tropical Forests） and five more specific forest types（Broadleaf Forests,and Coniferous Forests;Tropical Dry Deciduous Forests,Tropical Sub-evergreen Forests,and Tropical Evergreen Forests） were defined to conduct the analyses.FragStats 3.3 was used to estimate nine metrics of the spatial pattern of the forests for each forest type and date considered.The results indicate that the land cover transitions that have occurred between 1993 and 2002 have resulted in more isolated forest patches with simpler shapes in both the Temperate and Tropical Forests.The remaining Tropical Forest patches have become smaller and more numerous.In contrast,the remaining Temperate Forest patches are fewer and on average larger.Of the more specific forest types defined in this study,the Broadleaf Forests have the highest indicators of fragmentation.However these forests are usually embedded or adjacent to Coniferous Forests.Of more concern for conservation purposes are the high values of fragmentation metrics found for the Tropical Evergreen Forests and Tropical Dry Deciduous Forests,because these forest types are usually surrounded by non-forest land covers or anthropogenic land uses.展开更多
文摘This critical review of the literature assembles and compares available data on breast cancer clinical stage, time intervals to care, and access barriers in different countries. It provides evidence that while more than 70% of breast cancer patients in most high-income countries are diagnosed in stages Ⅰ and Ⅱ, only 20%-50% patients in the majority of low- and middleincome countries are diagnosed in these earlier stages. Most studies in the developed world show an association between an advanced clinical stage of breast cancer and delays greater than three months between symptom discovery and treatment start. The evidence assembled in this review shows that the median of this interval is 30-48 d in high-income countries but 3-8 mo in low- and middle-income countries. The longest delays occur between the first medical consultation and the beginning of treatment, known as the provider interval. The little available evidence suggests that access barriers and quality deficiencies in cancer care are determinants of provider delay in low- and middle-income countries. Research on specific access barriers and deficiencies in quality of care for the early diagnosis and treatment of breast cancer is practically non-existentin these countries, where it is the most needed for the design of cost-effective public policies that strengthen health systems to tackle this expensive and deadly disease.
文摘Forest managers and policy makers increasingly demand to have access to estimates of forest fragmentation, human accessibility to forest areas and levels of anthropogenic pressure on the remaining forests to integrate them into monitoring systems, management and conservation plans. Forest fragmentation is defined as the breaking up of a forest unit, where the number of patches and the amount of expose edge increase while the amount of core area decreases. Forest fragmentation studies in Mexico have been limited to local or regional levels and have concen- trated only on specific forest types. This paper presents an assessment of the fragmentation of all forest types at the national level, their effective proximity to anthropogenic influences, and the development of an indica- tor of anthropogenic pressure on the forests areas. Broadleaf forests, tropical evergreen forests and tropical dry deciduous forests show the greatest fragmentation. Almost half （47%） of the tropical forests are in close effective proximity to anthropogenic influences and only 12% of their area can be considered isolated from anthropogenic influences. The values for the temperate forests are 23% and 29% respectively. Anthro- pogenic pressure in the immediate vicinity of anthropogenic activities is much higher in the tropical forests （75 in a scale 0-100） than in the tem- perate forests （30）. When considering these results jointly, the tropical forests, and more specifically, the tropical evergreen forests and tropical dry deciduous forests are under the greatest pressure and risks of degra- dation.
文摘This paper presents assessments of the fragmentation of the temperate and tropical forests in Mexico at the national level for two dates 1993 and 2002.The study was based on land use and vegetation cover data sets scale 1：250,000.Two broad forest types（Temperate Forests and Tropical Forests） and five more specific forest types（Broadleaf Forests,and Coniferous Forests;Tropical Dry Deciduous Forests,Tropical Sub-evergreen Forests,and Tropical Evergreen Forests） were defined to conduct the analyses.FragStats 3.3 was used to estimate nine metrics of the spatial pattern of the forests for each forest type and date considered.The results indicate that the land cover transitions that have occurred between 1993 and 2002 have resulted in more isolated forest patches with simpler shapes in both the Temperate and Tropical Forests.The remaining Tropical Forest patches have become smaller and more numerous.In contrast,the remaining Temperate Forest patches are fewer and on average larger.Of the more specific forest types defined in this study,the Broadleaf Forests have the highest indicators of fragmentation.However these forests are usually embedded or adjacent to Coniferous Forests.Of more concern for conservation purposes are the high values of fragmentation metrics found for the Tropical Evergreen Forests and Tropical Dry Deciduous Forests,because these forest types are usually surrounded by non-forest land covers or anthropogenic land uses.
