Correlates of human immunodeficiency virus cervicovaginal shedding among postmenopausal and fertile-aged women

Objective: The aims of this study were to compare the intensity of human immunodeficiency virus (HIV)-RNA genital shedding among postmenopausal (PM) and fertile-aged (F) women and to investigate the association between viral shedding and gynecological features, HIV plasma viral loads, and other markers of HIV disease progression. Methods: We interviewed 146 HIV-infected women (73 PM/73 F) in search of gynecological complaints and signs and symptoms of HIV disease and obtained additional information concerning HIV infection by medical chart review. Cervicovaginal lavages (CVLs) were collected for assessment of HIV shedding. Laboratory analyses included CD4(+) cell counts, HIV-RNA quantitation in plasma and CVL, and screening for concurrent genital infections. Results: HIV-RNA genital shedding was detected in 16.4% of PM and 21.9% of F women (P = 0.400), and the intensity of HIV shedding did not differ between both groups (means-PM: 1.4log/mL; F: 1.4log/mL; P = 0.587). Three women (2 PM/1 F) exhibited viral shedding in the absence of detectable viremia. HIV plasma viral loads correlated with HIV shedding in both groups. In multivariable analysis, HIV plasma viral loads were independently associated with HIV shedding in both groups. Moreover, the intensity of shedding was independently associated with vaginal pH, tumor necrosis factor a concentrations in CVL, and HIV plasma viral loads. Conclusions: Despite significant changes that occur in the vaginal mucosa of PM women, HIV cervicovaginal shedding was not significantly influenced by this state in our cohort. In contrast, increased vaginal pH and genital inflammation, evidenced by increased tumor necrosis factor alpha concentrations in CVL and HIV plasma viral loads, were independently associated with the intensity of HIV shedding in PM and F women.

A review of the genus Speocarcinus Stimpson, 1859 (Crustacea: Brachyura: Xanthidae), with a key to its species and the description of one new species

Speocarcinus dentatus n. sp. is described from the southwestern Atlantic. The new species can be easily separated from its congeners by a suite of carapace and appendage characters. Speocarcinus Stimpson, 1859, now includes eight extant species, all from the Atlantic or Pacific coasts of the Americas. Additional characters to further differentiate between S. carolinensis Stimpson, 1859, and S. lobatus Guinot, 1969, and between S. granulimanus Rathbun, 1894, and S. spinicarpus Guinot, 1969 are documented. The lectotype of S. granulimanus is first described and a key to the species of Speocarcinus is provided.

Planejamento e déficit habitacional: estudo de caso a partir do cadúnico com beneficiários do programa bolsa família na zona norte de Natal

This research aims to analyze the housing conditions and socioeconomic of beneficiaries of the Bolsa Família Program – PBF of the North side of Natal city. For that, it is necessary a survey of this region's origins and how its expansion has occurred in the context of local urban development, considering demographic evolution, in particular, from the construction of housing complex and formal and informal allotments. From the field research, consisting of a pilot in loco with some households, it became possible to start the analysis of housing conditions that culminated with a detailed study of the Single Register form of the federal Government (CadÚnico), in relation to 100% (one hundred percent) of the beneficiaries of the Bolsa Familia program (PBF) of Natal city, with qualitative and quantitative information. From this general survey, a cut was done, contemplating only beneficiaries residing in the north of the city. To better understand this reality, the survey found the Brazilian housing deficit, considering its origins, historical contexts and concepts used by the following institutions: João Pinheiro Foundation (FJP), Brazilian Institute of Geography and Statistics (IBGE), Applied Economics Research Institute (IPEA), and Local Plan Housing of Social Interested (PLHIS) and the United Nations Centre for Human Settlements (UN-HABITAT). Furthermore, were compared the various concepts of city and its respective evolution, considering the importance of planning as an instrument of public policy necessary to governmental actions and permanent policy of State. As a result, there are a detach about the deficit and housing conditions in the city of Natal, mainly North Zone, pointing out the importance of using the Unified Register of the federal government as an effective tool to measure the living conditions of Brazilian municipalities.

Consórcio público regional de resíduos sólidos do Seridó/RN: perspectivas de um novo modelo de gestão

The problem of solid waste that involves the management, the management and the allocation of these is an issue that permeates all spheres of society, which denotes environmental implications that contribute to the discussion of the environmental crisis in progress. From this perspective, this study aims to investigate and understand the role that consortia, especially the Regional Public Waste Consortium Solid Seridó/RN have waste management, in order to observe their strengths and weaknesses in order to conclude whether they are an appropriate solution to the problem of solid waste. In studying a region that is undergoing a process of institutional organization guided in the solid waste, the focus turned into an interesting academic research point. Since this is a qualitative research, readings were taken of relevant authors to the object and the following legal frameworks, namely: the National Basic Sanitation Policy (Law nº 11.445/2007), the National Policy on Solid Waste (Law nº 12.305/2010 ) and the Law on Public Consortia (Law nº 11.107/2005). The consortium region has about 290.000 inhabitants, generated 40.000 tons of waste a year. As for the final disposal of waste, all municipalities in the region deposit their waste in the open, or in garbage dumps. In the analysis of the Consortium Seridó, a list of issues that are hindering their implementation has been identified. The demands come mainly from the political sphere, but also financial, technical and logistical. It is expected that with the realization of the Consortium by building its supporting structures (overfill Station and Landfill), a new model of solid waste management is implemented.

Literacia em saúde, dos dados à ação: tradução, validação e aplicação do European Health Literacy Survey em Portugal

Nos últimos anos, diferentes estudos têm demonstrado que um nível inadequado de literacia em saúde pode ter implicac¸ões significativas nos resultados em saúde, na utilizac¸ão dos servic¸os de saúde e, consequentemente, nos gastos em saúde. O conceito de literacia em saúde evoluiu de uma definic¸ão meramente cognitiva para uma definic¸ão que engloba as componentes pessoal e social do indivíduo, assumindo-se como a capacidade de tomar decisões fundamentadas no seu dia-a-dia. O presente estudo transversal analítico teve como objetivo traduzir e validar para a populac¸ão portuguesa o European Health Literacy Survey (HLS-EU). O HLS-EU-PT foi aplicado em todo o território nacional, incluindo as regiões autónomas, através de investigadores de uma rede académica. A recolha de dados foi realizada por entrevista presencial. A amostra final ficou constituída por 1.004 indivíduos com idades ≥ 16 anos. Este estudo disponibilizou o instrumento de avaliac¸ão do nível de literacia para a saúde em Portugal, tão importante na gestão da saúde. O HLS-EU-PT apresenta-se como um instrumento adequado para aferir o nível de literacia em saúde da populac¸ão portuguesa e evidencia propriedades psicométricas comparáveis às versões utilizadas nos outros países. Em Portugal, 61% da populac¸ão inquirida apresenta um nível de literacia geral em saúde problemático ou inadequado, situando-se a média dos 9 países em 49,2%. Relativamente à dimensão cuidados de saúde, apenas 44,2% apresenta um nível suficiente ou excelente de literacia em saúde. No que respeita à prevenc¸ão da doenc¸a, cerca de 45% dos inquiridos revela ter um nível suficiente ou excelente de literacia em saúde, comparativamente com a média dos 9 países, que nesta dimensão apresenta o valor de 54,5%. Na dimensão promoc¸ão da saúde, 60,2% da populac¸ão auscultada apresenta um nível de literacia em saúde problemático ou inadequado, sendo que a média se situa nos 52,1%. Assim, considera-se fundamental e urgente a conceção e implementação de uma estratégia nacional de literacia em saúde.