Prevalence and vulnerability of homeless people to HIV infection in Sao Paulo, Brazil

OBJECTIVE: To assess the prevalence and vulnerability of homeless people to HIV infection. METHODS: Cross-sectional study conducted with a non-probabilistic sample of 1,405 homeless users of shelters in the city of Sao Paulo, southeastern Brazil, from 2006 to 2007. They were all tested for HIV and a structured questionnaire was applied. Their vulnerability to HIV was determined by the frequency of condom use: those who reported using condoms only occasionally or never were considered the most vulnerable. Multinomial and logistic regression models were used to estimate effect measures and 95% confidence intervals. RESULTS: There was a predominance of males (85.6%), with a mean age of 40.9 years, 72.0% had complete elementary schooling, and 71.5% were non-white. Of all respondents, 15.7% reported being homosexual or bisexual and 62,0% reported having casual sex. The mean number of sexual partners in the last 12 months was 5.4. More than half (55.7%) of the respondents reported lifetime drug use, while 25.7% reported frequent use. Sexually-transmitted disease was reported by 39.6% of the homeless and 38.3% reported always using condoms. The prevalence of HIV infection was 4.9% (17.4% also tested positive for syphilis) and about half of the respondents (55.4%) had access to prevention programs. Higher HIV prevalence was associated with younger age (18-29 years, OR = 4.0 [95% CI 1.54; 10.46]); past history of sexually-transmitted disease (OR = 3.3 [95% CI 1.87; 5.73]); homosexual sex (OR = 3.0 [95% CI 1.28; 6.92]); and syphilis (OR = 2.4 [95% CI 1.13; 4.93]). Increased vulnerability to HIV infection was associated with being female; young; homosexual sex; having few partners or a steady partner; drug and alcohol use; not having access to prevention programs and social support. CONCLUSIONS: The HIV epidemic has a major impact on homeless people reflecting a cycle of exclusion, social vulnerability, and limited access to prevention.

Spatial analysis of the social vulnerability of adolescent pregnancy

The purpose of this study was to present a spatial analysis of the social vulnerability of teenage pregnancy by geoprocessing data on births and deaths present on the Brazilian Ministry of Health databases in order to support intersectoral management actions and strategies based on spatial analysis in neighborhood areas. The thematic maps of the educational, occupational, birth and marital status of mothers, from all births and deaths in the city, presented a spatial correlation with teenage pregnancy. These maps were superimposed to produce social vulnerability map of adolescent pregnancy and women in general. This process presents itself as a powerful tool for the study of social vulnerability.

Extractive summarization using complex networks and syntactic dependency

The realization that statistical physics methods can be applied to analyze written texts represented as complex networks has led to several developments in natural language processing, including automatic summarization and evaluation of machine translation. Most importantly, so far only a few metrics of complex networks have been used and therefore there is ample opportunity to enhance the statistics-based methods as new measures of network topology and dynamics are created. In this paper, we employ for the first time the metrics betweenness, vulnerability and diversity to analyze written texts in Brazilian Portuguese. Using strategies based on diversity metrics, a better performance in automatic summarization is achieved in comparison to previous work employing complex networks. With an optimized method the Rouge score (an automatic evaluation method used in summarization) was 0.5089, which is the best value ever achieved for an extractive summarizer with statistical methods based on complex networks for Brazilian Portuguese. Furthermore, the diversity metric can detect keywords with high precision, which is why we believe it is suitable to produce good summaries. It is also shown that incorporating linguistic knowledge through a syntactic parser does enhance the performance of the automatic summarizers, as expected, but the increase in the Rouge score is only minor. These results reinforce the suitability of complex network methods for improving automatic summarizers in particular, and treating text in general. (C) 2011 Elsevier B.V. All rights reserved.

Rationale and knowledge for the universal implementation of sanitation in areas of social vulnerability

The adoption of principles of equality and universality stipulated in legislation for the sanitation sector requires discussions on innovation. The existing model was able to meet sanitary demands, but was unable to attend all areas causing disparities in vulnerable areas. The universal implementation of sanitation requires identification of the know-how that promotes it and analysis of the model adopted today to establish a new method. Analysis of how different viewpoints on the restructuring process is necessary for the definition of public policy, especially in health, and understanding its complexities and importance in confirming social practices and organizational designs. These are discussed to contribute to universal implementation of sanitation in urban areas by means of a review of the literature and practices in the industry. By way of conclusion, it is considered that accepting a particular concept or idea in sanitation means choosing some effective interventions in the network and on the lives of individual users, and implies a redefinition of the space in which it exercises control and management of sewerage networks, such that connected users are perceived as groups with different interests.

Knowledge as a factor in vulnerability to tuberculosis among nursing students and professionals

The objective of this study was to identify vulnerability to tuberculosis (TB) related to knowledge about the disease among 76 nursing students and professionals. A quantitative descriptive study was conducted using a closed questionnaire for the collection of data regarding transmission, preventive and biosafety measures, diagnosis, and prejudice regarding the disease. The SAS software version 9.1.3 was used for data analysis, with the level of significance set at 5% (p < 0.05). Nursing students and professionals showed a vulnerability to TB related to knowledge about transmission, preventive and biosafety measures, and diagnosis of the disease. With respect to transmission, vulnerability was higher among nursing professionals. The results indicate the need for investment by healthcare institutions surrounding this topic in view of the important role of nursing in the establishment of strategies for prevention and control of the disease.

Spatio-temporal patterns of tuberculosis incidence in Ribeirao Preto, State of Sao Paulo, southeast Brazil, and their relationship with social vulnerability: a Bayesian analysis

Introduction: The purpose of this ecological study was to evaluate the urban spatial and temporal distribution of tuberculosis (TB) in Ribeirao Preto, State of Sao Paulo, southeast Brazil, between 2006 and 2009 and to evaluate its relationship with factors of social vulnerability such as income and education level. Methods: We evaluated data from TBWeb, an electronic notification system for TB cases. Measures of social vulnerability were obtained from the SEADE Foundation, and information about the number of inhabitants, education and income of the households were obtained from Brazilian Institute of Geography and Statistics. Statistical analyses were conducted by a Bayesian regression model assuming a Poisson distribution for the observed new cases of TB in each area. A conditional autoregressive structure was used for the spatial covariance structure. Results: The Bayesian model confirmed the spatial heterogeneity of TB distribution in Ribeirao Preto, identifying areas with elevated risk and the effects of social vulnerability on the disease. We demonstrated that the rate of TB was correlated with the measures of income, education and social vulnerability. However, we observed areas with low vulnerability and high education and income, but with high estimated TB rates. Conclusions: The study identified areas with different risks for TB, given that the public health system deals with the characteristics of each region individually and prioritizes those that present a higher propensity to risk of TB. Complex relationships may exist between TB incidence and a wide range of environmental and intrinsic factors, which need to be studied in future research.

Evaluation of the vulnerability of families assisted in Primary Care in Brazil

Objective: to characterize the profiles of families in the area covered by a Primary Health Center and to identify those in a vulnerable situation. Method: this is an epidemiological, observational, cross-sectional and quantitative study. 320 home visits were made, defined by a random sample of the areas covered by the Urban Center 1 in the city of Sao Sebastiao, in Brazil's Federal District. A structured questionnaire was used for data collection, elaborated based on the Family Development Index (FDI). Results: there was a predominance of young families, women, and low levels of schooling. The FDI permitted the identification of families in situations of "high" and "very high" vulnerability. The most critical dimensions were: "access to knowledge" and "access to work". Conclusion: the study indicated the importance of greater investments in the areas of education, work and income, and highlighted the need for the use of a wider concept of vulnerability by the health services.

Root niche separation can explain avoidance of seasonal drought stress and vulnerability of overstory trees to extended drought in a mature Amazonian forest

Large areas of Amazonian evergreen forest experience seasonal droughts extending for three or more months, yet show maximum rates of photosynthesis and evapotranspiration during dry intervals. This apparent resilience is belied by disproportionate mortality of the large trees in manipulations that reduce wet season rainfall, occurring after 2-3 years of treatment. The goal of this study is to characterize the mechanisms that produce these contrasting ecosystem responses. A mechanistic model is developed based on the ecohydrological framework of TIN (Triangulated Irregular Network)-based Real Time Integrated Basin Simulator + Vegetation Generator for Interactive Evolution (tRIBS+VEGGIE). The model is used to test the roles of deep roots and soil capillary flux to provide water to the forest during the dry season. Also examined is the importance of "root niche separation," in which roots of overstory trees extend to depth, where during the dry season they use water stored from wet season precipitation, while roots of understory trees are concentrated in shallow layers that access dry season precipitation directly. Observational data from the Tapajo's National Forest, Brazil, were used as meteorological forcing and provided comprehensive observational constraints on the model. Results strongly suggest that deep roots with root niche separation adaptations explain both the observed resilience during seasonal drought and the vulnerability of canopy-dominant trees to extended deficits of wet season rainfall. These mechanisms appear to provide an adaptive strategy that enhances productivity of the largest trees in the face of their disproportionate heat loads and water demand in the dry season. A sensitivity analysis exploring how wet season rainfall affects the stability of the rainforest system is presented. Citation: Ivanov, V. Y., L. R. Hutyra, S. C. Wofsy, J. W. Munger, S. R. Saleska, R. C. de Oliveira Jr., and P. B. de Camargo (2012), Root niche separation can explain avoidance of seasonal drought stress and vulnerability of overstory trees to extended drought in a mature Amazonian forest, Water Resour. Res., 48, W12507, doi:10.1029/2012WR011972.

Differences between female and male adolescents regarding individual vulnerability to HIV

The objective of this study was to comparatively analyze male and female adolescents' vulnerability to HIV/AIDS, based on their knowledge, values and practices. This is an exploratory-descriptive study, performed using a quantitative approach. The students answered a questionnaire from which relevant questions were selected for the analysis. The participants were 207 adolescents, 43.5% male and 56.5% female. Most adolescents report having initiated sexual activities. It was observed that the participants have knowledge deficits regarding HIV transmission and safe sexual practices. Although they report knowing about condom use as a method of protection against HIV, they do not always use them. It was observed that there are values connected to the representations of gender, but it is noticed there is an evolution regarding the autonomy and power of the girls' negotiation regarding condom use.

Incorporating label dependency into the binary relevance framework for multi-label classification

In multi-label classification, examples can be associated with multiple labels simultaneously. The task of learning from multi-label data can be addressed by methods that transform the multi-label classification problem into several single-label classification problems. The binary relevance approach is one of these methods, where the multi-label learning task is decomposed into several independent binary classification problems, one for each label in the set of labels, and the final labels for each example are determined by aggregating the predictions from all binary classifiers. However, this approach fails to consider any dependency among the labels. Aiming to accurately predict label combinations, in this paper we propose a simple approach that enables the binary classifiers to discover existing label dependency by themselves. An experimental study using decision trees, a kernel method as well as Naive Bayes as base-learning techniques shows the potential of the proposed approach to improve the multi-label classification performance.

Spatio-temporal patterns of tuberculosis incidence in Ribeirão Preto, State of São Paulo, southeast Brazil, and their relationship with social vulnerability: a Bayesian analysis

INTRODUCTION: The purpose of this ecological study was to evaluate the urban spatial and temporal distribution of tuberculosis (TB) in Ribeirão Preto, State of São Paulo, southeast Brazil, between 2006 and 2009 and to evaluate its relationship with factors of social vulnerability such as income and education level. METHODS: We evaluated data from TBWeb, an electronic notification system for TB cases. Measures of social vulnerability were obtained from the SEADE Foundation, and information about the number of inhabitants, education and income of the households were obtained from Brazilian Institute of Geography and Statistics. Statistical analyses were conducted by a Bayesian regression model assuming a Poisson distribution for the observed new cases of TB in each area. A conditional autoregressive structure was used for the spatial covariance structure. RESULTS: The Bayesian model confirmed the spatial heterogeneity of TB distribution in Ribeirão Preto, identifying areas with elevated risk and the effects of social vulnerability on the disease. We demonstrated that the rate of TB was correlated with the measures of income, education and social vulnerability. However, we observed areas with low vulnerability and high education and income, but with high estimated TB rates. CONCLUSIONS: The study identified areas with different risks for TB, given that the public health system deals with the characteristics of each region individually and prioritizes those that present a higher propensity to risk of TB. Complex relationships may exist between TB incidence and a wide range of environmental and intrinsic factors, which need to be studied in future research.

Auditory processing in children and adolescents in situations of risk and vulnerability

CONTEXT AND OBJECTIVE: Children and adolescents who live in situations of social vulnerability present a series of health problems. Nonetheless, affirmations that sensory and cognitive abnormalities are present are a matter of controversy. The aim of this study was to investigate aspects to auditory processing, through applying the brainstem auditory evoked potential (BAEP) and behavioral auditory processing tests to children living on the streets, and comparison with a control group. DESIGN AND SETTING: Cross-sectional study in the Laboratory of Auditory Processing, School of Medicine, Universidade de São Paulo. METHODS: The auditory processing tests were applied to a group of 27 individuals, subdivided into 11 children (7 to 10 years old) and 16 adolescents (11 to 16 years old), of both sexes, in situations of social vulnerability, compared with an age-matched control group of 10 children and 11 adolescents without complaints. The BAEP test was also applied to investigate the integrity of the auditory pathway. RESULTS: For both children and adolescents, there were significant differences between the study and control groups in most of the tests applied, with significantly worse performance in the study group, except in the pediatric speech intelligibility test. Only one child had an abnormal result in the BAEP test. CONCLUSIONS: The results showed that the study group (children and adolescents) presented poor performance in the behavioral auditory processing tests, despite their unaltered auditory brainstem pathways, as shown by their normal results in the BAEP test.

Incorporating IT & AT Convergence into Lean Thinking/Six Sigma via the Smarter Operation Transformation (SOT) Methodology

The growing demands for industrial products are imposing an increasingly intense level of competitiveness on the industrial operations. In the meantime, the convergence of information technology (IT) and automation technology (AT) is showing itself to be a tool of great potential for the modernization and improvement of industrial plants. However, for this technology fully to achieve its potential, several obstacles need to be overcome, including the demonstration of the reasoning behind estimations of benefits, investments and risks used to plan the implementation of corporative technology solutions. This article focuses on the evolutionary development of planning and adopting processes of IT & AT convergence. It proposes the incorporation of IT & AT convergence practices into Lean Thinking/Six Sigma, via the method used for planning the convergence of technological activities, known as the Smarter Operation Transformation (SOT) methodology. This article illustrates the SOT methodology through its application in a Brazilian company in the sector of consumer goods. In this application, it is shown that with IT & AT convergence is possible with low investment, in order to reduce the risk of not achieving the goals of key indicators.