A study of pent-up demand in ophthalmology: Divinolandia Hospital/Unicamp

Objective: To assess the waiting time for eye care identifying the number of patients with each complaint; to investigate how the waiting time may worsen the patient's condition; to check the screening of urgent cases for effectiveness; and to devise means of increasing the medical-surgical care capacity. Methods: A retrospective descriptive survey was conducted using data obtained on 12 occasions during collaborative team visits to provide eyecare services. These initiatives were designed to decrease the waiting time and to treat urgent cases that occurred on each occasion; eyecare services were provided every Saturday, in the period from June to August 2006, in 16 cities of the region covered by Conderg (Consortium for the Development of the Sao Joao da Boa Vista Administrative Region). Results: Referrals used 1,743 (87.1%) of the 2,000 places available. The most frequent diagnoses were refractive errors, with 683 cases, corresponding to 39.1% of the total, followed by cataracts, with 296 cases, corresponding to 20.9%. Of the 238 surgeries indicated, 54.6% were phakectomies. Thirty-five (2.0%) cases were considered urgent. Conclusion: The most common diagnoses made during the team visits to manage the excess demand for eyecare were refractive errors and cataracts, which, together, accounted for the majority of the cases. The Divinolandia Hospital has the necessary human and material resources to meet the demand left unattended by the local SUS network. Immediate referral of urgent cases by the primary units' screeners proved effective.

A study of pent-up demand in ophthalmology: Divinolândia Hospital/Unicamp

OBJECTIVE: To assess the waiting time for eye care identifying the number of patients with each complaint; to investigate how the waiting time may worsen the patient's condition; to check the screening of urgent cases for effectiveness; and to devise means of increasing the medical-surgical care capacity. METHODS: A retrospective descriptive survey was conducted using data obtained on 12 occasions during collaborative team visits to provide eyecare services. These initiatives were designed to decrease the waiting time and to treat urgent cases that occurred on each occasion; eyecare services were provided every Saturday, in the period from June to August 2006, in 16 cities of the region covered by Conderg (Consortium for the Development of the São João da Boa Vista Administrative Region). RESULTS: Referrals used 1,743 (87.1%) of the 2,000 places available. The most frequent diagnoses were refractive errors, with 683 cases, corresponding to 39.1% of the total, followed by cataracts, with 296 cases, corresponding to 20.9%. Of the 238 surgeries indicated, 54.6% were phakectomies. Thirty-five (2.0%) cases were considered urgent. CONCLUSION: The most common diagnoses made during the team visits to manage the excess demand for eyecare were refractive errors and cataracts, which, together, accounted for the majority of the cases. The Divinolândia Hospital has the necessary human and material resources to meet the demand left unattended by the local SUS network. Immediate referral of urgent cases by the primary units' screeners proved effective.

Efficient Forest Data Structure for Evolutionary Algorithms Applied to Network Design

The design of a network is a solution to several engineering and science problems. Several network design problems are known to be NP-hard, and population-based metaheuristics like evolutionary algorithms (EAs) have been largely investigated for such problems. Such optimization methods simultaneously generate a large number of potential solutions to investigate the search space in breadth and, consequently, to avoid local optima. Obtaining a potential solution usually involves the construction and maintenance of several spanning trees, or more generally, spanning forests. To efficiently explore the search space, special data structures have been developed to provide operations that manipulate a set of spanning trees (population). For a tree with n nodes, the most efficient data structures available in the literature require time O(n) to generate a new spanning tree that modifies an existing one and to store the new solution. We propose a new data structure, called node-depth-degree representation (NDDR), and we demonstrate that using this encoding, generating a new spanning forest requires average time O(root n). Experiments with an EA based on NDDR applied to large-scale instances of the degree-constrained minimum spanning tree problem have shown that the implementation adds small constants and lower order terms to the theoretical bound.

Cation Distribution and Local Order in Mixed Sodium Metaphosphate Glasses

Two structural properties in mixed alkali metal phosphate glasses that seem to be crucial to the development of the mixed ion effect in dc conductivity were systematically analyzed in Na mixed metaphosphates: the local order around the mobile species, and their distribution and mixing in the glass network. The set of glasses considered here, Na1-xMxPO3 with M = Li, Ag, K, Rb, and Cs and 0 <= x <= 1, encompass a broad degree of size mismatch between the mixed cation species. A comprehensive solid-state nuclear magnetic resonance study was carried out using P-31 MAS, Na-23 triple quantum MAS, Rb-87 QCPMG, P-31-Na-23 REDOR, Na-23-Li-7 and Li-7-Li-6 SEDOR, and Na-23 spin echo decay. It was observed that the arrangement of P atoms around Na in the mixed glasses was indistinguishable from that observed in the NaPO3 glass. However, systematic distortions in the local structure of the 0 environments around Na were observed, related to the presence of the second cation. The average Na-O distances show an expansion/compression When Na+ ions are replaced by cations with respectively smaller/bigger radii. The behavior of the nuclear electric quadrupole coupling. constants indicates that this expansion reduces the local symmetry, while the compression produces the opposite effect These effects become marginally small when the site mismatch between the cations is small, as in Na-Ag mixed glasses. The present study confirms the intimate mixing of cation species at the atomic scale, but clear deviations from random mixing were detected in systems with larger alkali metal ions (Cs-Na, K-Na, Rb-Na). In contrast, no deviations from the statistical ion mixture were found in the systems Ag-Na and Li-Na, where mixed cations are either of radii comparable to (Ag+) or smaller than (Li+) Na+. The set of results supports two fundamental structural features of the models proposed to explain the mixed ion effect: the. structural specificity of the sites occupied by each cation species and their mixing at the atomic scale.

Symmetry insights for design of supercomputer network topologies: roots and weights lattices

We present a family of networks whose local interconnection topologies are generated by the root vectors of a semi-simple complex Lie algebra. Cartan classification theorem of those algebras ensures those families of interconnection topologies to be exhaustive. The global arrangement of the network is defined in terms of integer or half-integer weight lattices. The mesh or torus topologies that network millions of processing cores, such as those in the IBM BlueGene series, are the simplest member of that category. The symmetries of the root systems of an algebra, manifested by their Weyl group, lends great convenience for the design and analysis of hardware architecture, algorithms and programs.

Organization and dynamics of Conselho Municipal de Seguranca Alimentar e Nutricional de Sao Paulo: implications of their participation on the creation of a municipal food and nutrition security policy

Objective This study analyzed the internal functioning, organization and political participation of the local food and nutrition security council and possible implications of their participation on the creation of a municipal food and nutrition security policy in the city of Sao Paulo. Methods This qualitative study was done in three stages: document analysis; observation of meetings and semi-structured interviews with board members considered key informants. The axis of analysis was the political participation of the council, considering its internal aspects, like board members, operating dynamics of political participation of its members and the relationship between these topics and the council's actions for the definition and creation of a food and nutrition security policy. Results The intellectual profile of the board members does not represent the majority of the population, thereby facilitating the omission of actual issues in council discussions. Its strict internal dynamics and the asymmetry of its members generally prevent the active participation of board members and, specifically, discussions about a food and nutrition security policy. The so-called "militant members" have a differentiated, more aggressive participation, with greater mastery of the subject and its topics. Conclusion The board member profiles, internal organization of the council, complexity of the subject and its low insertion in the society distance the council from social needs and lead them to act incipiently with regard to the municipal policies of food and nutrition security.

The Brazilian Network for HIV-1 Genotyping External Quality Control Assurance Programme

The Brazilian network for genotyping is composed of 21 laboratories that perform and analyze genotyping tests for all HIV-infected patients within the public system, performing approximately 25,000 tests per year. We assessed the interlaboratory and intralaboratory reproducibility of genotyping systems by creating and implementing a local external quality control evaluation. Plasma samples from HIV-1-infected individuals (with low and intermediate viral loads) or RNA viral constructs with specific mutations were used. This evaluation included analyses of sensitivity and specificity of the tests based on qualitative and quantitative criteria, which scored laboratory performance on a 100-point system. Five evaluations were performed from 2003 to 2008, with 64% of laboratories scoring over 80 points in 2003, 81% doing so in 2005, 56% in 2006, 91% in 2007, and 90% in 2008 (Kruskal-Wallis, p = 0.003). Increased performance was aided by retraining laboratories that had specific deficiencies. The results emphasize the importance of investing in laboratory training and interpretation of DNA sequencing results, especially in developing countries where public (or scarce) resources are used to manage the AIDS epidemic.

Too Big to Ignore: Global Partnership on Small-Scale Fisheries Research - the Latin America and Caribbean network

Too Big to Ignore (TBTI; www.toobigtoignore.net) is a research network and knowledge mobilization partnership established to elevate the profile of small-scale fisheries (SSF), to argue against their marginalization in national and international policies, and to develop research and governance capacity to address global fisheries challenges. Network participants and partners are conducting global and comparative analyses, as well as in-depth studies of SSF in the context of local complexity and dynamics, along with a thorough examination of governance challenges, to encourage careful consideration of this sector in local, regional and global policy arenas. Comprising 15 partners and 62 researchers from 27 countries, TBTI conducts activities in five regions of the world. In Latin America and the Caribbean (LAC) region, we are taking a participative approach to investigate and promote stewardship and self-governance in SSF, seeking best practices and success stories that could be replicated elsewhere. As well, the region will focus to promote sustainable livelihoods of coastal communities. Key activities include workshops and stakeholder meetings, facilitation of policy dialogue and networking, as well as assessing local capacity needs and training. Currently, LAC members are putting together publications that examine key issues concerning SSF in the region and best practices, with a first focus on ecosystem stewardship. Other planned deliverables include comparative analysis, a regional profile on the top research issues on SSF, and a synthesis of SSF knowledge in LAC

Hierarchical multi-label classification using local neural networks

Hierarchical multi-label classification is a complex classification task where the classes involved in the problem are hierarchically structured and each example may simultaneously belong to more than one class in each hierarchical level. In this paper, we extend our previous works, where we investigated a new local-based classification method that incrementally trains a multi-layer perceptron for each level of the classification hierarchy. Predictions made by a neural network in a given level are used as inputs to the neural network responsible for the prediction in the next level. We compare the proposed method with one state-of-the-art decision-tree induction method and two decision-tree induction methods, using several hierarchical multi-label classification datasets. We perform a thorough experimental analysis, showing that our method obtains competitive results to a robust global method regarding both precision and recall evaluation measures.