Assessment of Depressive Symptoms and Cognitive Impairment in Elders From Rural Areas of the Brazilian State of Rio Grande do Sul

The main objective of this study was to examine the relationships among demographic characteristics, depressive symptoms, and cognitive impairment in oldest-old elders from rural areas of the Brazilian State of Rio Grande do Sul. A cross-sectional, descriptive correlational design was used to conduct the study. 137 Brazilian elders age 80 years or over. A target population data form, a county data form, a demographic questionnaire, the Mini-Mental State Examination, and the Depressive Cognition Scale were used to collect the data. A significant difference was found between males and females in regard to cognitive impairment. In addition, educational level and depressive symptoms were correlated with cognitive impairment. Depressive symptoms were a weak but significant predictor of cognitive impairment after controlling for the effect of age, gender, and educational level of the oldest-old elders. The findings need to be interpreted cautiously since the sample scored above the cutoff points for cognitive impairment, and had low scores on depressive symptoms. Despite several limitations, findings from this study can be a foundation for further studies, and well-designed correlational or experimental approaches, are warranted.

Identification of nurses` competencies in primary health care through a Delphi study in southern Brazil

Objective: This investigation aimed to identify and analyze the general and specific competencies of nurses in the primary health care practice of Brazil. Design: The Delphi Technique was used as the method of study. Sample: 2 groups of participants were selected: One contained primary health care nurses (n=52) and the other specialists (n=57), including public health nurses and public or community health faculty. Measurements: 3 questionnaires were developed for the study. The first asked participants to indicate general and specific competencies, which were compiled into a list for each group. A Likert scale of 1-5 was added to these 2 lists in the second and third questionnaires. A consensus criterion of 75% for score 4 or 5 was adopted. Results: In the nurses` group, 17 general and 8 specific competencies reached the consensus criterion; 19 general and 9 specific competencies reached the criterion in the specialists` group. These competencies were classified into 10 domains: professional values, communication, teamwork, management, community-oriented, health promotion, problem solving, health care, and education and basic public health sciences. Conclusions: These competencies reflect Brazilian health policy and constitute a reference for health professional practice and education.

Guidance for the implementation of best practice for the care of patients with tuberculosis

The first two chapters of Best practice for the care of patients with tuberculosis: a guide for low-income countries include an introduction and guidance regarding implementation of best practice. The background to how the guide was developed is significant, as it was developed in collaboration with nurses and other health workers working in the most challenging settings. It therefore provides realistic and practical guidance for best practice where patient loads are large and resources are stretched. Guidance regarding standard setting and clinical audit is an important part of enabling people to recognise the strengths that already exist in their practice and approach those areas that require change in a systematic and practical way. The guide itself consists of a series of standards covering different aspects of patient care, from the moment they seek health care with symptoms to their diagnosis to early stages of treatment, directly observed treatment, the continuation phase and transfer of treatment. There are also standards relating specifically to HIV testing and the care of patients co-infected with tuberculosis and HIV. The standards themselves will appear in full in the subsequent chapters of this series.

Maternal decision on obtaining prenatal care: a study in Brazil

Objective: to address the social aspects of pregnancy and the views of pregnant women regarding prenatal assistance in Brazil. Design: this qualitative study was focused on describing the Social Representations of prenatal care held by pregnant women. The discourse of the collective subject (DCS) framework was used to analyse the data collected, within the theoretical background of social representations, as proposed and developed by Serge Moscovici. Participants and setting: 21 pregnant women who were users of the publicly funded Brazilian unified health-care system and resided in the area served by its family health programme in a low- to middle-income neighbourhood on the outskirts of Campo Grande, the capital of the state of Mato Grosso do Sul, in southwestern Brazil. Data were collected by conducting in-depth, face-to-face interviews from January to October 2006. Findings: all participants were married. Formal education of the participants was less than five years in four cases, between five and eight years in six cases, and greater than 11 years in 10 cases. Nine participants had informal jobs and earned up to US$ 200 per month, four paricipants had administrative jobs and earned over US$ 500 per month, and eight participants did not work. No specific racial/ethnic background predominated. Lack of adherence to prenatal care allowed for the identification of two DCS themes: `organisation of prenatal care services` and `lifestyle features`. Key conclusions: the respondents were found to have negative feelings about pregnancy which manifest as many fears, including the fear of harming their children`s health, of being punished during labour, and of being reprimanded by health-care professionals for overlooking their prenatal care, in addition to the insecurity felt towards the infant and self. Implications for practice: the findings reveal that communication between pregnant women and healthcare professionals has been ineffective and that prenatal care has not been effective for the group interviewed-features that are likely to be found among other low- to middle-income groups living elsewhere in Brazil. (C) 2009 Elsevier Ltd. All rights reserved.

Cultural meaning of quality of life: perspectives of Brazilian burn patients

Purpose. This study was designed to explore the cultural meaning and dimensions of quality of life from the perspective of Brazilian burn patients. Method. A qualitative research approach was used. Nineteen burn patients and their close relatives participated in this ethnographic study. Data were collected by means of direct observation and semi-structured interviews, conducted in a hospital outpatient clinic and during visits to patients` homes. The following inter-related phases guided the analysis process: reading of the material and data reduction, data display, conclusion outlining and verification. Results. Participants reported that the quality of life is related to autonomy and the ability to work. The dimensions of quality of life included: resuming work and functional ability, body image, having leisure and interpersonal relationships. Their descriptions revealed their feelings and attitudes about resuming their previous activities and social lives, particularly concerning the work. Conclusion. For burn patients, quality of life is associated with the concept of normality, the satisfactory performance of social roles in the context of family life and the social world. The results showed the importance of the sociocultural dimension in the concept of quality of life for persons undergoing burn rehabilitation.

Antimicrobial drug administration errors identified in Brazilian multicentric study

Medication administration errors (MAE) are the most frequent kind of medication errors. Errors with antimicrobial drugs (AD) are relevant because they may interfere inpatient safety and in the development of microbial resistance. The aim of this study is to analyze the AD errors detected in a Brazilian multicentric study of MAE. It was a devcriptive and explorotory study carried out in clinical units in five Brazilian teaching hospitals. The hospitals were investigated during 30 days. MAE were detected by observation technique. MAE were classified in categories: wrong route(WR), wrong patient(WP), wrong dose(WD) wrong time (WT) and unordered drug (UD). AD with MA E were classified by Anatomical-Therapeutical-Chemical Classification System. AD with narrow therapeutic index (NTI) wet-e identified A descriptive statistical analysis was performed using SPSS version 11.5 software. A total of 1500 errors were observed, 277 (18.5%) of them were error with AD. The hopes of AD error were: WT87.7%, QD 6.9%, WR 1.5%, UD 3.2% and WP 0.7%. The number of AD found was 36. The mostly ATC class were fluoroquinolones 13.9%, combinations of penicillin 13.9%, macrolides 8.3% and third-generation cephalosporines 5.6%. The parenteral drug dosage form was associated with 55.6% of AD. 16.7% of AD were NTI. 47.4% of WD and 21.8% WT were with NTI drugs. This study shows that these errors should be considered potential areas for improvement in the medication process and patient safety plus there is requirement to develop rational drug use of AD.

Multidimensional cluster stability analysis from a Brazilian Bradyrhizobium sp RFLP/PCR data set

The taxonomy of the N(2)-fixing bacteria belonging to the genus Bradyrhizobium is still poorly refined, mainly due to conflicting results obtained by the analysis of the phenotypic and genotypic properties. This paper presents an application of a method aiming at the identification of possible new clusters within a Brazilian collection of 119 Bradryrhizobium strains showing phenotypic characteristics of B. japonicum and B. elkanii. The stability was studied as a function of the number of restriction enzymes used in the RFLP-PCR analysis of three ribosomal regions with three restriction enzymes per region. The method proposed here uses Clustering algorithms with distances calculated by average-linkage clustering. Introducing perturbations using sub-sampling techniques makes the stability analysis. The method showed efficacy in the grouping of the species B. japonicum and B. elkanii. Furthermore, two new clusters were clearly defined, indicating possible new species, and sub-clusters within each detected cluster. (C) 2008 Elsevier B.V. All rights reserved.

Environmental management system and human resource practices: is there a link between them in four Brazilian companies?

The aim of this article is to analyze the theoretical model proposed by [Jabbour CJC, Santos FCA. Relationships between human resource dimensions and environmental management in companies: proposal of a model. Journal of Cleaner Production 2008;16(1):5 1-8.] based on the data collected in four Brazilian companies. This model investigates how the phases of the environmental management system can be linked to human resource practices in order to attain continuous improvement of a company`s environmental performance. Our aim is to contribute to a field, which has little empirical evidence. Although the interaction between the phases of the environmental management system and human resource practices is recommended by the specialized literature [Daily BE Huang S. Achieving sustainability through attention to human resource factors in environmental management. International Journal of Operations and Production Management 2001:21(12):1539-52.], the results indicate that most of the theoretical assumptions could not be confirmed in these Brazilian companies. (C) 2008 Elsevier Ltd. All rights reserved.

Tropical woods: influence of density in hardness parallel and normal to the grain for some Brazilian tropical tree species

The aim of this work is to verify the possibility to correlating specific gravity and wood hardness parallel and perpendicular to the grain. The purpose is to offer one more tool to help in the decision about wood species choice for use in floors and sleepers. To reach this intent, we considered the results of standard tests (NBR 7190:1997, Timber Structures Design, Annex B, Brazilian Association of Technical Standards) to determine hardness parallel and normal to the grain in fourteen tropical high density wood species (over 850 kg/m(3), at 12% moisture content). For each species twelve determinations were made, based on the material obtained at Sao Carlos and its regional wood market. Statistical analysis led to some expressions to describe the cited properties relationships, with a determination coefficient about 0.8.

Influence of concrete strength and length/diameter on the axial capacity of CFT columns

This paper presents an experimental analysis of the confinement effects in steel-concrete composite columns regarding two parameters: concrete compressive strength and column slenderness. Sixteen concrete-filled steel tubular columns with circular cross section were tested under axial loading. The tested columns were filled by concrete with compressive strengths of 30, 60. 80, and 100 MPa, and had length/diameter ratios of 3, 5, 7, and 10. The experimental values of the columns` ultimate load were compared to the predictions of 4 code provisions: the Brazilian Code NBR 8800:2008, Eurocode 4 (EN 1994-1-1:2004), AINSI/AISC 360:2005, and CAN/CSA S16-01:2001. According to the results, the load capacity of the composite columns increased with increasing concrete strength and decreased with increasing length/diameter ratio. In general, the code provisions were highly accurate in the prediction of column capacity. Among them, the Brazilian Code was the most conservative, while Eurocode 4 presented the values closest to the experimental results. (C) 2009 Elsevier Ltd. All rights reserved.

PERMEABILITY MEASUREMENTS OF BRAZILIAN PINUS ELLIOTTII

The liquid and gas phase permeability, of Brazilian Pinus elliotii was studied with a custom built gas and liquid flow rate analysis chamber. The longitudinal gas phase permeability is shown to be six times greater than the radial permeability. There is no statistically significant difference between the longitudinal permeability of water versus wood preservative. Scanning Electron Microscopy (SEM) images confirm that the reported permeability properties arc due to the wood itself rather than to blocked pores or other artifacts of the sample cutting process. Wood composition analysis shows that the samples of Pinus elliotii grown in Brazil are similar to other species of Pinus grown in tropical climates. Specifically, the Pinus elliotti in this study is composed of 17% extractives, 0,27% ashes, 21% hemicellulose, 45% cellulose and 30% lignin. Results arc discussed in the context of the continued search for effective wood preservatives for use in tropical climates.

GIS applied to geotechnical and environmental risk management in a Brazilian oil pipeline

The paper presents the development of a decision support system for the management of geotechnical and environmental risks in oil pipelines using a geographical information system. The system covers a 48.5 km long section of the So Paulo to Brasilia (OSBRA) oil pipeline, which crosses three municipalities in the northeast region of the So Paulo state (Brazil) and represents an area of 205.8 km(2). The spatial database was created using geo-processing procedures, surface and intrusive investigations and geotechnical reports. The risk assessment was based mainly on qualitative models (relative numeric weights and multicriteria decision analysis) and considered pluvial erosion, slope movements, soil corrosion and third party activities. The maps were produced at a scale of 1:10,000.

Morphological and molecular characterization of cyanobacteria from a Brazilian facultative wastewater stabilization pond and evaluation of microcystin production

The cyanobacterial population in the Cajati waste stabilization pond system (WSP) from Sao Paulo State, Brazil was assessed by cell isolation and direct microscope counting techniques. Ten strains, belonging to five genera (Synechococcus, Merismopedia, Leptolyngbya, Limnothrix, and Nostoc), were isolated and identified by morphological and molecular analyses. Morphological identification of the isolated strains was congruent with their phylogenetic analyses based on 16S rDNA gene sequences. Six cyanobacterial genera (Synechocystis, Aphanocapsa, Merismopedia, Lyngbya, Phormidium, and Pseudanabaena) were identified by direct microscope inspection. Both techniques were complementary, since, of the six genera identified by direct microscopic inspection, only Merismopedia was isolated, and the four other isolated genera were not detected by direct inspection. Direct microscope counting of preserved cells showed that cyanobacteria were the dominant members (> 90%) of the phytoplankton community during both periods evaluated (summer and autumn). ELISA tests specific for hepatotoxicmicrocystins gave positive results for six strains (Synechococcus CENA108, Merismopedia CENA106, Leptolyngbya CENA103, Leptolyngbya CENA112, Limnothrix CENA109, and Limnothrix CENA110), and for wastewater samples collected from raw influent (3.70 mu g microcystins/l) and treated effluent (3.74 mu g microcystins/l) in summer. Our findings indicate that toxic cyanobacteria in WSP systems are of concern, since the treated effluent containing cyanotoxins will be discharged into rivers, irrigation channels, estuaries, or reservoirs, and can affect human and animal health.

Verification of a mixed high-order accurate DNS code for laminar turbulent transition by the method of manufactured solutions

This paper presents results on a verification test of a Direct Numerical Simulation code of mixed high-order of accuracy using the method of manufactured solutions (MMS). This test is based on the formulation of an analytical solution for the Navier-Stokes equations modified by the addition of a source term. The present numerical code was aimed at simulating the temporal evolution of instability waves in a plane Poiseuille flow. The governing equations were solved in a vorticity-velocity formulation for a two-dimensional incompressible flow. The code employed two different numerical schemes. One used mixed high-order compact and non-compact finite-differences from fourth-order to sixth-order of accuracy. The other scheme used spectral methods instead of finite-difference methods for the streamwise direction, which was periodic. In the present test, particular attention was paid to the boundary conditions of the physical problem of interest. Indeed, the verification procedure using MMS can be more demanding than the often used comparison with Linear Stability Theory. That is particularly because in the latter test no attention is paid to the nonlinear terms. For the present verification test, it was possible to manufacture an analytical solution that reproduced some aspects of an instability wave in a nonlinear stage. Although the results of the verification by MMS for this mixed-order numerical scheme had to be interpreted with care, the test was very useful as it gave confidence that the code was free of programming errors. Copyright (C) 2009 John Wiley & Sons, Ltd.

Collapse behavior of soil in a Brazilian region affected by a rising water table

Collapsible soils are usually nonsaturated, low density, and metastable-structured soils that are known to exhibit a volume reduction following an episode of moisture increase or suction reduction. This paper describes the collapsible behavior of clayey sand based on controlled soil suction tests carried out on undisturbed samples from the city of Pereira Barreto, in the State of Sao Paulo, Brazil. Foundation settlements due to soil collapse are common in this region and occurred during the filling of the reservoir of the Tres Irmaos Dam, which induced the elevation of the groundwater table in different parts of Pereira Barreto. This paper shows that collapse strains depend on the stress and soil suction acting in the sample and that saturation is not necessary for a collapse to occur. The influence of soil suction, gradual wetting, and the wetting and drying cycle on the collapsible behavior of the soil is also shown and discussed.