Rede de atenção à saúde mental de base comunitária: a experiência de Santo André

Os distúrbios psiquiátricos constituem um grave problema de saúde pública. Por muitos anos, a única terapêutica disponível ao portador de transtornos mentais era a internação em hospitais psiquiátricos. Hoje a Organização Mundial de Saúde recomenda os serviços de base comunitária como modelo de tratamento em saúde mental. Assim, o objetivo é descrever as características de uma rede de atenção à saúde mental de base comunitária no município de Santo André, SP. Foi realizado um estudo retrospectivo do tipo descritivo, em dados secundários do período de 1987 a 2006. O estudo incidiu sobre o histórico, a infra-estrutura, os recursos humanos, a produção, as práticas e processos de trabalho dos serviços de saúde mental de Santo André. Foram analisados documentos do Programa Municipal de Saúde Mental, da Secretaria Municipal de Saúde, da Prefeitura de Santo André, da Associação José Martins de Araújo Júnior-Organização Social De Volta Para Casa. A Secretaria Municipal de Saúde proveu meios para uma transformação dos serviços de saúde mental no período estudado, partindo de um atendimento exclusivamente manicomial para uma rede de serviços de saúde mental com modelo centrado na comunidade, focando a doença no aspecto psicossocial e com abordagem por equipe multiprofissional. Estas ações no município de Santo André foram corroborativas aos esforços da sociedade civil e o pleno desenvolvimento da mudança do modelo hospitalocêntrico

Design methodology for multi-pumped discrete Raman amplifiers: case-study employing photonic crystal fibers

This paper proposes a new design methodology for discrete multi-pumped Raman amplifier. In a multi-objective optimization scenario, in a first step the whole solution-space is inspected by a CW analytical formulation. Then, the most promising solutions are fully investigated by a rigorous numerical treatment and the Raman amplification performance is thus determined by the combination of analytical and numerical approaches. As an application of our methodology we designed an photonic crystal fiber Raman amplifier configuration which provides low ripple, high gain, clear eye opening and a low power penalty. The amplifier configuration also enables to fully compensate the dispersion introduced by a 70-km singlemode fiber in a 10 Gbit/s system. We have successfully obtained a configuration with 8.5 dB average gain over the C-band and 0.71 dB ripple with almost zero eye-penalty using only two pump lasers with relatively low pump power. (C) 2009 Optical Society of America

Work disability remains a major problem in rheumatoid arthritis in the 2000s: data from 32 countries in the QUEST-RA Study

Introduction: Work disability is a major consequence of rheumatoid arthritis (RA), associated not only with traditional disease activity variables, but also more significantly with demographic, functional, occupational, and societal variables. Recent reports suggest that the use of biologic agents offers potential for reduced work disability rates, but the conclusions are based on surrogate disease activity measures derived from studies primarily from Western countries. Methods: The Quantitative Standard Monitoring of Patients with RA (QUEST-RA) multinational database of 8,039 patients in 86 sites in 32 countries, 16 with high gross domestic product (GDP) (>24K US dollars (USD) per capita) and 16 low-GDP countries (<11K USD), was analyzed for work and disability status at onset and over the course of RA and clinical status of patients who continued working or had stopped working in high-GDP versus low-GDP countries according to all RA Core Data Set measures. Associations of work disability status with RA Core Data Set variables and indices were analyzed using descriptive statistics and regression analyses. Results: At the time of first symptoms, 86% of men (range 57%-100% among countries) and 64% (19%-87%) of women <65 years were working. More than one third (37%) of these patients reported subsequent work disability because of RA. Among 1,756 patients whose symptoms had begun during the 2000s, the probabilities of continuing to work were 80% (95% confidence interval (CI) 78%-82%) at 2 years and 68% (95% CI 65%-71%) at 5 years, with similar patterns in high-GDP and low-GDP countries. Patients who continued working versus stopped working had significantly better clinical status for all clinical status measures and patient self-report scores, with similar patterns in high-GDP and low-GDP countries. However, patients who had stopped working in high-GDP countries had better clinical status than patients who continued working in low-GDP countries. The most significant identifier of work disability in all subgroups was Health Assessment Questionnaire (HAQ) functional disability score. Conclusions: Work disability rates remain high among people with RA during this millennium. In low-GDP countries, people remain working with high levels of disability and disease activity. Cultural and economic differences between societies affect work disability as an outcome measure for RA.

Multi-trait and random regression mature weight heritability and breeding value estimates in Nelore cattle

Mature weight breeding values were estimated using a multi-trait animal model (MM) and a random regression animal model (RRM). Data consisted of 82 064 weight records from 8 145 animals, recorded from birth to eight years of age. Weights at standard ages were considered in the MM. All models included contemporary groups as fixed effects, and age of dam (linear and quadratic effects) and animal age as covariates. In the RRM, mean trends were modelled through a cubic regression on orthogonal polynomials of animal age and genetic maternal and direct and maternal permanent environmental effects were also included as random. Legendre polynomials of orders 4, 3, 6 and 3 were used for animal and maternal genetic and permanent environmental effects, respectively, considering five classes of residual variances. Mature weight (five years) direct heritability estimates were 0.35 (MM) and 0.38 (RRM). Rank correlation between sires' breeding values estimated by MM and RRM was 0.82. However, selecting the top 2% (12) or 10% (62) of the young sires based on the MM predicted breeding values, respectively 71% and 80% of the same sires would be selected if RRM estimates were used instead. The RRM modelled the changes in the (co) variances with age adequately and larger breeding value accuracies can be expected using this model.

An analytical approach to the dwarf galaxies cusp problem

Aims. An analytical solution for the discrepancy between observed core-like profiles and predicted cusp profiles in dark matter halos is studied. Methods. We calculate the distribution function for Navarro-Frenk-White halos and extract energy from the distribution, taking into account the effects of baryonic physics processes. Results. We show with a simple argument that we can reproduce the evolution of a cusp to a flat density profile by a decrease of the initial potential energy.

The merging cluster Abell 1758 revisited: multi-wavelength observations and numerical simulations

Context. Cluster properties can be more distinctly studied in pairs of clusters, where we expect the effects of interactions to be strong. Aims. We here discuss the properties of the double cluster Abell 1758 at a redshift z similar to 0.279. These clusters show strong evidence for merging. Methods. We analyse the optical properties of the North and South cluster of Abell 1758 based on deep imaging obtained with the Canada-France-Hawaii Telescope (CFHT) archive Megaprime/Megacam camera in the g' and r' bands, covering a total region of about 1.05 x 1.16 deg(2), or 16.1 x 17.6 Mpc(2). Our X-ray analysis is based on archive XMM-Newton images. Numerical simulations were performed using an N-body algorithm to treat the dark-matter component, a semi-analytical galaxy-formation model for the evolution of the galaxies and a grid-based hydrodynamic code with a parts per million (PPM) scheme for the dynamics of the intra-cluster medium. We computed galaxy luminosity functions (GLFs) and 2D temperature and metallicity maps of the X-ray gas, which we then compared to the results of our numerical simulations. Results. The GLFs of Abell 1758 North are well fit by Schechter functions in the g' and r' bands, but with a small excess of bright galaxies, particularly in the r' band; their faint-end slopes are similar in both bands. In contrast, the GLFs of Abell 1758 South are not well fit by Schechter functions: excesses of bright galaxies are seen in both bands; the faint-end of the GLF is not very well defined in g'. The GLF computed from our numerical simulations assuming a halo mass-luminosity relation agrees with those derived from the observations. From the X-ray analysis, the most striking features are structures in the metal distribution. We found two elongated regions of high metallicity in Abell 1758 North with two peaks towards the centre. In contrast, Abell 1758 South shows a deficit of metals in its central regions. Comparing observational results to those derived from numerical simulations, we could mimic the most prominent features present in the metallicity map and propose an explanation for the dynamical history of the cluster. We found in particular that in the metal-rich elongated regions of the North cluster, winds had been more efficient than ram-pressure stripping in transporting metal-enriched gas to the outskirts. Conclusions. We confirm the merging structure of the North and South clusters, both at optical and X-ray wavelengths.

Comparison Between Single-Diode Low-Level Laser Therapy (LLLT) and LED Multi-Diode (Cluster) Therapy (LEDT) Applications Before High-Intensity Exercise

Background Data and Objective: There is anecdotal evidence that low-level laser therapy (LLLT) may affect the development of muscular fatigue, minor muscle damage, and recovery after heavy exercises. Although manufacturers claim that cluster probes (LEDT) maybe more effective than single-diode lasers in clinical settings, there is a lack of head-to-head comparisons in controlled trials. This study was designed to compare the effect of single-diode LLLT and cluster LEDT before heavy exercise. Materials and Methods: This was a randomized, placebo-controlled, double-blind cross-over study. Young male volleyball players (n = 8) were enrolled and asked to perform three Wingate cycle tests after 4 x 30 sec LLLT or LEDT pretreatment of the rectus femoris muscle with either (1) an active LEDT cluster-probe (660/850 nm, 10/30mW), (2) a placebo cluster-probe with no output, and (3) a single-diode 810-nm 200-mW laser. Results: The active LEDT group had significantly decreased post-exercise creatine kinase (CK) levels (-18.88 +/- 41.48U/L), compared to the placebo cluster group (26.88 +/- 15.18U/L) (p < 0.05) and the active single-diode laser group (43.38 +/- 32.90U/L) (p<0.01). None of the pre-exercise LLLT or LEDT protocols enhanced performance on the Wingate tests or reduced post-exercise blood lactate levels. However, a non-significant tendency toward lower post-exercise blood lactate levels in the treated groups should be explored further. Conclusion: In this experimental set-up, only the active LEDT probe decreased post-exercise CK levels after the Wingate cycle test. Neither performance nor blood lactate levels were significantly affected by this protocol of pre-exercise LEDT or LLLT.

Magnetoconfined levels in a parabolic quantum dot: An analytical solution of a three-dimensional Fock-Darwin problem in a tilted magnetic field

The energy spectrum of an electron confined in a quantum dot (QD) with a three-dimensional anisotropic parabolic potential in a tilted magnetic field was found analytically. The theory describes exactly the mixing of in-plane and out-of-plane motions of an electron caused by a tilted magnetic field, which could be seen, for example, in the level anticrossing. For charged QDs in a tilted magnetic field we predict three strong resonant lines in the far-infrared-absorption spectra.

The clusters Abell 222 and Abell 223: a multi-wavelength view

Context. The Abell 222 and 223 clusters are located at an average redshift z similar to 0.21 and are separated by 0.26 deg. Signatures of mergers have been previously found in these clusters, both in X-rays and at optical wavelengths, thus motivating our study. In X-rays, they are relatively bright, and Abell 223 shows a double structure. A filament has also been detected between the clusters both at optical and X-ray wavelengths. Aims. We analyse the optical properties of these two clusters based on deep imaging in two bands, derive their galaxy luminosity functions (GLFs) and correlate these properties with X-ray characteristics derived from XMM-Newton data. Methods. The optical part of our study is based on archive images obtained with the CFHT Megaprime/Megacam camera, covering a total region of about 1 deg(2), or 12.3 x 12.3 Mpc(2) at a redshift of 0.21. The X-ray analysis is based on archive XMM-Newton images. Results. The GLFs of Abell 222 in the g' and r' bands are well fit by a Schechter function; the GLF is steeper in r' than in g'. For Abell 223, the GLFs in both bands require a second component at bright magnitudes, added to a Schechter function; they are similar in both bands. The Serna & Gerbal method allows to separate well the two clusters. No obvious filamentary structures are detected at very large scales around the clusters, but a third cluster at the same redshift, Abell 209, is located at a projected distance of 19.2 Mpc. X-ray temperature and metallicity maps reveal that the temperature and metallicity of the X-ray gas are quite homogeneous in Abell 222, while they are very perturbed in Abell 223. Conclusions. The Abell 222/Abell 223 system is complex. The two clusters that form this structure present very different dynamical states. Abell 222 is a smaller, less massive and almost isothermal cluster. On the other hand, Abell 223 is more massive and has most probably been crossed by a subcluster on its way to the northeast. As a consequence, the temperature distribution is very inhomogeneous. Signs of recent interactions are also detected in the optical data where this cluster shows a ""perturbed"" GLF. In summary, the multiwavelength analyses of Abell 222 and Abell 223 are used to investigate the connection between the ICM and the cluster galaxy properties in an interacting system.

Musical genres: beating to the rhythms of different drums

Online music databases have increased significantly as a consequence of the rapid growth of the Internet and digital audio, requiring the development of faster and more efficient tools for music content analysis. Musical genres are widely used to organize music collections. In this paper, the problem of automatic single and multi-label music genre classification is addressed by exploring rhythm-based features obtained from a respective complex network representation. A Markov model is built in order to analyse the temporal sequence of rhythmic notation events. Feature analysis is performed by using two multi-variate statistical approaches: principal components analysis (unsupervised) and linear discriminant analysis (supervised). Similarly, two classifiers are applied in order to identify the category of rhythms: parametric Bayesian classifier under the Gaussian hypothesis (supervised) and agglomerative hierarchical clustering (unsupervised). Qualitative results obtained by using the kappa coefficient and the obtained clusters corroborated the effectiveness of the proposed method.

TESTING STATISTICAL HYPOTHESIS ON RANDOM TREES AND APPLICATIONS TO THE PROTEIN CLASSIFICATION PROBLEM

Efficient automatic protein classification is of central importance in genomic annotation. As an independent way to check the reliability of the classification, we propose a statistical approach to test if two sets of protein domain sequences coming from two families of the Pfam database are significantly different. We model protein sequences as realizations of Variable Length Markov Chains (VLMC) and we use the context trees as a signature of each protein family. Our approach is based on a Kolmogorov-Smirnov-type goodness-of-fit test proposed by Balding et at. [Limit theorems for sequences of random trees (2008), DOI: 10.1007/s11749-008-0092-z]. The test statistic is a supremum over the space of trees of a function of the two samples; its computation grows, in principle, exponentially fast with the maximal number of nodes of the potential trees. We show how to transform this problem into a max-flow over a related graph which can be solved using a Ford-Fulkerson algorithm in polynomial time on that number. We apply the test to 10 randomly chosen protein domain families from the seed of Pfam-A database (high quality, manually curated families). The test shows that the distributions of context trees coming from different families are significantly different. We emphasize that this is a novel mathematical approach to validate the automatic clustering of sequences in any context. We also study the performance of the test via simulations on Galton-Watson related processes.

ON THE THREE-DIMENSIONAL BLASCHKE-LEBESGUE PROBLEM

The width of a closed convex subset of n-dimensional Euclidean space is the distance between two parallel supporting hyperplanes. The Blaschke-Lebesgue problem consists of minimizing the volume in the class of convex sets of fixed constant width and is still open in dimension n >= 3. In this paper we describe a necessary condition that the minimizer of the Blaschke-Lebesgue must satisfy in dimension n = 3: we prove that the smooth components of the boundary of the minimizer have their smaller principal curvature constant and therefore are either spherical caps or pieces of tubes (canal surfaces).

Multi-commutation in spectrometry

We review recent developments in manifold components and the introduction of light-emitting-diode technology in spectroscopic detection in order to evaluate the tremendous possibilities offered by multi-commutation for infield and in-situ measurements, based on the use of multi-pumping and low-voltage, portable batteries, which make possible a dramatic reduction in size, weight and power requirements of spectrometric devices. (C) 2009 Elsevier Ltd. All rights reserved.

Evidences of turbulent mixing in multi-pumping flow systems

Multi-pumping flow systems exploit pulsed flows delivered by Solenoid pumps. Their improved performance rely on the enhanced radial mass transport inherent to the pulsed flow, which is a consequence of the establishment of vortices thus a tendency towards turbulent mixing. This paper presents several evidences of turbulent mixing in relation to pulsed flows. such as recorded peak shape, establishment of fluidized beds, exploitation of flow reversal, implementation of relatively slow chemical reactions and/or heating of the reaction medium. In addition, Reynolds number associated with the GO period of a pulsed flow is estimated and photographic images of dispersing samples flowing under laminar regime and pulsed flow conditions are presented. (C) 2009 Elsevier B.V. All rights reserved.