The burden of physical activity on type 2 diabetes public healthcare expenditures among adults: a retrospective study

Background: Determinants of public healthcare expenditures in type 2 diabetics are not well investigated in developing nations and, therefore, it is not clear if higher physical activity decreases healthcare costs. The purpose of this study was to analyze the relationship between physical activity and the expenditures in public healthcare on type 2 diabetes mellitus treatment. Methods: Cross-sectional study carried out in Brazil. A total of 121 type 2 diabetics attended to in two Basic Healthcare Units were evaluated. Public healthcare expenditures in the last year were estimated using a specific standard table. Also evaluated were: socio-demographic variables; chronological age; exogenous insulin use; smoking habits; fasting glucose test; diabetic neuropathy and anthropometric measures. Habitual physical activity was assessed by questionnaire. Results: Age (r = 0.20; p = 0.023), body mass index (r = 0.33; p = 0.001) and waist-to-hip ratio (r = 0.20; p = 0.025) were positively related to expenditures on medication for the treatment of diseases other than diabetes. Insulin use was associated with increased expenditures. Higher physical activity was associated with lower expenditure, provided medication for treatment of diseases other than diabetes (OR = 0.19; p = 0.007) and medical consultations (OR = 0.26; p = 0.029). Conclusions: Type 2 diabetics with higher enrollment in physical activity presented consistently lower healthcare expenditures for the public healthcare system.

Prevalence of Human T-Cell Lymphotropic Virus (HTLV-1/2) in Individuals from Public Health Centers in Mozambique

The prevalence of human T-cell lymphotropic viruses types 1 and 2 (HTLV-1/2) in Mozambique is not known. The present study examined blood samples from 208, 226, and 318 individuals from Northern, Central, and Southern Mozambique, respectively, of all socioeconomic and demographic strata attending public health centers in Mozambique for HTLV-1/2-specific antibodies. Serum samples were assessed for HIV- and HTLV-1/2-specific antibodies by using enzyme immunoassays, and infections with HTLV-1 and -2 were confirmed by using Western blot. An overall HTLV-1/2 prevalence of 2.3% (2.9% in female and 1.1% in male subjects) was observed, and the prevalence of infection increased with age. Regional variation in the prevalence of HIV and HTLV-1/2 was observed; 32.2%, 65.5%, and 44% of individuals tested HIV positive in Northern, Central, and Southern Mozambique, respectively, and 2.4%, 3.9%, and 0.9% tested HTLV-1/2 positive in the same regions. HTLV-1 infection was confirmed in these individuals. No association between HTLV-1 infection and socio-demographic variables or HIV status was detected, although the low number of HTLV-1-positive cases did not allow robust statistical analyses. The results obtained suggest different risk factors and epidemiologic correlates of HIV and HTLV-1 transmission in Mozambique. Furthermore, our results suggested that North and Central Mozambique should be considered endemic regions for HTLV-1 infection. As no cases of HTLV-2 were detected, HTLV-2 appears to have not been introduced into Mozambique.

The role of heritage in revalorization politicos of urban space

Certain areas of the city of Sao Paulo, as many others around the world, including in Lisbon, Barcelona and Buenos Aires, have been going through a process of requalification, in special the ones commonly known as old and/or traditional city. Regarding Sao Paulo, some exceptional actions have been taken downtown with investments in rehabilitation/requalification of areas that concentrated the historical, urbanistic and cultural heritages, such as Praca da S and its cathedral, as well as the revaluation/rehabilitation projects of other squares like Praca da Republica, other areas as the previously called Cracolandia (due to high consumption/deal of crack), known today as Nova Luz, besides propositions to reevaluate areas already modified, such as Vale do Anhangabau. In all propositions to modify sites, it is firstly underlined its deterioration, litter and the presence of low-income populations (passer-bys, street vendors or residents), generally stigmatized as ""potential suspects"", emphasizing danger and lack of security in those places. This belief, which has become consensual, results in that: public as well as private companies promote the rehabilitation of the areas basing their reasoning in the necessity of adding value to the existing urban heritage, although, as it will be discussed in this paper, part of this heritage might be destroyed in this very process, under the allegation that upon completion, the action would allow the social, cultural and economical revaluation/requalification of the area. This paper is intended to provide a contribution to this discussion.

Incorporation of Real-Time PCR into Routine Public Health Surveillance of Culture Negative Bacterial Meningitis in Sao Paulo, Brazil

Real-time (RT)-PCR increases diagnostic yield for bacterial meningitis and is ideal for incorporation into routine surveillance in a developing country. We validated a multiplex RT-PCR assay for Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae in Brazil. Risk factors for being culture-negative, RT-PCR positive were determined. The sensitivity of RT-PCR in cerebrospinal fluid (CSF) was 100% (95% confidence limits, 96.0%-100%) for N. meningitidis, 97.8% (85.5%-99.9%) for S. pneumoniae, and 66.7% (9.4%-99.2%) for H. influenzae. Specificity ranged from 98.9% to 100%. Addition of RT-PCR to routine microbiologic methods increased the yield for detection of S. pneumoniae, N. meningitidis, and H. influenzae cases by 52%, 85%, and 20%, respectively. The main risk factor for being culture negative and RT-PCR positive was presence of antibiotic in CSF (odds ratio 12.2, 95% CI 5.9-25.0). RT-PCR using CSF was highly sensitive and specific and substantially added to measures of meningitis disease burden when incorporated into routine public health surveillance in Brazil.

AMBIVALENT IMPLICATIONS OF HEALTH CARE INFORMATION SYSTEMS: A STUDY IN THE BRAZILIAN PUBLIC HEALTH CARE SYSTEM

This article evaluates social implications of the ""SIGA"" Health Care Information System (HIS) in a public health care organization in the city of Sao Paulo. The evaluation was performed by means of an in-depth case study with patients and staff of a public health care organization, using qualitative and quantitative data. On the one hand, the system had consequences perceived as positive such as improved convenience and democratization of specialized treatment for patients and improvements in work organization. On the other hand, negative outcomes were reported, like difficulties faced by employees due to little familiarity with IT and an increase in the time needed to schedule appointments. Results show the ambiguity of the implications of HIS in developing countries, emphasizing the need for a more nuanced view of the evaluation of failures and successes and the importance of social contextual factors.

New perspectives on the processing and release of public information

This article discusses issues related to the organization and reception of information in the context of services and public information systems driven by technology. It stems from the assumption that in a ""technologized"" society, the distance between users and information is almost always of cognitive and socio-cultural nature, a product of our effort to design communication. In this context, we favor the approach of the information sign, seeking to answer how a documentary message turns into information, i.e. a structure recognized as socially useful. Observing the structural, cognitive and communicative aspects of the documentary message, based on Documentary Linguistics, Terminology, as well as on Textual Linguistics, the policy of knowledge management and innovation of the Government of the State of Sao Paulo is analyzed, which authorizes the use of Web 2.0, also questioning to what extent this initiative represents innovation in the environment of libraries.

Professional development and a discussion of the professional preparation provided by information and library science degree programs in public universities in Madrid, 2000-2005

A study was designed to determine how the degree programs in Information and library science available in 2000-2005 at the public universities of Madrid fit the tabour market needs of their students. The methodology used was the development of a questionnaire addressed to graduates. Although the number of surveys completed is not high (118), the authors believe that the results obtained permit a series of conclusions that may be extrapolated to the entire cohort.

Organ donation: Acceptance and refusal among users of the public health system from Brazil

The present study sought to identify the perception of a given group of users of the Brazilian Public Health System (Sistema Unico de Saude) regarding organ donation and to implement an educational policy. Structured interviews were conducted with the aim of describing the profile of donor and nondonor subjects, the importance of organ donation, and the knowledge regarding donation and brain death. One hundred subjects were interviewed: 33% of them considered themselves potential donors; 40% were donors; 13% were nondonors; and 14% were ill-informed potential donors. However, only 40% of users have already officially expressed to their families a willingness to donate. Regarding their knowledge about the propitious moment for organ donation, only 64% of them associated the donation act with brain death. Although the present results revealed that users of the Brazilian Public Health System are prone to organ donation, there actually was a high amount of refusals, which may be due to lack of information and knowledge regarding the donation-transplantation process.

Remote control of CNC machines using the CyberOPC communication system over public networks

During the last few years, the evolution of fieldbus and computers networks allowed the integration of different communication systems involving both production single cells and production cells, as well as other systems for business intelligence, supervision and control. Several well-adopted communication technologies exist today for public and non-public networks. Since most of the industrial applications are time-critical, the requirements of communication systems for remote control differ from common applications for computer networks accessing the Internet, such as Web, e-mail and file transfer. The solution proposed and outlined in this work is called CyberOPC. It includes the study and the implementation of a new open communication system for remote control of industrial CNC machines, making the transmission delay for time-critical control data shorter than other OPC-based solutions, and fulfilling cyber security requirements.

Working in public health services in Brazil: The relationship between different rationalities

Success in a public health system is related to its ability to change its production process and to deal with general principles of the health system, such as universality and equity. The frameworks proposed by service marketing scholars have been developed primarily for private services; they focus on acceptance by the targeted client-users, and on the technical specifications of the new service delivery processes. Little attention has been given to the employees` point of view and their activities to maintain service operations modulated by innovation. In a public health system, workers make decisions in real time related to users` needs and the technical specifications of the process; therefore, it is very important to understand how the changes impact on employees` activities and on the quality delivered for citizens. This article discusses how changes implemented in Sao Paulo, Brazil impact the organizational parameters and working activities for front-line workers. (C) 2008 Elsevier Ltd. All rights reserved.

A vaccination game based on public health actions and personal decisions

Susceptible-infective-removed (SIR) models are commonly used for representing the spread of contagious diseases. A SIR model can be described in terms of a probabilistic cellular automaton (PCA), where each individual (corresponding to a cell of the PCA lattice) is connected to others by a random network favoring local contacts. Here, this framework is employed for investigating the consequences of applying vaccine against the propagation of a contagious infection, by considering vaccination as a game, in the sense of game theory. In this game, the players are the government and the susceptible newborns. In order to maximize their own payoffs, the government attempts to reduce the costs for combating the epidemic, and the newborns may be vaccinated only when infective individuals are found in their neighborhoods and/or the government promotes an immunization program. As a consequence of these strategies supported by cost-benefit analysis and perceived risk, numerical simulations show that the disease is not fully eliminated and the government implements quasi-periodic vaccination campaigns. (C) 2011 Elsevier B.V. All rights reserved.

Consumer purchase habits and views on food safety: A Brazilian study

This study aimed to evaluate the attitudes towards food safety among consumers in the city of So Paulo, the major consumer market in Brazil. Focus group sessions were conducted with 30 adults responsible for food choices and purchases. Results indicated a preference for supermarkets over street markets, for the variety of foods, convenience and confidence in the safety assurance. On the other hand, the ""naturalness"" of the products in the street markets was the main reason for purchases in those places. Participants showed concerns with respect to food additives, hormones and pesticides - technological rather than ""natural"" hazards. Minimally processed and ready-to-eat foods were considered convenient products meeting the need for time/labor-savings in the kitchen, although suspicion about wholesomeness and safety came up among consumers. Lack of awareness regarding potentially risky behaviors was observed, including handling and storage of foods in the domestic environment. In conclusion, this study suggests that Brazilian regulators should create more effective risk communication combining technical information with actual consumer perceptions of food risks. (C) 2010 Elsevier Ltd. All rights reserved.

Production efficiency and financing of public health: an analysis of small municipalities in the state of Sao Paulo - Brazil

This paper measured the variations in performance of small municipalities in the State of Sao Paulo, Brazil, regarding the technical efficiency in the use of public funds in public primary health care actions concerning the funding profile, in a scenario of fiscal federalism. Technical efficiency is one of the parameters of evaluation of public sector performance and was measured by means of Data Envelopment Analysis (DEA). The correlation analysis of DEA score was used to verify possible associations between technical efficiency and the funding profile of expenses with health care. The results showed that 6.41% of the municipalities were considered efficient. They also showed that the level of municipality dependence to inter-governmental general purpose grants and the national health funding specific purpose grants have negative correlation with efficiency scores.

Public sociology and social engagement - Considerations on Brazil

The debate on public sociology is spreading in Brazil, a country potentially responsive to Burawoy`s proposals for two reasons: as one of the most unequal countries on the planet, Brazil offers much historical material for reflexive and socially engaged sociology to bring to the non-academic public; and Brazil has a critical and militant sociology that strongly interacts with public sociology. This article provides a `different` reading, through the lens of public sociology of the intellectual and political course of two representatives of this critical and militant sociology: Florestan Fernandes and Francisco de Oliveira.

The actual incidence of congenital adrenal hyperplasia in Brazil may not be as high as inferred - An estimate based on a public neonatal screening program in the state of Goias

The incidence of 21-hydroxylase deficiency (CYP21 D) congenital adrenal hyperplasia (CAH) in Brazil is purportedly one of the highest in the world (1:7,533). However, this information is not based on official data. The aim of this study was to determine the incidence of CYP21 D CAH in the state of Goias, Brazil, based on the 2005 results of government-funded mandatory screening. Of the live births during this period, 92.95% were screened by heel-prick capillary 17 alpha-hydroxyprogesterone (17-OHP). Of these, 82,343 were normal, 28 were at high risk for CAH and 232 at low risk for CAH. Eight cases, all from the high risk group, were confirmed. Eight asymptomatic children at 6-18 months of age still have high 17-OHP levels and await diagnostic definition. Based on the number of confirmed CYP21 D CAH cases among the 82,603 screened, the estimated annual incidence of the disease was 1:10,325, lower than the previously reported rate in Brazil.