Development of a digital hearing aid to meet the Brazilian Government`s Ordinance 587 (APAC) - Health Department

The treatment of sensorineural hearing loss is based on hearing aids, also known as individual sound amplification devices. The hearing aids purchased by the Brazilian Government, aiming at fulfilling public policies, are based on dedicated components, which bring about benefits, but also render them expensive and may impair repair services after manufacture`s warranty expires. Aim: to design digital behind-the-ear hearing aids built from standardized components coming from the very supply chain of these manufacturers. Study design: experimental. Materials and Methods: to identify the supply chain of these manufacturers, request samples and set up hearing aids in the laboratory. Results: The developed hearing aids did not show lesser electroacoustic characteristics when compared to those acquired by the Government, also being tested by the same reference international technical standard. Conclusion: It is possible to develop digital behind-the-ear hearing aids based on off-the-shelf components from hearing aid manufacturers` supply chain. Their advantages include low operational costs - for acquisition (with clear advantages for the Government) and service (advantage for the patient).

Adherence to cervical and breast cancer programs is crucial to improving screening performance

Introduction: Cervical and breast cancer are the most common malignancies among women worldwide. Effective screening can facilitate early detection and dramatically reduce mortality rates. The interface between those screening patients and patients most needing screening is complex, and women in remote areas of rural counties face additional barriers that limit the effectiveness of cancer prevention programs. This study compared various methods to improve compliance with mass screening for breast and cervical cancer among women in a remote, rural region of Brazil. Methods: In 2003, a mobile unit was used to perform 10 156 mammograms and Papanicolaou smear tests for women living in the Barretos County region of Sao Paulo state, Brazil (consisting of 19 neighbouring cities). To reach the women, the following community outreach strategies were used: distribution of flyers and pamphlets; media broadcasts (via radio and car loudspeakers); and community healthcare agents (CHCAs) making home visits. Results: The most useful intervention appeared to be the home visits by healthcare agents or CHCAs. These agents of the Family Health Programme of the Brazilian Ministry of Health reached an average of 45.6% of those screened, with radio advertisements reaching a further 11.9%. The great majority of the screened women were illiterate or had elementary level schooling (80.9%) and were of 'poor' or 'very poor' socioeconomic class (67.2%). Conclusions: Use of a mobile screening unit is a useful strategy in developing countries where local health systems have inadequate facilities for cancer screening in underserved populations. A multimodal approach to community outreach strategies, especially using CHCAs and radio advertisements, can improve the uptake of mass screening in low-income, low-educational background female populations.

Demographic profile of blood donors at three major Brazilian blood centers: results from the International REDS-II study, 2007 to 2008

BACKGROUND: The profile of blood donors changed dramatically in Brazil over the past 20 years, from remunerated to nonremunerated and then from replacement to community donors. Donor demographic data from three major blood centers establish current donation profiles in Brazil, serving as baseline for future analyses and tracking longitudinal changes in donor characteristics. STUDY DESIGN AND METHODS: Data were extracted from the blood center, compiled in a data warehouse, and analyzed. Population data were obtained from the Brazilian census. RESULTS: During 2007 to 2008, there were 615,379 blood donations from 410,423 donors. A total of 426,142 (69.2%) were from repeat (Rpt) donors and 189,237 (30.8%) were from first-time (FT) donors. Twenty percent of FT donors returned to donate in the period. FT donors were more likely to be younger, and Rpt donors were more likely to be community donors. All were predominantly male. Replacement donors still represent 50% of FT and 30% of Rpt donors. The mean percentage of the potentially general population who were donors was approximately 1.2% for the three centers (0.7, 1.5, and 3.1%). Adjusting for the catchment`s area, the first two were 2.1 and 1.6%. CONCLUSIONS: Donors in the three Brazilian centers tended to be younger with a higher proportion of males than in the general population. Donation rates were lower than desirable. There were substantial differences in sex, age, and community/replacement status by center. Studies on the safety, donation frequencies, and motivations of donors are in progress to orient efforts to enhance the availability of blood.

Políticas públicas para o controle da anemia ferropriva

A anemia por deficiência de ferro configura um problema epidemiológico da maior relevância atuando nos gastos públicos de saúde, nas consequências sociais do aumento de riscos no período gestacional, na redução da produtividade e, ainda, nas consequências, em longo prazo, do desenvolvimento mental. Algumas datas marcam o envolvimento do governo brasileiro em busca de alternativas de controle da deficiência marcial: 1977 - 1ª Reunião do Ministério da Saúde (INAN), com especialistas nacionais e internacionais, para discutir perspectivas e intervenções para o controle da anemia; 1982/83 - distribuição de suplemento de ferro para a clientela do Programa de Atenção à Gestante e dosagem de hemoglobina na 1ª consulta; 1992 - assinatura de compromisso brasileiro de reduzir em 1/3 a prevalência de anemia em gestantes; 1994 - implantação do Programa de Leite Vivaleite, no estado de São Paulo, fornecendo leite fortificado com ferro a famílias com crianças até 6 anos e renda inferior a dois salários mínimos; 2002/junho 2004 - fortificação das farinhas de trigo e de milho com ferro; 2005 - programa de suplementação de ferro a lactentes; 2009/março - divulgação do resultado do levantamento de prevalência de anemia em mulheres (15-49 anos) e crianças (6 - 59 meses) no Brasil; 2009/agosto - foi reeditada a Portaria no 1793/GM/agosto/2009 do Ministério da Saúde, instituindo a Comissão Interinstitucional para implementação, acompanhamento e monitorização das ações de fortificação das farinhas de trigo e milho e seus subprodutos.

ALFABETIZAÇÃO DIGITAL: proposição de parâmetros metodológicos em competência informacional

Much has been discussed about Digital Literacy, but it is quite obscure the identification of the skills required to develop such process. This study was done towards an integration of the Digital Literacy process to the specific informational skills a person may dominate, search, retrieve and use information efficiently, in its professional, academic or personal life. The main objective of this work is to propose methodological parameters for training in informational skills. Otherwise, the specific objectives are associated to the supposition and identification of the desired skills of the Digital Literacy program participants. The methodological procedures applied to the research are of exploratory character, and to do so two tools are used: the literature research and case studies. Besides having the methodology in structured information competence, the study points out to the fact that the country is too far from what is desired concerning development and employment of Digital Literacy programs consistent enough to support the teaching and learning of searching, recovering and using of information by the participants. Therefore, it is essential to create programs that provide not only machinery, but motivate individuals to develop informational skills to help in the learning process.

A gestão do conhecimento na educação ambiental

Information and knowledge are resources of environmental education (EE) that can be performed through knowledge management (KM). The aim of this paper is to propose measures of knowledge creation (KC) to improve performance of EE. This study is based on the research literature without empirical findings; therefore, the results are limited by the methodological resources of the theoretical essay. However, this limitation is the greatest motivation for future research which could investigate the proximity of EE with KM and KC in empirical investigations. Some suggestions for developing the requirements of KC programs to EE are presented as the results: possibility of the SECI process to better perform various aspects of environmental education such as social learning, interaction activities, dialogue, experience exchanging, information and knowledge, and of different ideas and ways of acting, done by EE and, finally, the possibility of Ba to develop a proper space for creation of new environmental knowledge. This article contains academic contributions to KM by providing greater discussion and understanding of KC; to EE when it allows a different view based on the work of information and knowledge about the processes of teaching, when contributing to social programs for EE, improving their practices and, consequently, contributing to an environmentally sustainable economic development.

Validation of an HPLC analytical method for determination of pancuronium bromide in pharmaceutical injections

Pancuronium bromide is used with general anesthesia in surgery for muscle relaxation and as an aid to intubation. A high performance liquid chromatographic method was fully validated for the quantitative determination of pancuronium bromide in pharmaceutical injectable solutions. The analytical method was performed on an amino column (Luna 150mm4.6mm, 5m). The mobile phase was composed of acetonitrile:water containing 50mmol L-1 of 1-octane sulfonic acid sodium salt (20:80v/v) with a flow rate of 1.0mL min-1 and ultraviolet (UV) detection at 210nm. The proposed analytical method was compared with that described in the British Pharmacopoeia.

CHARACTERIZATION OF AGROINDUSTRIAL SYSTEMS: A COMPARATIVE STUDY OF THE SUCRO-ENERGETIC SECTORS OF BRASIL AND COLOMBIA

Concern about the growing demand of food and fuel has focused the attention on countries with conditions to provide for global requirements. Also, the build-up of an environmental awareness has compelled several governments to implement programs for the addition of biofuels to oil derivatives. Considering their relevance as world and South American producers, this study makes a characterization of the sucro-energetic sectors of Brazil and Colombia, based on a view of agro-industrial systems, industrial organization and transaction cost economy. The approach followed considered of a secondary information survey and in-depth interviews. The main differences found are centered on institutional development level and production volumes. However, the use of the same raw material, sugarcane, trade opening policies, cultural approaches and regional integration, are factors that could generate links of commercial exchange and technological cooperation between the two countries.

Bariatric Surgery Reverses Natural Killer (NK) Cell Activity and NK-Related Cytokine Synthesis Impairment Induced by Morbid Obesity

Background Obesity is related to a higher rate of infections and some types of cancer. Here we analyzed the impact of obesity and weight loss induced by Roux-en-Y gastric bypass (RYGB) on immunological parameters, i.e., cytokine productions and natural killer cell function. Methods We analyzed 28 morbidly obese patients before and 6 months after RYGB. Biochemical parameters were analyzed in plasma. The percent of natural killer (NK) cells, their cytotoxicity, and the production of cytokines by peripheral blood mononuclear cells were analyzed. The percent of NK cells was determined by flow cytometry and cytokine production determined by enzyme-linked immunosorbent assay. NK cytotoxicity was determined by the lactate dehydrogenase release assay. Results The weight loss 6 months following surgery was 35.3 +/- 4.5 kg. RYGB also improves biochemical parameters. No significant difference was found in the percent of NK cells after surgery. We found an increase in the production of interferon-gamma, interleukin (IL)-12 and IL-18, but not in IL-2, 6 months after RYGB. Cytotoxic activity of NK cells was significantly enhanced 6 months after RYGB [17.1 +/- 14.7% before RYGB vs 51.8 +/- 11.3% at 6 months after, at 40: 1 effector to target cell ratio; p<0.001]. We observed significant post-surgical improvement in the cytotoxic activity curve in 22 out of 28 patients (78.6%), irrespective of the target to effector cell ratio. Conclusions The weight loss induced by RYGB modifies the production of cytokines related with NK cell function and improves its activity.