Dependência de Internet e de jogos eletrônicos: uma revisão

OBJETIVO: Com a inclusão das novas tecnologias contemporâneas, a Internet e os jogos eletrônicos tornaram-se ferramentas de uso amplo e irrestrito, transformando-se em um dos maiores fenômenos mundiais da última década. Diversas pesquisas atestam os benefícios desses recursos, mas seu uso sadio e adaptativo progressivamente deu lugar ao abuso e à falta de controle ao criar severos impactos na vida cotidiana de milhões de usuários. O objetivo deste estudo foi revisar de forma sistemática os artigos que examinam a dependência de Internet e jogos eletrônicos na população geral. Almejamos, portanto, avaliar a evolução destes conceitos no decorrer da última década, assim como contribuir para a melhor compreensão do quadro e suas comorbidades. MÉTODO: Foi feita uma revisão sistemática da literatura através do MedLine, Lilacs, SciELO e Cochrane usando-se como parâmetro os termos: "Internet addiction", pathological "Internet use", "problematic Internet use", "Internet abuse", "videogame", "computer games" e "electronic games". A busca eletrônica foi feita até dezembro de 2007. DISCUSSÃO: Estudos realizados em diferentes países apontam para prevalências ainda muito diversas, o que provavelmente se deve à falta de consenso e ao uso de diferentes denominações, dando margem à adoção de distintos critérios diagnósticos. Muitos pacientes que relatam o uso abusivo e dependência passam a apresentar prejuízos significativos na vida profissional, acadêmica (escolar), social e familiar. CONCLUSÕES: São necessárias novas investigações para determinar se esse uso abusivo de Internet e de jogos eletrônicos pode ser compreendido como uma das mais novas classificações psiquiátricas do século XXI ou apenas substratos de outros transtornos.

(Im)possibilidades de implementar uma direção única no SUS em município de grande porte: o caso de São Paulo, Brasil

A construção da direção única na saúde constitui-se um desafio para a gestão local do SUS, particularmente para municípios de grande porte. Este artigo analisou o processo de implementação do SUS no município de São Paulo, visando identificar estratégias para viabilizar uma direção única, no período de 2001 a 2008. Com base em um estudo de caso, foram utilizados dados obtidos de informantes privilegiados da gestão e de documentos de gestão. O conceito de integração sanitária foi utilizado como categoria analítica. Foram analisados movimentos e estratégias dos atores institucionais envolvidos diretamente na gestão do SUS, os gestores municipal e estadual. Observaram-se avanços institucionais como a municipalização das unidades básicas de saúde estaduais e a habilitação do município na gestão plena do sistema municipal. Apesar dessa condição de gestão e da identidade político-partidária entre os governos municipal e estadual desde 2005, constatou-se a coexistência de dois subsistemas públicos de saúde pouco integrados. Um municipal, que concentrava os serviços de atenção básica; outro estadual, que concentrava parte considerável dos serviços de média e alta complexidades. Instrumentos de gestão adotados, como o sistema de regulação, mostraram-se frágeis para superar a falta de integração entre os referidos subsistemas. Como implementar a direção única no SUS implica uma (re)divisão de recursos e poder, discute-se que não bastam normas nem instrumentos de gestão para viabilizá-la. É um desafio estratégico para o SUS implementar processo de negociação, envolvendo os atores institucionais e políticos, visando a pactuação de um projeto político na saúde.

Surveillance for adverse events after DTwP/Hib vaccination in Brazil: sensitivity and factors associated with reporting

We estimated the sensitivity, i.e., the proportion of all cases of adverse events following immunization (AEFIs) reported to the Brazilian passive surveillance for adverse events following immunization (PSAEFI) with the diphtheria-tetanus-whole-cell pertussis-Haemophilus influenzae type b (DTwP-Hib) vaccine, as well as investigating factors associated with AEFIs reporting. During 2003–2004, 8303 AEFIs associated with DTwP-Hib were reported; hypotonic-hyporesponsive episodes (HHEs), fever and convulsions being the most common. Cure without sequel was achieved in 98.4 per cent of the cases. The mean sensitivity of the PSAEFI was 22.3 per cent and 31.6 per cent, respectively, for HHE and convulsions, varying widely among states. Reporting rates correlated positively with the Human Development Index and coverage of adequate prenatal care, correlating negatively with infant mortality rates. Quality of life indicators and the degree of organization of health services are associated with greater PSAEFI sensitivity. In addition to consistently describing the principal AEFIs, PSAEFI showed the DTwP/Hib vaccine to be safe and allayed public fears related to its use

Methods and Participant Characteristics of a Randomized Intervention to Promote Physical Activity and Healthy Eating Among Brazilian High School Students: The Saude na Boa Project

Background: A cross-cultural, randomized study was proposed to observe the effects of a school-based intervention designed to promote physical activity and healthy eating among high school students in 2 cities from different regions in Brazil: Recife and Florianopolis. The objective of this article is to describe the methodology and subjects enrolled in the project. Methods: Ten schools from each region were matched and randomized into intervention and control conditions. A questionnaire and anthropometry were used to collect data in the first and last month of the 2006 school year. The sample (n = 2155 at baseline; 55.7% females; 49.1% in the experimental group) included students 15 to 24 years, attending nighttime classes. The intervention focused on simple environmental/organizational changes, diet and physical activity education, and personnel training. Results: The central aspects of the intervention have been implemented in all 10 intervention schools. Problems during the intervention included teachers' strikes in both sites and lack of involvement of the canteen owners in schools. Conclusions: The Saude no Boa study provides evidence that public high schools in Brazil represent an important environment for health promotion. Its design and simple measurements increase the chances of it being sustained and disseminated to similar schools in Brazil.

Effectiveness of a School-Based Intervention on Physical Activity for High School Students in Brazil: The Saude na Boa Project

Background: We evaluated the effectiveness of a school-based intervention on the promotion of physical activity among high school students in Brazil: the Saude no Boa project. Methods: A school-based, randomized trial was carried out in 2 Brazilian cities: Recife (northeast) and Florianopolis (south). Ten schools in each city were matched by size and location, and randomized into intervention or control groups. The intervention included environmental/organizational changes, physical activity education, and personnel training and engagement. Students age 15 to 24 years were evaluated at baseline and 9 months later (end of school year). Results: Although similar at baseline, after the intervention, the control group reported significantly fewer d/wk accumulating 60 minutes+ moderate-to-vigorous physical activity (MVPA) in comparison with the intervention group (2.6 versus 3.3, P < .001). The prevalence of inactivity (0 days per week) rose in the control and decreased in the intervention group. The odds ratio for engaging at least once per week in physical activity associated with the intervention was 1.83 (95% CI = 1.24-2.71) in the unadjusted analysis and 1.88 (95% CI = 1.27-2.79) after controlling for gender. Conclusion: The Saude no Boa intervention was effective at reducing the prevalence of physical inactivity. The possibility of expanding the intervention to other locations should be considered.

Spatial patterns of malaria in a land reform colonization project, Juruena municipality, Mato Grosso, Brazil

Background: In Brazil, 99% of malaria cases are concentrated in the Amazon, and malaria's spatial distribution is commonly associated with socio-environmental conditions on a fine landscape scale. In this study, the spatial patterns of malaria and its determinants in a rural settlement of the Brazilian agricultural reform programme called ""Vale do Amanhecer"" in the northern Mato Grosso state were analysed. Methods: In a fine-scaled, exploratory ecological study, geocoded notification forms corresponding to malaria cases from 2005 were compared with spectral indices, such as the Normalized Difference Vegetation Index (NDVI) and the third component of the Tasseled Cap Transformation (TC_3) and thematic layers, derived from the visual interpretation of multispectral TM-Landsat 5 imagery and the application of GIS distance operators. Results: Of a total of 336 malaria cases, 102 (30.36%) were caused by Plasmodium falciparum and 174 (51.79%) by Plasmodium vivax. Of all the cases, 37.6% (133 cases) were from residents of a unique road. In total, 276 cases were reported for the southern part of the settlement, where the population density is higher, with notification rates higher than 10 cases per household. The local landscape mostly consists of open areas (38.79 km(2)). Training forest occupied 27.34 km(2) and midsize vegetation 7.01 km(2). Most domiciles with more than five notified malaria cases were located near areas with high NDVI values. Most domiciles (41.78%) and malaria cases (44.94%) were concentrated in areas with intermediate values of the TC_3, a spectral index representing surface and vegetation humidity. Conclusions: Environmental factors and their alteration are associated with the occurrence and spatial distribution of malaria cases in rural settlements.

Balance control in hemiparetic stroke patients: Main tools for evaluation

Balance problems in hemiparetic patients after stroke can be caused by different impairments in the physiological systems involved in Postural control, including sensory afferents, movement strategies, biomechanical constraints, cognitive processing, and perception of verticality. Balance impairments and disabilities must be appropriately addressed. This article reviews the most common balance abnormalities in hemiparetic patients with stroke and the main tools used to diagnose them.

No-match ORESTES explored as tumor markers

Sequencing technologies and new bioinformatics tools have led to the complete sequencing of various genomes. However, information regarding the human transcriptome and its annotation is yet to be completed. The Human Cancer Genome Project, using ORESTES (open reading frame EST sequences) methodology, contributed to this objective by generating data from about 1.2 million expressed sequence tags. Approximately 30 of these sequences did not align to ESTs in the public databases and were considered no-match ORESTES. On the basis that a set of these ESTs could represent new transcripts, we constructed a cDNA microarray. This platform was used to hybridize against 12 different normal or tumor tissues. We identified 3421 transcribed regions not associated with annotated transcripts, representing 83.3 of the platform. The total number of differentially expressed sequences was 1007. Also, 28 of analyzed sequences could represent noncoding RNAs. Our data reinforces the knowledge of the human genome being pervasively transcribed, and point out molecular marker candidates for different cancers. To reinforce our data, we confirmed, by real-time PCR, the differential expression of three out of eight potentially tumor markers in prostate tissues. Lists of 1007 differentially expressed sequences, and the 291 potentially noncoding tumor markers were provided.

Monitoring stress tolerance and occurrences of upper respiratory illness in basketball players by means of psychometric tools and salivary biomarkers

The aim of the study was to evaluate the possible relationships between stress tolerance, training load, banal infections and salivary parameters during 4 weeks of regular training in fifteen basketball players. The Daily Analysis of Life Demands for Athletes` questionnaire (sources and symptoms of stress) and the Wisconsin Upper Respiratory Symptom Survey were used on a weekly basis. Salivary cortisol and salivary immunoglobulin A (SIgA) were collected at the beginning (before) and after the study, and measured by enzyme-linked immunosorbent assay (ELISA). Ratings of perceived exertion (training load) were also obtained. The results from ANOVA with repeated measures showed greater training loads, number of upper respiratory tract infection episodes and negative sensation to both symptoms and sources of stress, at week 2 (p < 0.05). Significant increases in cortisol levels and decreases in SIgA secretion rate were noted (before to after). Negative sensations to symptoms of stress at week 4 were inversely and significantly correlated with SIgA secretion rate. A positive and significant relationship between sources and symptoms of stress at week 4 and cortisol levels were verified. In summary, an approach incorporating in conjunction psychometric tools and salivary biomarkers could be an efficient means of monitoring reaction to stress in sport. Copyright (C) 2010 John Wiley & Sons, Ltd.

Modeling associations between genetic markers using Bayesian networks

Motivation: Understanding the patterns of association between polymorphisms at different loci in a population ( linkage disequilibrium, LD) is of fundamental importance in various genetic studies. Many coefficients were proposed for measuring the degree of LD, but they provide only a static view of the current LD structure. Generative models (GMs) were proposed to go beyond these measures, giving not only a description of the actual LD structure but also a tool to help understanding the process that generated such structure. GMs based in coalescent theory have been the most appealing because they link LD to evolutionary factors. Nevertheless, the inference and parameter estimation of such models is still computationally challenging. Results: We present a more practical method to build GM that describe LD. The method is based on learning weighted Bayesian network structures from haplotype data, extracting equivalence structure classes and using them to model LD. The results obtained in public data from the HapMap database showed that the method is a promising tool for modeling LD. The associations represented by the learned models are correlated with the traditional measure of LD D`. The method was able to represent LD blocks found by standard tools. The granularity of the association blocks and the readability of the models can be controlled in the method. The results suggest that the causality information gained by our method can be useful to tell about the conservability of the genetic markers and to guide the selection of subset of representative markers.

Fault Detection in Power Distribution Systems Using Automated Integration of Computational Intelligence Tools

The main purpose of this paper is to present architecture of automated system that allows monitoring and tracking in real time (online) the possible occurrence of faults and electromagnetic transients observed in primary power distribution networks. Through the interconnection of this automated system to the utility operation center, it will be possible to provide an efficient tool that will assist in decisionmaking by the Operation Center. In short, the desired purpose aims to have all tools necessary to identify, almost instantaneously, the occurrence of faults and transient disturbances in the primary power distribution system, as well as to determine its respective origin and probable location. The compilations of results from the application of this automated system show that the developed techniques provide accurate results, identifying and locating several occurrences of faults observed in the distribution system.

Support Tool to the Validation Process of Functional Requirements

The activity of validating identified requirements for an information system helps to improve the quality of a requirements specification document and, consequently, the success of a project. Although various different support tools to requirements engineering exist in the market, there is still a lack of automated support for validation activity. In this context, the purpose of this paper is to make up for that deficiency, with the use of an automated tool, to provide the resources for the execution of an adequate validation activity. The contribution of this study is to enable an agile and effective follow-up of the scope established for the requirements, so as to lead the development to a solution which would satisfy the real necessities of the users, as well as to supply project managers with relevant information about the maturity of the analysts involved in requirements specification.

Ultrasound, eddy current and magnetic Barkhausen noise as tools for sigma phase detection on a UNS S31803 duplex stainless steel

Sigma phase is a deleterious one which can be formed in duplex stainless steels during heat treatment or welding. Aiming to accompany this transformation, ferrite and sigma percentage and hardness were measured on samples of a UNS S31803 duplex stainless steel submitted to heat treatment. These results were compared to measurements obtained from ultrasound and eddy current techniques, i.e., velocity and impedance, respectively. Additionally, backscattered signals produced by wave propagation were acquired during ultrasonic inspection as well as magnetic Barkhausen noise during magnetic inspection. Both signal types were processed via a combination of detrended-fluctuation analysis (DFA) and principal component analysis (PCA). The techniques used were proven to be sensitive to changes in samples related to sigma phase formation due to heat treatment. Furthermore, there is an advantage using these methods since they are nondestructive. (C) 2010 Elsevier B.V. All rights reserved.

Assessing the evolution of sustainability reporting in the mining sector

Since the 1990s several large companies have been publishing nonfinancial performance reports. Focusing initially on the physical environment, these reports evolved to consider social relations, as well as data on the firm`s economic performance. A few mining companies pioneered this trend, and in the last years some of them incorporated the three dimensions of sustainable development, publishing so-called sustainability reports. This article reviews 31 reports published between 2001 and 2006 by four major mining companies. A set of 62 assessment items organized in six categories (namely context and commitment, management, environmental, social and economic performance, and accessibility and assurance) were selected to guide the review. The items were derived from international literature and recommended best practices, including the Global Reporting Initiative G3 framework. A content analysis was performed using the report as a sampling unit, and using phrases, graphics, or tables containing certain information as data collection units. A basic rating scale (0 or 1) was used for noting the presence or absence of information and a final percentage score was obtained for each report. Results show that there is a clear evolution in report`s comprehensiveness and depth. Categories ""accessibility and assurance"" and ""economic performance"" featured the lowest scores and do not present a clear evolution trend in the period, whereas categories ""context and commitment"" and ""social performance"" presented the best results and regular improvement; the category ""environmental performance,"" despite it not reaching the biggest scores, also featured constant evolution. Description of data measurement techniques, besides more comprehensive third-party verification are the items most in need of improvement.

Tiering strategic environmental assessment and project environmental impact assessment in highway planning in Sao Paulo, Brazil

Constructing highways in dense urban areas is always a challenge. In Sao Paulo Metropolitan Region, heavy truck traffic contributes to clog streets and expressways alike. As part of the traffic neither originates nor head to the region, a peripheral highway has been proposed to reduce traffic problems. This project called Rodoanel, is an expressway approximately 175 km long. The fact that the projected south and north sections would cross catchments that supply most of the metropolis water demand was strongly disputed and made the environmental permitting process particularly difficult. The agency in charge commissioned a strategic environmental assessment (SEA) of a revamped project, and called it the Rodoanel Programme. However, the SEA report failed to satisfactorily take account of significant strategic issues. Among these, the highway potential effect of inducing urban sprawl over water protection zones is the most critical issue, as it emerged later as a hurdle to project licensing. Conclusion is that, particularly where no agreed-upon framework for SEA exists, when vertical tiering with downstream project EIA is sought, then a careful scoping of strategic issues is more than necessary. If an agreement on `what is strategic` is not reached and not recognized by influential stakeholders, then the unsettled conflicts will be transferred to project EIA. In such a context, SEA will have added another loop to the usually long road to project approval. (c) 2008 Elsevier Inc. All rights reserved.