Prevalência de deficiência auditiva referida e causas atribuídas: um estudo de base populacional

Objetivou-se verificar a prevalência de deficiência auditiva referida pela população urbana de quatro localidades do Estado de São Paulo, Brasil, e estudar as causas atribuídas e variáveis sócio-demográficas. Foi realizado um estudo transversal de base populacional com dados referentes à população com 12 anos ou mais residente nas quatro localidades, em 2001 e 2002. Participaram 5.250 sujeitos selecionados por amostragem probabilística, estratificada e selecionada por conglomerados, em dois estágios. A análise dos dados foi exploratória, incluindo análise bivariada e regressão logística múltipla. A prevalência de deficiência auditiva foi 5,21%, mais acentuada nas faixas etárias acima de 59 anos (18,7%), que referiram doenças nos 15 dias anteriores à entrevista (8,4%), com transtorno mental comum (8,85%) e que fizeram uso de medicamentos nos últimos 3 dias (8,45%). O estudo dos fatores que se associam à deficiência auditiva direcionam intervenções de saúde para que atendam as reais necessidades da população, principalmente na atenção primária. Há necessidade de mais estudos populacionais com enfoque na audição, visto que esta é uma área escassa de publicações no Brasil.

Residential high-rise buildings in São Paulo: aspects related to the adequacy to the occupant`s needs

This paper analyzes the production of apartment buildings for the middle-income segment in the city of So Paulo, Brazil, from a historical perspective. Tracing the response to the occupants` needs, the focus is on family profiles and their demands, the relationship between architectural design and marketing, and satisfaction levels of current users. The paper begins with a brief historical overview of how apartment buildings have evolved over the past eight decades, highlighting the consolidation of the tripartite model. Next, it analyzes family profiles and their current needs, which would call for a redesign of domestic space. From a different angle, it shows how the real-estate market reacts to this situation, namely by introducing minor changes in the domestic space that are closely linked to major investments in marketing. This leads to a discussion on the quality of recent architectural designs in light of Post-Occupancy Evaluation (POE) case studies, which corroborate the tendencies previously outlined. The conclusions drawn from the POEs suggest that the market should establish a closer and deeper relationship between the assessment of the human behavior in the domestic space and the architectural quality of homes as a means of increasing satisfaction levels and improving design performance.

Perspectiva das mulheres na avaliação do Programa de Humanização do Pré-Natal e Nascimento

OBJETIVO: Analisar a importância da inclusão da perspectiva das mulheres na avaliação do Programa de Humanização do Pré-Natal e Nascimento. PROCEDIMENTOS METODOLÓGICOS: Estudo qualitativo realizado em base a dados primários coletados para a avaliação do Programa de Humanização do Pré-Natal e Nascimento, do Ministério da Saúde, em 2003, em sete municípios das cinco regiões do Brasil, selecionados a partir de dados extraídos de sistemas de bancos de dados oficiais já existentes. Um dos atores considerado fundamental para a coleta de informações foi a mulher atendida pelo Programa, abordada por meio de dezesseis grupos focais realizados em unidades de saúde. Para o tratamento dos dados empíricos foi utilizado o método do Discurso do Sujeito Coletivo. A análise e discussão foram realizadas com o apoio dos conceitos em saúde pública de acessibilidade e Saúde Paidéia. ANÁLISE DOS RESULTADOS: O Programa estudado normatiza para todos os serviços de saúde do país os procedimentos para a atenção ao pré-natal e o parto e os fluxos a serem observados. A análise do discurso das gestantes, nos grupos focais realizados, trouxe clareza quanto à dissonância existente entre muitas dessas recomendações e os desejos e necessidades da mulher, o que faz com que ela procure traçar para si um outro fluxo de atendimentos. Esta ocorrência traz prejuízos ao vínculo que estabelece com o serviço de saúde, além de dificuldades de controle pelo serviço do seguimento real que está sendo oferecido. CONCLUSÕES: A reflexão realizada do Programa, tomando por base a perspectiva das mulheres atendidas, identificou aspectos cuja consideração no momento da avaliação poderia resultar em maior efetividade e humanização do controle pré-natal oferecido

A oferta de serviços de informação por situação de vida em sítios Web de bibliotecas virtuais: em busca da qualidade no atendimento

With the advent and development of technology, mainly in the Internet, more and more electronic services are being offered to customers in all areas of business, especially in the offering of information services, as in virtual libraries. This article proposes a new opportunity to provide services to virtual libraries customers, presenting a methodology for the implementation of electronic services oriented by these customers' life situations. Through analytical observations of some national virtual libraries sites, it could be identified that the offer of services considering life situations and relationship interest situations can promote the service to their customers, providing greater satisfaction and, consequently, improving quality in the offer of information services. The visits to those sites and the critical analysis of the data collected during these visits, supported by bibliographic researches results, have enabled the description of this methodology, concluding that the provision of services on an isolated way or in accordance with the user's profile on sites of virtual libraries is not always enough to ensure the attendance to the needs and expectations of its customers, which suggests the offering of these services considering life situations and relationship interest situations as a complement that adds value to the business of virtual library. This becomes relevant when indicates new opportunities to provide virtual libraries services with quality, serving as a guide to the information providers managers, enabling the offering of new means to access information services by such customers, looking for pro - activity and services integration, in order to solve definitely real problems.

Validation of reference genes for gene expression studies in the honey bee, Apis mellifera, by quantitative real-time RT-PCR

For obtaining accurate and reliable gene expression results it is essential that quantitative real-time RT-PCR (qRT-PCR) data are normalized with appropriate reference genes. The current exponential increase in postgenomic studies on the honey bee, Apis mellifera, makes the standardization of qRT-PCR results an important task for ongoing community efforts. For this aim we selected four candidate reference genes (actin, ribosomal protein 49, elongation factor 1-alpha, tbp-association factor) and used three software-based approaches (geNorm, BestKeeper and NormFinder) to evaluate the suitability of these genes as endogenous controls. Their expression was examined during honey bee development, in different tissues, and after juvenile hormone exposure. Furthermore, the importance of choosing an appropriate reference gene was investigated for two developmentally regulated target genes. The results led us to consider all four candidate genes as suitable genes for normalization in A. mellifera. However, each condition evaluated in this study revealed a specific set of genes as the most appropriated ones.

Development of Hepatitis C Virus Genotyping by Real-Time PCR Based on the NS5B Region

Background: Hepatitis C virus (HCV) genotyping is the most significant predictor of the response to antiviral therapy. The aim of this study was to develop and evaluate a novel real-time PCR method for HCV genotyping based on the NS5B region. Methodology/Principal Findings: Two triplex reaction sets were designed, one to detect genotypes 1a, 1b and 3a; and another to detect genotypes 2a, 2b, and 2c. This approach had an overall sensitivity of 97.0%, detecting 295 of the 304 tested samples. All samples genotyped by real-time PCR had the same type that was assigned using LiPA version 1 (Line in Probe Assay). Although LiPA v. 1 was not able to subtype 68 of the 295 samples (23.0%) and rendered different subtype results from those assigned by real-time PCR for 12/295 samples (4.0%), NS5B sequencing and real-time PCR results agreed in all 146 tested cases. Analytical sensitivity of the real-time PCR assay was determined by end-point dilution of the 5000 IU/ml member of the OptiQuant HCV RNA panel. The lower limit of detection was estimated to be 125 IU/ml for genotype 3a, 250 IU/ml for genotypes 1b and 2b, and 500 IU/ml for genotype 1a. Conclusions/Significance: The total time required for performing this assay was two hours, compared to four hours required for LiPA v. 1 after PCR-amplification. Furthermore, the estimated reaction cost was nine times lower than that of available commercial methods in Brazil. Thus, we have developed an efficient, feasible, and affordable method for HCV genotype identification.

Real-Time PCR in HIV/Trypanosoma cruzi Coinfection with and without Chagas Disease Reactivation: Association with HIV Viral Load and CD4(+) Level

Background: Reactivation of chronic Chagas disease, which occurs in approximately 20% of patients coinfected with HIV/Trypanosoma cruzi (T. cruzi), is commonly characterized by severe meningoencephalitis and myocarditis. The use of quantitative molecular tests to monitor Chagas disease reactivation was analyzed. Methodology: Polymerase chain reaction (PCR) of kDNA sequences, competitive (C-) PCR and real-time quantitative (q) PCR were compared with blood cultures and xenodiagnosis in samples from 91 patients (57 patients with chronic Chagas disease and 34 with HIV/T. cruzi coinfection), of whom 5 had reactivation of Chagas disease and 29 did not. Principal Findings: qRT-PCR showed significant differences between groups; the highest parasitemia was observed in patients infected with HIV/T. cruzi with Chagas disease reactivation (median 1428.90 T. cruzi/mL), followed by patients with HIV/T. cruzi infection without reactivation (median 1.57 T. cruzi/mL) and patients with Chagas disease without HIV (median 0.00 T. cruzi/mL). Spearman's correlation coefficient showed that xenodiagnosis was correlated with blood culture, C-PCR and qRT-PCR. A stronger Spearman correlation index was found between C-PCR and qRT-PCR, the number of parasites and the HIV viral load, expressed as the number of CD4(+) cells or the CD4(+)/CD8(+) ratio. Conclusions: qRT-PCR distinguished the groups of HIV/T. cruzi coinfected patients with and without reactivation. Therefore, this new method of qRT-PCR is proposed as a tool for prospective studies to analyze the importance of parasitemia (persistent and/or increased) as a criterion for recommending pre-emptive therapy in patients with chronic Chagas disease with HIV infection or immunosuppression. As seen in this study, an increase in HIV viral load and decreases in the number of CD4(+) cells/mm(3) and the CD4(+)/CD8(+) ratio were identified as cofactors for increased parasitemia that can be used to target the introduction of early, pre-emptive therapy.

Detection of dengue virus in saliva and urine by real time RT-PCR

Early diagnosis of dengue virus (DENV) infection is important for patient management and control of dengue outbreaks. The objective of this study was to analyze the usefulness of urine and saliva samples for early diagnosis of DENV infection by real time RT-PCR. Two febrile patients, who have been attended at the General Hospital of the School of Medicine of Ribeirao Preto, Sao Paulo University were included in the study. Serum, urine and saliva samples collected from both patients were subjected to real time RT-PCR for DENV detection and quantification. Dengue RNA was detected in serum, urine and saliva samples of both patients. Patient 1 was infected with DENV-2 and patient 2 with DENV-3. Data presented in this study suggest that urine and saliva could be used as alternative samples for early diagnosis of dengue virus infection when blood samples are difficult to obtain, e.g.,in newborns and patients with hemorrhagic syndromes.

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.

Designing real nanotube-based gas sensors

Using a combination of density functional theory and recursive Green's functions techniques, we present a full description of a large scale sensor, accounting for disorder and different coverages. Here, we use this method to demonstrate the functionality of nitrogen-rich carbon nanotubes as ammonia sensors as an example. We show how the molecules one wishes to detect bind to the most relevant defects on the nanotube, describe how these interactions lead to changes in the electronic transport properties of each isolated defect, and demonstrate that there are significative resistance changes even in the presence of disorder, elucidating how a realistic nanosensor works.

Real-time PCR investigation on the expression of sboA and ituD genes in Bacillus spp

Aims: To investigate the expression of sboA and ituD genes among strains of Bacillus spp. at different pH and temperature. Methods and Results: Different Bacillus strains from the Amazon basin and Bacillus subtilis ATCC 19659 were investigated for the production of subtilosin A and iturin A by qRT-PCR, analysing sboA and ituD gene expression under different culture conditions. Amazonian strains presented a general gene expression level lower than B. subtilis ATCC 19659 for sboA. In contrast, when analysing the expression of ituD gene, the strains from the Amazon, particularly P40 and P45B, exhibited higher levels of expression. Changes in pH (6 and 8) and temperature (37 and 42 degrees C) caused a decrease in sboA expression, but increased ituD expression among strains from Amazonian environment. Conclusions: Temperature and pH have an important influence on the expression of genes sboA (subtilosin A) and ituD (iturin A) among Bacillus spp. The strains P40 and P45B can be useful for the production of antimicrobial peptide iturin A. Significance and Impact of the Study: Monitoring the expression of essential biosynthetic genes by qRT-PCR is a valuable tool for optimization of the production of antimicrobial peptides.

Real-Time Voltage Regulation in Power Distribution System Using Fuzzy Control

Two different fuzzy approaches to voltage control in electric power distribution systems are introduced in this paper. The real-time controller in each case would act on power transformers equipped with under-load tap changers. Learning systems are employed to turn the voltage-control relays into adaptive devices. The scope of this study has been limited to the power distribution substation, and the voltage measurements and control actions are carried out on the secondary bus. The capacity of fuzzy systems to handle approximate data, together with their unique ability to interpret qualitative information, make it possible to design voltage-control strategies that satisfy the requirements of the Brazilian regulatory bodies and the real concerns of the electric power distribution companies. Fuzzy control systems based on these two strategies have been implemented and the test results were highly satisfactory.

Mechanistic approach to predict real machining time for milling free-form geometries applying high feed rate

An accurate estimate of machining time is very important for predicting delivery time, manufacturing costs, and also to help production process planning. Most commercial CAM software systems estimate the machining time in milling operations simply by dividing the entire tool path length by the programmed feed rate. This time estimate differs drastically from the real process time because the feed rate is not always constant due to machine and computer numerical controlled (CNC) limitations. This study presents a practical mechanistic method for milling time estimation when machining free-form geometries. The method considers a variable called machine response time (MRT) which characterizes the real CNC machine`s capacity to move in high feed rates in free-form geometries. MRT is a global performance feature which can be obtained for any type of CNC machine configuration by carrying out a simple test. For validating the methodology, a workpiece was used to generate NC programs for five different types of CNC machines. A practical industrial case study was also carried out to validate the method. The results indicated that MRT, and consequently, the real machining time, depends on the CNC machine`s potential: furthermore, the greater MRT, the larger the difference between predicted milling time and real milling time. The proposed method achieved an error range from 0.3% to 12% of the real machining time, whereas the CAM estimation achieved from 211% to 1244% error. The MRT-based process is also suggested as an instrument for helping in machine tool benchmarking.

FOREIGN INVESTMENT AND THE BRAZILIAN REAL ESTATE MARKET

This article discusses the main aspects of the Brazilian real estate market in order to illustrate if it would be attractive for a typical American real estate investor to buy office-building portfolios in Brazil. The article emphasizes: [i] - the regulatory frontiers, comparing investment securitization, using a typical American REIT structure, with the Brazilian solution, using the Fundo de Investimento Imobiliario - FII; [ii] - the investment quality attributes in the Brazilian market, using an office building prototype, and [iii] - the comparison of [risk vs. yield] generated by an investment in the Brazilian market, using a FII, benchmarked against an existing REIT (OFFICE SUB-SECTOR) in the USA market. We conclude that investing dollars exchanged for Reais [the Brazilian currency] in a FII with a triple A office-building portfolio in the Sao Paulo marketplace will yield an annual income and a premium return above an American REIT investment. The highly aggressive scenario, along with the strong persistent exchange rate detachment to the IGP-M variations, plus instabilities affecting the generation of income, and even if we adopt a 300-point margin for the Brazil-Risk level, demonstrates that an investment opportunity in the Brazilian market, in the segment we have analyzed, outperforms an equivalent investment in the American market.

Fuzzy computational control for real Chua circuit

We preserit a computational procedure to control art experimental chaotic system by applying the occasional proportional feedback (OPF) method. The method implementation uses the fuzzy theory to relate the variable correction to the necessary adjustment in the control parameter. As an application We control the chaotic attractors of the Chua circuit. We present file developed circuits and algorithms to implement this control in real time. To simplify the used procedure, we use it low resolution analog to digital converter compensated for a lowpass filter that facilitates similar applications to control other systems. (C) 2007 Elsevier Ltd. All rights reserved.