Grupos de catadores aut��nomos na coleta seletiva do munic��pio de S��o Paulo

Pesquisa na cidade de S��o Paulo identificou dificuldades que grupos de catadores aut��nomos de recicl��veis enfrentam para se inserirrem no Programa de Coleta Seletiva oficial. A cidade gera diariamente 16 mil toneladas de res��duos, apenas 1% destinados �� coleta seletiva. Entretanto, grupos de catadores coletam informalmente sem ser inclu��dos nas estat��stias. Foram levantados bibliografia, legisla����o sobre res��duos, grupos atuantes na coleta seletiva; e aplicados formul��rios em 13 grupos. Dados indicaram organiza����oDados indicaram organiza����o e gest��o dos grupos, dificuldades, gerenciamento e divis��o dos recursos, participantes e interesse de participarem da coleta seletiva oficial. Das dificuldades que os grupos apontaram est��o: falta de espa��o adequado para guardar, separar e enfardar material coletado; falta de recursos para seu desenvolvimento; e falta de apoio do governo

Performance of transport and selective media for swine Bordetella bronchiseptica recovery and it comparison to polymerase chain reaction detection

Three comparative assays were performed seeking to improve the sensitivity of the diagnosis of Bordetella bronchiseptica infection analyzing swine nasal swabs. An initial assay compared the recovery of B. bronchiseptica from swabs simultaneously inoculated with B. bronchiseptica and some interfering bacteria, immersed into three transport formulations (Amies with charcoal, trypticase soy broth and phosphate buffer according to Soerensen supplemented with 5% of bovine fetal serum) and submitted to different temperatures (10��C and 27��C) and periods of incubation (24, 72 and 120 hours). A subsequent assay compared three selective media (MacConkey agar, modified selective medium G20G and a ceftiofur medium) for their recovery capabilities from clinical specimens. One last assay compared the polymerase chain reaction to the three selective media. In the first assay, the recovery of B. bronchiseptica from transport systems was better at 27��C and the three formulations had good performances at this temperature, but the collection of qualitative and quantitative analysis indicated the advantage of Amies medium for nasal swabs transportation. The second assay indicated that MacConkey agar and modified G20G had similar results and were superior to the ceftiofur medium. In the final assay, polymerase chain reaction presented superior capability of B. bronchiseptica detection to culture procedures.

Heart failure disease management program experience in 4,545 heart failure admissions to a community hospital

Background Disease management programs (DMPs) are developed to address the high morbi-mortality and costs of congestive heart failure (CHF). Most studies have focused on intensive programs in academic centers. Washington County Hospital (WCH) in Hagerstown, MD, the primary reference to a semirural county, established a CHF DMP in 2001 with standardized documentation of screening and participation. Linkage to electronic records and state vital statistics enabled examination of the CHF population including individuals participating and those ineligible for the program. Methods All WCH inpatients with CHF International Classification of Diseases, Ninth Revision code in any position of the hospital list discharged alive. Results Of 4,545 consecutive CHF admissions, only 10% enrolled and of those only 52.2% made a call. Enrollment in the program was related to: age (OR 0.64 per decade older, 95% CI 0.58-0.70), CHF as the main reason for admission (OR 3.58, 95% CI 2.4-4.8), previous admission for CHF (OR 1.14, 95% CI 1.09-1.2), and shorter hospital stay (OR 0.94 per day longer, 95% CI 0.87-0.99). Among DMP participants mortality rates were lowest in the first month (80/1000 person-years) and increased subsequently. The opposite mortality trend occurred in nonenrolled groups with mortality in the first month of 814 per 1000 person-years in refusers and even higher in ineligible (1569/1000 person-years). This difference remained significant after adjustment. Re-admission rates were lower among participants who called consistently (adjusted incidence rate ratio 0.62, 95% CI 0.52-0.77). Conclusion Only a small and highly select group participated in a low-intensity DMP for CHF in a community-based hospital. Design of DMPs should incorporate these strong selective factors to maximize program impact. (Am Heart J 2009; 15 8:459-66.)

Short-Term effect of COX-2 selective inhibitor as an adjunct for the treatment of periodontal disease: a clinical double-blind study in humans

Adjunctive therapeutic strategies that modulate the inflammatory mediators can play a significant role in periodontal therapy. In this double-blind, placebo-controlled study, 60 subjects diagnosed as periodontitis patients were evaluated for 28 days after periodontal treatment combined with selective cyclooxygenase-2 (COX-2) inhibitor. The experimental group received scaling and root planning (SRP) combined with the Loxoprofen antiinflammatory drug (SRP+Loxoprofen). The control group received SRP combined with placebo (SRP+placebo). Plaque index (PI), probing pocket depth (PD) and bleeding on probing (BOP) were monitored with an electronic probe at baseline and after 14 and 28 days. Both groups displayed clinical improvement in PD, PI and BOP. They also showed statistically similar values (p>0.05) of PD reduction on day 14 (0.4 mm) and on day 28 (0.6 mm). At the baseline, few deeper sites (>7 mm) from SRP+Loxoprofen group were responsible and most PD reduction was observed after 14 days (p<0.05). The percentage of remaining deep pockets (>7 mm) after 14 days in the SRP+Loxoprofen group was significantly lower (p<0.05) than in the SRP+placebo group. Loxoprofen presents potential effect as an adjunct of periodontal disease treatment, but long-term clinical trials are necessary to confirm its efficacy.

PENCALC: a program for penetrance estimation in autosomal dominant diseases

We present a computer program developed for estimating penetrance rates in autosomal dominant diseases by means of family kinship and phenotype information contained within the pedigrees. The program also determines the exact 95% credibility interval for the penetrance estimate. Both executable (PenCalc for Windows) and web versions (PenCalcWeb) of the software are available. The web version enables further calculations, such as heterozygosity probabilities and assessment of offspring risks for all individuals in the pedigrees. Both programs can be accessed and down-loaded freely at the home-page address http://www.ib.usp.br/~otto/software.htm.

A catalogue of types of Conopoidea, Diopsoidea, Nerioidea and Tephritoidea (Diptera, Schizophora) in the collection of the Museu de Zoologia da Universidade de S��o Paulo

A catalogue is provided with the type material of four superfamilies of "Acalyptrate" (Conopoidea, Diopsoidea, Nerioidea and Tephritoidea) held in the collection of the Museu de Zoologia da Universidade de S��o Paulo (MZUSP), S��o Paulo, Brazil. Concerning the taxa dealt with herein, the Diptera collection of MZUSP held 77 holotypes, 4 "allotypes" and 194 paratypes. In this paper, information about data labels, preservation and missing structures of the type specimens is given.

Morphological analysis of three populations of Anopheles (Nyssorhynchus) nuneztovari Gabald��n (Diptera: Culicidae) from Colombia

Based on the results of comparative analyses of 1,039 specimens of several progenies of Anopheles nuneztovarifrom three localities in Colombia, eight costal wing spot patterns were observed. Patterns I and III were the most frequent: 77.96% and 11.36%, respectively. Using the diagnostic characters ratio of the length of the basal dark area of hind tarsomere II/length of hind tarsomere II, ratio of the length of the humeral pale spot/length of the pre-humeral dark spot, and the ratio of the length of the subcostal pale spot/length of the distal sector dark spot (DS-III2/Ta-III2, HP/PHD, SCP/DSD) approximately 5% of the adult females were misidentified as a species of Nyssorhynchus, different from An. nuneztovari. Approximately 5% of the specimens showed DS-III2/Ta-III2 ratio less than 0.25 (range 0.21 - 0.24), and among them 3.34% shared a HP/PHD ratio less than 1.50. Consequently, 1.52% of An. nuneztovari individuals can be misidentified as Anopheles oswaldoi. In those specimens with the DS-III2/Ta-III2 ratios higher than 0.25, 34.45% displayed SCP/DSD values greater than 0.50 and of these, 3.65% displayed HP/PHD values greater than 1.8. This combination of characters could lead one to misidentify samples of An. nuneztovari as Anopheles rangeli. Similarly, 2.43% of the females could be identified erroneously as either Anopheles aquasalis or Anopheles benarrochi. Individuals with a HP/PHD ratio greater than 2.0, could be misidentified as Anopheles trinkae, Anopheles strodei or Anopheles evansae. A distinct combination of diagnostic characters for An. nuneztovari from Colombia is proposed.

Excesso de peso e hipertens��o arterial em trabalhadores de empresas beneficiadas pelo Programa de Alimenta����o do Trabalhador (PAT)

OBJETIVO: Avaliar as preval��ncias de excesso de peso (EP), hipertens��o arterial (HA) e fatores associados em trabalhadores de empresas beneficiadas pelo Programa de Alimenta����o do Trabalhador (PAT) da cidade de S��o Paulo. M��TODOS: Estudo transversal com 1.339 trabalhadores de 30 empresas. A coleta de dados envolveu a aplica����o de um question��rio com dados de caracteriza����o dos trabalhadores e peso e altura auto-referidos. Foi realizada a aferi����o da press��o arterial e o estado nutricional foi classificado segundo o ��ndice de Massa Corporal (IMC). Odds ratios foram estimadas na avalia����o dos fatores de risco associados a HA e EP. RESULTADOS: Os trabalhadores apresentaram, em m��dia, 36,4 anos (dp = 10,3) e 9,9 anos de estudo (dp = 2,3), sendo 60% da amostra pertencente ao sexo masculino. Na compara����o com homens, mulheres apresentaram valores significativamente menores de idade, press��o arterial sist��lica (PAS) e diast��lica (PAD) e IMC e maior escolaridade. As preval��ncias em homens de EP (25 kg/m2) (56%) e de HA (PAS > 140 mmHg e/ou PAD > 90 mmHg ou uso de medica����es anti-hipertensivas) (38%), foram aproximadamente o dobro da registrada em mulheres (30% e 19%), respectivamente. Idade foi fator de risco para a ocorr��ncia de EP e HA em ambos os sexos, enquanto que a escolaridade foi fator de prote����o para EP e HA em mulheres e fator de risco para o desenvolvimento de EP em homens. CONCLUS��O: Os trabalhadores do sexo masculino constitu��ram uma popula����o de maior risco para ocorr��ncia de HA e EP e devem ser priorizados nos programas que visam a preven����o dessas doen��as. Neste sentido, o PAT pode representar um lugar de destaque nas a����es de sa��de e nutri����o no ambiente de trabalho.

O programa de incentivo �� instala����o de cozinhas comunit��rias: avalia����o de uma pol��tica p��blica brasileira

O trabalho tem como objetivo descrever e avaliar as Cozinhas Comunit��rias (CC) apoiadas pelo Minist��rio do Desenvolvimento Social (MDS) em funcionamento no Brasil em 2006. Trata-se de estudo transversal que investigou as CC, com projetos contemplados nos editais do MDS realizados entre os anos de 2003 a 2005. Inicialmente foram identificadas as CC em funcionamento e estas CC foram visitadas para a coleta de dados relativos ao atendimento prestado, avalia����o da estrutura f��sica e das refei����es oferecidas. A estrutura f��sica foi avaliada por meio de um check-list, baseado nas exig��ncias da legisla����o sanit��ria, e a oferta de refei����es foi caracterizada pelos alimentos e prepara����es oferecidas pelas CC para determinar o valor nutricional das refei����es. A maioria das cozinhas financiadas (60%) estava em fase de implementa����o no momento da entrevista, entre as cozinhas em funcionamento, a maioria estava localizada nos Estados de Santa Catarina e Paran��. Observou-se tamb��m que cerca de 20% das cozinhas n��o ofereciam refei����es regularmente. Ao realizar a avalia����o nutricional das refei����es, foi observada uma grande heterogeneidade na oferta de alimentos. Ao avaliar as condi����es higi��nico-sanit��rias, quase a totalidade das CC foram classificadas como deficientes ou regulares, indicando inadequa����o na produ����o de refei����es. O Programa das Cozinhas Comunit��rias pode exercer importante papel nas pol��ticas de seguran��a alimentar e nutricional do pa��s, no entanto, devem ser realizados esfor��os no sentido de garantir a implanta����o em comunidades situadas nos Estados menos desenvolvidos, com fixa����o de n��meros m��nimos para atendimento, de par��metros nutricionais e garantia de fornecimento seguro de alimentos

Interactive Brazilian program to prevent eating disorders behaviors: a pilot study

During a four month scholarly leave in United States of America, researchers designed a culturally appropriate prevention program for eating disorders (ED) for Brazilian adolescent girls. The program "Se Liga na Nutri����o" was modeled on other effective programs identified in a research literature review and was carried out over eleven interactive sessions. It was positively received by the adolescents who suggested that it be part of school curricula. The girls reported that it helped them to develop critical thinking skills with regards to sociocultural norms about body image, food and eating practices

M��es de crian��as com defici��ncia visual: percep����es, conduta e constribui����o do atendimento em grupo

A presente pesquisa teve quatro objetivos: 1) identificar rea����es de m��es em rela����o ao diagn��stico da defici��ncia visual; 2) identificar o respons��vel pela detec����o da defici��ncia; 3) verificar dificuldades da crian��a no processo de escolariza����o, e 4) verificar poss��veis contribui����es de atividades terap��uticas direcionadas ao grupo de m��es. Foi realizado um "survey" descritivo com as m��es de crian��as com defici��ncia visual, atendidas no CEPRE-FCM-Unicamp. Para a coleta de dados foi utilizado um question��rio aplicado por entrevista, desenvolvido ap��s estudo explorat��rio. Comp��s-se uma amostra n��o probabil��stica, constitu��da por 14 m��es. Entre os resultados obtidos, com rela����o aos sentimentos apontados pelas m��es em rela����o ao diagn��stico, destacaram-se: a tristeza (71,0 por cento); o medo (64,0 por cento) e a decep����o (42,0 por cento). O problema visual foi percebido por m��es em 53,0 por cento dos casos, por pediatras em 26,0 por cento e por familiares em 21,0 por cento. Entre as dificuldades da crian��a no processo de escolariza����o foram apontadas: medo de n��o conseguirem acompanhar as exig��ncias escolares (75,0 por cento) e discrimina����o (63,0 por cento). A maioria das m��es (78,0 por cento) acredita que as atividades do grupo contribuem para o esclarecimento de d��vidas, e as atividades terap��uticas contribu��ram para que aprendessem a lidar com as dificuldades de seus filhos (78,0 por cento). Os resultados obtidos contribu��ram para concluir: que os sentimentos de tristeza, medo e decep����o mostraram-se mais evidentes; que, na maioria dos casos, a defici��ncia visual foi detectada pela m��e; que na opini��o das m��es, as crian��as teriam dificuldades em acompanhar as atividades escolares e que o grupo contribuiu para esclarecer d��vidas e favorecer troca de experi��ncias

Ticks produce highly selective chemokine binding proteins with antiinflammatory activity

Bloodsucking parasites such as ticks have evolved a wide variety of immunomodulatory proteins that are secreted in their saliva, allowing them to feed for long periods of time without being detected by the host immune system. One possible strategy used by ticks to evade the host immune response is to produce proteins that selectively bind and neutralize the chemokines that normally recruit cells of the innate immune system that protect the host from parasites. We have identified distinct cDNAs encoding novel chemokine binding proteins (CHPBs), which we have termed Evasins, using an expression cloning approach. These CHBPs have unusually stringent chemokine selectivity, differentiating them from broader spectrum viral CHBPs. Evasin-1 binds to CCL3, CCL4, and CCL18; Evasin-3 binds to CXCL8 and CXCL1; and Evasin-4 binds to CCL5 and CCL11. We report the characterization of Evasin-1 and -3, which are unrelated in primary sequence and tertiary structure, and reveal novel folds. Administration of recombinant Evasin-1 and - 3 in animal models of disease demonstrates that they have potent antiinflammatory properties. These novel CHBPs designed by nature are even smaller than the recently described single-domain antibodies (Hollinger, P., and P. J. Hudson. 2005. Nat. Biotechnol. 23: 1126-1136), and may be therapeutically useful as novel antiinflammatory agents in the future.

Selective activation of the rectus abdominis muscle during low-intensity and fatiguing tasks

In order to understand the potential selective activation of the rectus abdominis muscle, we conducted two experiments. In the first, subjects performed two controlled isometric exercises: the curl up (supine trunk raise) and the leg raise (supine bent leg raise) at low intensity (in which only a few motor units are recruited). In the second experiment, subjects performed the same exercises, but they were required to maintain a certain force level in order to induce fatigue. We recorded the electromyographic (EMG) activities of the lower and upper portions of the rectus abdominis muscle during the exercises and used spatial-temporal and frequency analyses to describe muscle activation patterns. At low-intensity contractions, the ratio between the EMG intensities of the upper and lower portions during the curl up exercise was significantly larger than during the leg raise exercise (p = 0.02). A cross-correlation analysis indicated that the signals of the abdominal portions were related to each other and this relation did not differ between the tasks (p = 0.12). In the fatiguing condition, fatigue for the upper portion was higher than for the lower portion during the curl up exercise (p = 0.008). We conclude that different exercises evoked, to a certain degree, individualized activation of each part of the rectus abdominis muscle, but different portions of the rectus abdominis muscle contributed to the same task, acting like a functional unit. These results corroborate the relevance of varying exercise to modify activation patterns of the rectus abdominis muscle.

Phylogenetic relationships within the speciose family Characidae (Teleostei: Ostariophysi: Characiformes) based on multilocus analysis and extensive ingroup sampling

Background: With nearly 1,100 species, the fish family Characidae represents more than half of the species of Characiformes, and is a key component of Neotropical freshwater ecosystems. The composition, phylogeny, and classification of Characidae is currently uncertain, despite significant efforts based on analysis of morphological and molecular data. No consensus about the monophyly of this group or its position within the order Characiformes has been reached, challenged by the fact that many key studies to date have non-overlapping taxonomic representation and focus only on subsets of this diversity. Results: In the present study we propose a new definition of the family Characidae and a hypothesis of relationships for the Characiformes based on phylogenetic analysis of DNA sequences of two mitochondrial and three nuclear genes (4,680 base pairs). The sequences were obtained from 211 samples representing 166 genera distributed among all 18 recognized families in the order Characiformes, all 14 recognized subfamilies in the Characidae, plus 56 of the genera so far considered incertae sedis in the Characidae. The phylogeny obtained is robust, with most lineages significantly supported by posterior probabilities in Bayesian analysis, and high bootstrap values from maximum likelihood and parsimony analyses. Conclusion: A monophyletic assemblage strongly supported in all our phylogenetic analysis is herein defined as the Characidae and includes the characiform species lacking a supraorbital bone and with a derived position of the emergence of the hyoid artery from the anterior ceratohyal. To recognize this and several other monophyletic groups within characiforms we propose changes in the limits of several families to facilitate future studies in the Characiformes and particularly the Characidae. This work presents a new phylogenetic framework for a speciose and morphologically diverse group of freshwater fishes of significant ecological and evolutionary importance across the Neotropics and portions of Africa.

Oral Health Promotion Through an Online Training Program for Medical Students

The objective of this study was to compare the impact on knowledge and counseling skills of face-to-face and Internet-based oral health training programs on medical students. Participants consisted of 148 (82 percent) of the 180 invited students attending their fifth academic year at the Faculty of Medicine, University of Sao Paulo, Brasil, in 2007. The interventions took place during a three-month training period in the clinical Center for Health Promotion, which comprised part of a clerkship in Internal Medicine. The students were divided into four groups: 1) Control Group (Control), with basic intervention; 2) Brochure Group (Br), with basic intervention plus complete brochure with oral health themes; 3) Cybertutor Group (Cy), with basic intervention plus access to an Internet-based training program about oral health themes; and 4) Cybertutor + Contact Group (Cy+C), the same as Cy plus brief proactive contact with a tutor. The impact of these interventions on student knowledge was measured with pre- and post assessments, and student skills in asking and counseling about oral health were assessed with an objective structured clinical examination (OSCE). Multivariate logistic regression models were applied to identify the odds ratios of scoring above Control's medians on the final assessment and the OSCE. In the results, Cy+C performed significantly better than Control on both the final assessment (OR 9.4; 95% CI 2.7-32.8) and the OSCE (OR 5.6; 95% CI 1.9-16.3) and outperformed all the other groups. The Cy+C group showed the most significant increase in knowledge and the best skills in asking and counseling about oral health.