Asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden: a questionnaire-based comparison

The Global Initiative Against Asthma (GINA) was developed to meet the global challenge of asthma. GINA has been adopted in most countries and comparison of asthma management in different parts of the world may be of help when assessing the global dissemination of the guideline. The overall goals in GINA include that asthma patients should be free of symptoms, acute asthma attacks and activity limitations. The aim of the present study was to compare asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden. Information was collected from asthmatics in Sao Paulo and Uppsala with a questionnaire. The questionnaire dealt with the following issues: symptoms, smoking, self-management, hospital visits, effect on school/work and medication. The Sao Paulo patients were more likely to have uncontrolled asthma (36% vs 13%, P < 0.001), having made emergency room visits (57% vs 29%, P < 0.001) and having lost days at school or work because of their asthma (46% vs 28%, P = 0.03) than the asthmatics from Uppsala. There were no difference in the use of inhaled corticosteroids, but the Brazilian patients were more likely to be using theophylline (18% vs 1%, P = 0.001) and less likely to be using long-acting beta-2 agonists (18% vs 37%, P < 0.001). We conclude that the level of asthma control was lower among the patients from Sao Paulo than Uppsala. Few of the patients in either city reached the goals set up by GINA. Improved asthma management may therefore lead to health-economic benefits in both locations. Please cite this paper as: Skorup P, Rizzo LV, Machado-Boman L and Janson C. Asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden: a questionnaire-based comparison. The Clinical Respiratory Journal 2009; 3: 22-28.

Use of the mini nutritional assessment tool in elderly people from long-term institutions of southeast of Brazil

Background: the Mini Nutritional Assessment (MNA) is a multidimensional method of nutritional evaluation that allows the diagnosis of malnutrition and risk of malnutrition in elderly people, it is important to mention that this method has not been well studied in Brazil. Objective: to verify the use of the MNA in elderly people that has been living in long term institutions for elderly people. Design: transversal study. Participants: 89 people (>= 60 years), being 64.0% men. The average of age for both genders was 73.7 +/- 9.1 years old, being 72.8 +/- 8.9 years old for men, and 75.3 +/- 9.3 years old for women. Setting: long-term institutions for elderly people located in the Southeast of Brazil. Methods: it was calculated the sensibility, specificity, and positive and negative predictive values. It was data to set up a ROC curve to verify the accuracy of the MNA. The variable used as a ""standard"" for the nutritional diagnosis of the elderly people was the corrected arm muscle area because it is able to provide information or an estimative of the muscle reserve of a person being considered a good indicator of malnutrition in elderly people. Results: the sensibility was 84.0%, the specificity was 36.0%, the positive predictive value was 77.0%, and the negative predictive value was 47.0%; the area of the ROC curve was 0.71 (71.0%). Conclusion: the MNA method has showed accuracy, and sensibility when dealing with the diagnosis of malnutrition and risk of malnutrition in institutionalized elderly groups of the Southeastern region of Brazil, however, it presented a low specificity.

Floristic inventory of cerrado at Pedregulho, Sao Paulo State, Brazil

Pedregulho municipality in the far northeastern region of Sao Paulo state has fragments of cerrado vegetation thought to be floristically distinct from other cerrado remmants in the state. In this study, a floristic survey was carried out at Pedregulho, focusing on two geologically distinct regions: Furnas do Bom Jesus State Park and the Estreito district. In each region, 50x50 m plots were set up for a total sample area of 1 hectare, where 65 families and 379 angiosperm species were recorded. Collecting efforts in adjacent areas resulted in a total of 71 families and 443 species. The two study areas had low floristic similarity. Geographic species distribution was analyzed and eight patterns were defined for those species restricted to the Pedregulho region in Sao Paulo.

First evidence of insect attraction by a Southern Hemisphere Splachnaceae: The case of Tayloria dubyi Broth. in the Reserve Biosphere Cape Horn, Chile

The moss Tayloria dubyi (Splachnaceae) is endemic to the subantarctic Magallanes ecoregion where it grows exclusively on bird dung and perhaps only on feces of the goose Chloephaga picta, a unique habitat among Splachnaceae. Some species of Splachnaceae from the Northern Hemisphere are known to recruit coprophilous flies as a vector to disperse their spores by releasing intense odors mimicking fresh clung or decaying corpses. The flies land on the capsule, and may get in contact with the protruding mass of spores that stick to the insect body. The dispersal strategy relies on the spores falling off when the insect reaches fresh droppings or carrion. Germination is thought to be rapid and a new population is quickly established over the entire substrate. The objectives of this investigation were to determine whether the coprophilous T. dubyi attracts flies and to assess the taxonomic diversity of the flies visiting this moss. For this, fly traps were set up above mature sporophyte bearing populations in two peatlands on Navarino Island. We captured 64 flies belonging to the Muscidae (Palpibracus chilensis), Tachinidae (Dasyuromyia sp) and Sarcophagidae (not identified to species) above sporophytes of T. dubyi, whereas no flies were captured in control traps set up above Sphagnum mats nearby.

Susceptible-infected-recovered and susceptible-exposed-infected models

Two stochastic epidemic lattice models, the susceptible-infected-recovered and the susceptible-exposed-infected models, are studied on a Cayley tree of coordination number k. The spreading of the disease in the former is found to occur when the infection probability b is larger than b(c) = k/2(k - 1). In the latter, which is equivalent to a dynamic site percolation model, the spreading occurs when the infection probability p is greater than p(c) = 1/(k - 1). We set up and solve the time evolution equations for both models and determine the final and time-dependent properties, including the epidemic curve. We show that the two models are closely related by revealing that their relevant properties are exactly mapped into each other when p = b/[k - (k - 1) b]. These include the cluster size distribution and the density of individuals of each type, quantities that have been determined in closed forms.

Conservative ensembles for nonequilibrium lattice-gas systems

We show how to set up a constant particle ensemble for the steady state of nonequilibrium lattice-gas systems which originally are defined on a constant rate ensemble. We focus on nonequilibrium systems in which particles are created and annihilated on the sites of a lattice and described by a master equation. We consider also the case in which a quantity other than the number of particle is conserved. The conservative ensembles can be useful in the study of phase transitions and critical phenomena particularly discontinuous phase transitions.

FAST, PARALLEL AND SECURE CRYPTOGRAPHY ALGORITHM USING LORENZ`S ATTRACTOR

A novel cryptography method based on the Lorenz`s attractor chaotic system is presented. The proposed algorithm is secure and fast, making it practical for general use. We introduce the chaotic operation mode, which provides an interaction among the password, message and a chaotic system. It ensures that the algorithm yields a secure codification, even if the nature of the chaotic system is known. The algorithm has been implemented in two versions: one sequential and slow and the other, parallel and fast. Our algorithm assures the integrity of the ciphertext (we know if it has been altered, which is not assured by traditional algorithms) and consequently its authenticity. Numerical experiments are presented, discussed and show the behavior of the method in terms of security and performance. The fast version of the algorithm has a performance comparable to AES, a popular cryptography program used commercially nowadays, but it is more secure, which makes it immediately suitable for general purpose cryptography applications. An internet page has been set up, which enables the readers to test the algorithm and also to try to break into the cipher.

A robust Bayesian approach to null intercept measurement error model with application to dental data

Measurement error models often arise in epidemiological and clinical research. Usually, in this set up it is assumed that the latent variable has a normal distribution. However, the normality assumption may not be always correct. Skew-normal/independent distribution is a class of asymmetric thick-tailed distributions which includes the Skew-normal distribution as a special case. In this paper, we explore the use of skew-normal/independent distribution as a robust alternative to null intercept measurement error model under a Bayesian paradigm. We assume that the random errors and the unobserved value of the covariate (latent variable) follows jointly a skew-normal/independent distribution, providing an appealing robust alternative to the routine use of symmetric normal distribution in this type of model. Specific distributions examined include univariate and multivariate versions of the skew-normal distribution, the skew-t distributions, the skew-slash distributions and the skew contaminated normal distributions. The methods developed is illustrated using a real data set from a dental clinical trial. (C) 2008 Elsevier B.V. All rights reserved.