Health surveys and use of maternal and child health care services in three municipalities within the São Paulo metropolitan area

Objectives. To describe the changes in the use of maternal and child health care services by residents of three municipalities-Embu, Itapecerica da Serra, and Taboao da Serra-in the São Paulo metropolitan area, 12 years after the implementation of the Unified Health System (SUS) in Brazil, and to analyze the potential of population-based health care surveys as sources of data to evaluate these changes.Methods. Two population-based, cross-sectional surveys were carried out in 1990 and 2002 in municipalities located within the São Paulo metropolitan area. For children under 1 year of age, the two periods were compared in terms of outpatient services utilization and hospital admission; for the mothers, the periods were compared in terms of prenatal care and deliveries. In both surveys, stratified and multiple-stage conglomerate sampling was employed, with standardization of interview questions.Results. The most important changes observed were regarding the location of services used for prenatal care, deliveries, and hospitalization of children less than 1 year of age. There was a significant increase in the use of services in the surrounding region or hometown, and decrease in the utilization of services in the city of São Paulo (in 1990, 80% of deliveries and almost all admissions for children less than 1 year versus 32% and 46%, respectively, in 2002). The use of primary care units and 24-hour walk-in clinics also increased. All these changes reflect care provided by public resources. In the private sector, there was a decrease in direct payments and payments through company-paid health insurance and an increase in payments through self-paid health insurance.Conclusions. The major changes observed in the second survey occurred simultaneous to the changes that resulted from the implementation of the SUS. Population-based health surveys are adequate for analyzing and comparing the utilization of health care services at different times.

Utilizing the CORBA platform in the construction of a highly immersive virtual environment

This article presents the implementation of a distributed system of virtual reality, through the integration of services offered by the CORBA platform (Common Object Request Broker Architecture) and by the environment of development of 3D graphic applications in real time, the WorldToolkit, of Sense8. The developed application for the validation of this integration is that of a virtual city, with an emphasis on its traffic ways, vehicles (movable objects) and buildings (immovable objects). In this virtual world, several users can interact, each one controlling his/her own car. Since the modelling of the application took into consideration the criteria and principles of the Transport Engineering, the aim is to use it in the planning, project and construction of traffic ways for vehicles. The system was structured according to the approach client/server utilizing multicast communication among the participating nodes. The chosen implementation for the CORBA was the Iona's ORBIX software. The performance results obtained are presented and discussed in the end.

Propagandas de medicamentos psicoativos: Análise das informações científicas

Objective: According to the World Health Organization, medicinal drug promotion should be reliable, accurate, truthful, informative, balanced, up-to-date and capable of substantiation. The objective of the present study was to review psychoactive drug advertisements to physicians as for information consistency with the related references and accessibility of the cited references. Methods: Data was collected in the city of Araraquara, Southeastern Brazil, in 2005. There were collected and reviewed 152 drug advertisements, a total of 304 references. References were requested directly from pharmaceutical companies' customer services and searched in UNESP (Ibict, Athenas) and BIREME (SciELO, PubMed, free-access indexed journals) library network and CAPES journals. Advertisement statements were checked against references using content analysis. Results: Of all references cited in the advertisements studied, 66.7% were accessed. Of 639 promotional statements identified, 346 (54%) were analyzed. The analysis showed that 67.7% of promotional statements in the advertisements were consistent with their references, while the remaining was either partially consistent or inconsistent. Of the material analyzed, an average 2.5 (1-28) references was cited per advertisement. In the text body, there were identified 639 pieces of information clearly associated with at least one cited reference (average 3.5 pieces of information per advertisement). Conclusion: The study results evidenced difficult access to the references. Messages on efficacy, safety and cost, among others, are not always supported by scientific studies. There is a need for regulation changes and effective monitoring of drug promotional materials.

Analysis of quality in Brazilian e-commerce (B2C)

The business world has changed the way how people think and act on products and services. In this context, the most recent amendment of the scenarios of retail operations has been the use of technology in sales and distribution. The internet has revolutionized the way people communicate, and moreover as they purchase their goods and services. Thus, the e-commerce, specifically the relation business to customer, or simply B2C, has acted so convincingly in this change of paradigm, namely the purchases in the physical location for the virtual site. Quotes online, ease of payment, price, speed of delivery, have become real order winners of applications for companies that compete in this segment. With the focus on quality of services on e-commerce, the research examines the dimension related to the quality of services, and looks for what of these factors are winners of applications. © 2010 IFIP International Federation for Information Processing.

Analysis of agonist and antagonist effects on thyroid hormone receptor conformation by hydrogen/deuterium exchange

Thyroid hormone receptors (TRs) are ligand-gated transcription factors with critical roles in development and metabolism. Although x-ray structures of TR ligand-binding domains (LBDs) with agonists are available, comparable structures without ligand (apo-TR) or with antagonists are not. It remains important to understand apo-LBD conformation and the way that it rearranges with ligands to develop better TR pharmaceuticals. In this study, we conducted hydrogen/deuterium exchange on TR LBDs with or without agonist (T 3) or antagonist (NH3). Both ligands reduce deuterium incorporation into LBD amide hydrogens, implying tighter overall folding of the domain. As predicted, mass spectroscopic analysis of individual proteolytic peptides after hydrogen/ deuterium exchange reveals that ligand increases the degree of solvent protection of regions close to the buried ligand-binding pocket. However, there is also extensive ligand protection of other regions, including the dimer surface at H10-H11, providing evidence for allosteric communication between the ligand-binding pocket and distant interaction surfaces. Surprisingly, Cterminal activation helix H12, which is known to alter position with ligand, remains relatively protected from solvent in all conditions suggesting that it is packed against the LBD irrespective of the presence or type of ligand. T 3, but not NH3, increases accessibility of the upper part of H3-H5 to solvent, and we propose that TR H12 interacts with this region in apo-TR and that this interaction is blocked by T 3 but not NH3.Wepresent data from site-directed mutagenesis experiments and molecular dynamics simulations that lend support to this structural model of apo-TR and its ligand-dependent conformational changes. (Molecular Endocrinology 25: 15-31, 2011). Copyright © 2011 by The Endocrine Society.

Um es tudo sobre as condições de acess ibilidade em pré-es colas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A proposal for reliability evaluation of components on electric power distribution system integrating probabilistic models and fuzzy inference systems

The system reliability depends on the reliability of its components itself. Therefore, it is necessary a methodology capable of inferring the state of functionality of these components to establish reliable indices of quality. Allocation models for maintenance and protective devices, among others, have been used in order to improve the quality and availability of services on electric power distribution systems. This paper proposes a methodology for assessing the reliability of distribution system components in an integrated way, using probabilistic models and fuzzy inference systems to infer about the operation probability of each component. © 2012 IEEE.

Perfil de utilização de serviços de saúde no município de Botucatu-SP-2001-2002

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Multi-scale structural and chemical analysis of sugarcane bagasse in the process of sequential acid-base pretreatment and ethanol production by Scheffersomyces shehatae and Saccharomyces cerevisiae

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Tecnologia assistiva: analisando espaços de acessibilidade às pessoas com deficiência visual em universidades públicas

Pós-graduação em Educação Escolar - FCLAR

DNA human identification for the family rights: one year of agreement between UNESP/laboratory of paternity and public defender service in São Paulo State

The universities have realized the importance of extending their knowledge to the population through the provision of services. Thus, this paper presents the data obtained in an agreement between UNESP/Laboratory of Paternity and Public Defender Service in São Paulo State to make DNA paternity tests.

School inclusion: analyzing the establishment and organization of a special needs education service in a brazilian municipality

The present research integrates a network of studies called National Monitoring Center for Special Education (NMCSE) which studies the Multi-purpose Feature Rooms (MFRs) in regular schools. We aim to investigate whether the service offered by such rooms, maintained by the Department of Education of the Municipality of Araraquara, in São Paulo State, Brazil, is being successful at supporting the education of children and youth with special needs, pervasive developmental disorders and high skilled/gifted individuals. We have also investigated the limits and possibilities of such rooms concerning the set of services offered to their participants. In order to conduct the present research, we have performed: an interview with the Special Education Program manager from the abovementioned Department of Education; and the analysis of a Training Program that MFRs teachers must take. The training program consists of ten morning and afternoon shift meetings. The analyzed data leads us to conclude that the policy of implementation of MFRs, even in this relatively restricted universe is seen from different perspectives. Some interpretations are still permeated by the clinical model, considering individual action. The challenges observed in the classrooms show that the cooperation among teachers still occur randomly and, among other difficulties raised by them, is the selection of the right placement methods to identify eligible students who will benefit from the Specialized Educational Service (SES). In addition, teaching evaluation was considered fragile, as well as the training and the general requirements demanded in order to achieve the expected results.

Access of children to the oral health service

Dental caries still affect a considerable proportion of children, however the epidemiological profile of oral diseases is changing, social inequalities cause different disease patterns. The same problems occur for the use of services, which damage those who are more susceptible to oral diseases in numerous ways. To verify the association between the variables: socioeconomic condition, oral health and access to dental services providing oral health care for preschool children. The study population consisted of 2,759 children up to 6 years-old. The clinical exams followed the World Health Organization (WHO) criteria. The data were collected using a self-applied questionnaire, answered by the carers of children, with questions about socioeconomic variables and access to dental services. In terms of social class, a majority of the subjects came from the middle socioeconomic level (babies, 84.7%; children, 82.8%). Babies who had caries, 48.4% and 67.2% of the children that had decayed teeth had access to dental service. There was a association between the variables: the reason for the last dental appointment and the parent's perception of the treatment need of their children (babies p=0.0004 and children p < 0.0001); the parent's perception of the treatment need of their children and the oral health condition (babies p=0.0008 and children p < 0.0001); access to dental services and oral health condition (babies p=0.0021 and children p < 0.0001). The majority of the population studied sought care from public dental service and was from the middle class.

Improving logistics services through the technology used in fleet management

Outsourcing logistics has established itself in the area of the LSP (Logistics Service Provider), which offers a range of services to its customers. In this line, transportation is characterized as one of the most important services, and therefore efficient fleet management is essential for establishing a high level of customer service. With advances in technology and vehicle tracking systems, this approach of management has gained new possibilities for the improvement of logistics services. By studying the specific case of an LSP, this paper investigates the use of these technologies in the management of their business and services. The results indicate that the LSP seeks to increase its services and to streamline information in order to respond to customer needs in real time. It is also evident in this case under study that the combination of the technology available together with the fleet management system has become a distinguishing feature for this LSP, one which increases their skills and important information for both customers and business.

Condições de acessibilidade na universidade: o ponto de vista de estudantes com deficiência

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)