Cultural singularities: indigenous elderly access to Public Health Service

OBJECTIVEDescribing how Kaingang seniors and their primary caregivers experience access to public health services.METHODA qualitative study guided by ethnography, conducted with 28 elderly and 19 caregivers. Data were collected between November 2010 and February 2013 through interviews and participative observation analyzed by ethnography.RESULTSThe study revealed the benefits and difficulties of the elderly access to health services, the facility to obtain health care resources such as appointments, medications and routine procedures, and the difficulties such as special assistance service problems and delays in the dispatching process between reference services.CONCLUSIONThe importance of knowing and understanding the cultural specificities of the group in order to offer greater opportunities for the elderly access to health services was reinforced.

Estimation of soil moisture in the root-zone from remote sensing data

Field-based soil moisture measurements are cumbersome. Thus, remote sensing techniques are needed because allows field and landscape-scale mapping of soil moisture depth-averaged through the root zone of existing vegetation. The objective of the study was to evaluate the accuracy of an empirical relationship to calculate soil moisture from remote sensing data of irrigated soils of the Apodi Plateau, in the Brazilian semiarid region. The empirical relationship had previously been tested for irrigated soils in Mexico, Egypt, and Pakistan, with promising results. In this study, the relationship was evaluated from experimental data collected from a cotton field. The experiment was carried out in an area of 5 ha with irrigated cotton. The energy balance and evaporative fraction (Λ) were measured by the Bowen ratio method. Soil moisture (θ) data were collected using a PR2 - Profile Probe (Delta-T Devices Ltd). The empirical relationship was tested using experimentally collected Λ and θ values and was applied using the Λ values obtained from the Surface Energy Balance Algorithm for Land (SEBAL) and three TM - Landsat 5 images. There was a close correlation between measured and estimated θ values (p<0.05, R² = 0.84) and there were no significant differences according to the Student t-test (p<0.01). The statistical analyses showed that the empirical relationship can be applied to estimate the root-zone soil moisture of irrigated soils, i.e. when the evaporative fraction is greater than 0.45.

Open access and connectedness: stimulating unexpected innovation through the use of institutional open archives

The author reviews past work with Ibict and the global progress made by the Open Access Movement. He postulates a theory of open access being an example of a complex adaptive system created by Internet-based scholarly publishing. Open access could be the cause of a cascade of increasing complexity and opportunities that will reshape this system. He has chosen the pervasive and global "Connectedness" created by the internet and the content spaces it provides for open access collections as a "simple disruptive agent". He discusses how connectedness influences infinite variety, creativity, work, change, knowledge, and the information economy. Case studies from the University of New Mexico Libraries are used where appropriate.

ETDs, NDLTD, and open access: a 5S perspective

Worldwide initiatives toward digital library (DL) support for electronic theses and dissertations (ETDs), facilitated by the work of the Networked Digital Library of Theses and Dissertations (NDLTD), are a key part of the move toward open access. When all graduate students learn to use openly available ETDs, and have experience with authoring and submission in connection with their own research results, it will be easy for them to continue these efforts through other contributions to open access. When all universities support ETD activities, they will be key participants in institutional repositories and open access, and will have engaged in discussion and infrastructure development supportive of further open access activities. Understanding of open access also can be facilitated through modeling of all of these efforts using the 5S framework, considering the key aspects of DL development: Societies, Scenarios, Spaces, Structures, and Streams.

The Brazilian electronic theses and dissertations digital library: providing open access for scholarly information

This paper describes a project led by the Instituto Brasileiro de Informações em Ciência e Tecnologia (Ibict), a government institution, to build a national digital library for electronic theses and dissertations - Bibliteca Digital de Teses e Dissertações (BDTD). The project has been a collaborative effort among Ibict, universities and other research centers in Brazil. The developers adopted a system architecture based on the Open Archives Initiative (OAI) in which universities and research centers act as data providers and Ibict as a service provider. A Brazilian metadata standard for electronic theses and dissertations was developed for the digital library. A toolkit including open source package was also developed by Ibict to be distributed to potential data providers. BDTD has been integrated with the international initiative: the Networked Digital Library of Thesis and Dissertation (NDLTD). Discussions in the paper address various issues related to project design, development and management as well as the role played by Ibict. Conclusions highlight some important lessons learned to date and challenges for the future in expanding the BDTD project.

Multispectral remote sensing for site-specific nitrogen fertilizer management

The objective of this work was to evaluate the use of multispectral remote sensing for site-specific nitrogen fertilizer management. Satellite imagery from the advanced spaceborne thermal emission and reflection radiometer (Aster) was acquired in a 23 ha corn-planted area in Iran. For the collection of field samples, a total of 53 pixels were selected by systematic randomized sampling. The total nitrogen content in corn leaf tissues in these pixels was evaluated. To predict corn canopy nitrogen content, different vegetation indices, such as normalized difference vegetation index (NDVI), soil-adjusted vegetation index (Savi), optimized soil-adjusted vegetation index (Osavi), modified chlorophyll absorption ratio index 2 (MCARI2), and modified triangle vegetation index 2 (MTVI2), were investigated. The supervised classification technique using the spectral angle mapper classifier (SAM) was performed to generate a nitrogen fertilization map. The MTVI2 presented the highest correlation (R²=0.87) and is a good predictor of corn canopy nitrogen content in the V13 stage, at 60 days after cultivating. Aster imagery can be used to predict nitrogen status in corn canopy. Classification results indicate three levels of required nitrogen per pixel: low (0-2.5 kg), medium (2.5-3 kg), and high (3-3.3 kg).

Using an aerial system of remote sensing to detect different nutritional status in Brachiaria decumbens

The aim of this study was to use digital images acquired by cameras attached to a helium balloon to detect variation of the nutritional status in Brachiaria decumbens. The treatments consisted of five doses of nitrogen (0, 50, 100, 150 e 200kg ha-1) with six replications each, evaluated in a completely randomized statistical design. A remote sensing system composed of digital cameras and microcomputers was used for image acquisition, and a helium balloon lifted the cameras to the heights of 15, 20, 25 and 30m. A portable chlorophyll meter and analyses of leaf nitrogen content were used to make comparisons with data obtained by the remote sensing system. Data was acquired in two phases, in different climatic conditions. At the end of each phase, dry matter production was measured. Three vegetation indices were used to evaluate the detection of different nutritional status. The three indices were able to detect the effects of N doses. The indices constructed with the Green spectral band showed to be more efficient.

Geostatistics and remote sensing methods in the classification of images of areas cultivated with citrus

This study compares the precision of three image classification methods, two of remote sensing and one of geostatistics applied to areas cultivated with citrus. The 5,296.52ha area of study is located in the city of Araraquara - central region of the state of São Paulo (SP), Brazil. The multispectral image from the CCD/CBERS-2B satellite was acquired in 2009 and processed through the Geographic Information System (GIS) SPRING. Three classification methods were used, one unsupervised (Cluster), and two supervised (Indicator Kriging/IK and Maximum Likelihood/Maxver), in addition to the screen classification taken as field checking.. Reliability of classifications was evaluated by Kappa index. In accordance with the Kappa index, the Indicator kriging method obtained the highest degree of reliability for bands 2 and 4. Moreover the Cluster method applied to band 2 (green) was the best quality classification between all the methods. Indicator Kriging was the classifier that presented the citrus total area closest to the field check estimated by -3.01%, whereas Maxver overestimated the total citrus area by 42.94%.

Video assisted resections. Increasing access to minimally invasive liver surgery?

Objective: To evaluate perioperative outcomes, safety and feasibility of video-assisted resection for primary and secondary liver lesions. Methods : From a prospective database, we analyzed the perioperative results (up to 90 days) of 25 consecutive patients undergoing video-assisted resections in the period between June 2007 and June 2013. Results : The mean age was 53.4 years (23-73) and 16 (64%) patients were female. Of the total, 84% were suffering from malignant diseases. We performed 33 resections (1 to 4 nodules per patient). The procedures performed were non-anatomical resections (n = 26), segmentectomy (n = 1), 2/3 bisegmentectomy (n = 1), 6/7 bisegmentectomy (n = 1), left hepatectomy (n = 2) and right hepatectomy (n = 2). The procedures contemplated postero-superior segments in 66.7%, requiring multiple or larger resections. The average operating time was 226 minutes (80-420), and anesthesia time, 360 minutes (200-630). The average size of resected nodes was 3.2 cm (0.8 to 10) and the surgical margins were free in all the analyzed specimens. Eight percent of patients needed blood transfusion and no case was converted to open surgery. The length of stay was 6.5 days (3-16). Postoperative complications occurred in 20% of patients, with no perioperative mortality. Conclusion : The video-assisted liver resection is feasible and safe and should be part of the liver surgeon armamentarium for resection of primary and secondary liver lesions.

Single access laparoscopic cholecystectomy: technique without the need for special materials and with better ergonomics

The authors describe a surgical technique which allows, without increasing costs, to perform laparoscopic cholecystectomy with a single incision, without using specific materials and with better surgical ergonomics. The technique consists of a longitudinal umbilical incision, navel detachment, use of a permanent 10mm trocar and two clamps directly and bilaterally through the aponeurosis without the use of 5mm trocars, transcutaneous gallbladder repair with straight needle cotton suture, ligation with unabsorbable suture and umbilical incision for the specimen extraction. The presented technique enables the procedure with conventional and permanent materials, improving surgical ergonomics, with safety and aesthetic advantages.

Hind limb ischemic preconditioning induces an anti-inflammatory response by remote organs in rats

Ischemic preconditioning (IPC), a strategy used to attenuate ischemia-reperfusion injury, consists of brief ischemic periods, each followed by reperfusion, prior to a sustained ischemic insult. The purpose of the present study was to evaluate the local and systemic anti-inflammatory effects of hind limb IPC in male Wistar rat (200-250 g) models of acute inflammation. IPC was induced with right hind limb ischemia for 10 min by placing an elastic rubber band tourniquet on the proximal part of the limb followed by 30 min of reperfusion. Groups (N = 6-8) were submitted to right or left paw edema (PE) with carrageenan (100 µg) or Dextran (200 µg), hemorrhagic cystitis with ifosfamide (200 mg/kg, ip) or gastric injury (GI) with indomethacin (20 mg/kg, vo). Controls received similar treatments, without IPC (Sham-IPC). PE is reported as variation of paw volume (mL), vesical edema (VE) as vesical wet weight (mg), vascular permeability (VP) with Evans blue extravasation (µg), GI with the gastric lesion index (GLI; total length of all erosions, mm), and neutrophil migration (NM) from myeloperoxidase activity. The statistical significance (P < 0.05) was determined by ANOVA, followed by the Tukey test. Carrageenan or Dextran-induced PE and VP in either paw were reduced by IPC (42-58.7%). IPC inhibited VE (38.8%) and VP (54%) in ifosfamide-induced hemorrhagic cystitis. GI and NM induced by indomethacin were inhibited by IPC (GLI: 90.3%; NM: 64%). This study shows for the first time that IPC produces local and systemic anti-inflammatory effects in models of acute inflammation other than ischemia-reperfusion injury.

Chronic kidney disease in disadvantaged populations

The increased burden of chronic kidney disease (CKD) in disadvantaged populations is due to both global factors and population-specific issues. Low socioeconomic status and poor access to care contribute to health care disparities and exacerbate the negative effects of genetic or biological predisposition. Provision of appropriate renal care to these populations requires a two-pronged approach: expanding the reach of dialysis through development of low-cost alternatives that can be practiced in remote locations, and implementation and evaluation of cost-effective prevention strategies. Kidney transplantation should be promoted by expansion of deceased donor transplant programs and use of inexpensive, generic immunosuppressive drugs. The message of World Kidney Day 2015 is that a concerted attack against the diseases that lead to end-stage renal disease, by increasing community outreach, better education, improved economic opportunity, and access to preventive medicine for those at highest risk, could end the unacceptable relationship between CKD and disadvantage in these communities.

Food access and consumption in a rural settlement in Castanhal, PA, Brazil

Abstract The study aimed to assess the food accessibility and consumption among families in the Cupiúba rural settlement, in the city of Castanhal, Pará, Brazil. It was found that the access to food is worrying and indicated that most families are in food insecurity conditions. Moreover, income and food safety level were associated. The consumption of the settler families comprises mainly high-energy, low-nutrient content foods, characterized by the low intake of fruits and vegetables and the introduction of processed foods with high energy density and sugar-added beverages, although the traditional dietary habits (rice and beans) are still present. This configures a diet at risk for important nutritional deficits, obesity, and many non-communicable chronic diseases.