HIV testing among pregnant women in Brazil: rates and predictors

OBJECTIVE: To assess rates of offering and uptake of HIV testing and their predictors among women who attended prenatal care. METHODS: A population-based cross-sectional study was conducted among postpartum women (N=2,234) who attended at least one prenatal care visit in 12 cities. Independent and probabilistic samples were selected in the cities studied. Sociodemographic data, information about prenatal care and access to HIV prevention interventions during the current pregnancy were collected. Bivariate and multivariate analyses were carried out to assess independent effects of the covariates on offering and uptake of HIV testing. Data collection took place between November 1999 and April 2000. RESULTS: Overall, 77.5% of the women reported undergoing HIV testing during the current pregnancy. Offering of HIV testing was positively associated with: previous knowledge about prevention of mother-to-child transmission of HIV; higher number of prenatal care visits; higher level of education and being white. HIV testing acceptance rate was 92.5%. CONCLUSIONS: The study results indicate that dissemination of information about prevention of mother-to-child transmission among women may contribute to increasing HIV testing coverage during pregnancy. Non-white women with lower level of education should be prioritized. Strategies to increase attendance of vulnerable women to prenatal care and to raise awareness among health care workers are of utmost importance.

Composition and structure of the fig wasp community in Amazonia

An understanding of the complex ecological interaction between fig wasps and their host plants in Amazonia requires previous knowledge of their distribution and diversity. The objective of this study was to describe the composition and structure of the wasp community associated with four species of Ficus in the municipal area of Manaus, Amazonas, Brazil. A total of 600 syconia from four species were collected. The study species were: Ficus obtusifolia Kunth; Ficus citrifolia Mill; F. americana subspecies guianensis Desv. form mathewsii; and F. americana subspecies guianensis Desv. form parkeriana. Statistical analyses were used to examine the relationship between fig wasp diversity and syconium diameter, and the effect of non-pollinating wasps on numbers of pollinators and seeds. Forty three species of fig wasp were identified, distributed across seven genera (Pegoscapus, Idarnes, Aepocerus, Physothorax, Anidarnes, Heterandrium , Eurytoma). Idarnes (carme group) was the wasps genus non-pollinator with greatest number of individuals with the greatest number of infested syconia (7409 wasps in 376 syconia). Analysing non-pollinating wasp diversity in relation to fig diameter, a significant difference was observed between the four fig species. Ficus citrifolia and F. americana subspecies guianensis form mathewsii had the smallest diameter but the greatest diversity of fig wasp. Ficus obtusifolia was the only species in which the non-pollinating wasps had a significant negative effect on the number of Pegoscapus sp. and on seed production.

Detection of coronary artery disease based on the calcification index obtained by helical computed tomography

OBJECTIVE: To assess the relation between coronary artery disease and the calcification index on helical computed tomography. METHOD: We studied 22 patients (ages ranging from 40 to 70 years) who underwent coronary angiography because of chest pain suggestive of angina pectoris. Findings on coronary angiography were classified as follows: significant obstructive disease (stenosis > or = 50%), nonobstructive disease (stenosis <50%), and no disease. With no previous knowledge of the results of the coronary angiography and within 7 days, helical computed tomography of the chest was performed. Then, data of the coronary angiography were correlated with the calcification index obtained by helical computed tomography. RESULTS: The sensitivity of helical computed tomography to the presence of significant obstructive lesions on coronary angiography was 87.5%, specificity was 100%, and negative and positive predictive values were 75% and 100%, respectively. The mean calcification index was greater in patients with severe coronary lesions, mainly when involvement of 2 or 3 vessels occurred, than that in patients with no coronary artery disease or with nonobstructive coronary artery lesions (p<0.05). CONCLUSION: Helical computed tomography is an effective method for detecting and quantifying coronary artery calcification, and it has proved to be sensitive to and specific for the noninvasive diagnosis of coronary artery stenosis.

Um esquema geral para a discussão do movimento de materiais para as células vivas e tecidos

A generalized comprehensive scheme concerning the movement of materials into living cells and tissues is presented. It is designed for use by investigators and teachers who, is assumed, have a previous knowledge of the subject as well as familiarity with previously published literature on the subject. Footnotes to figure 2 X = a constituent component material, arising from extermal sources or through metabolism, capable of migration under favorable conditions. e, i, ec, ic, mc = subscripts indicating location. oC = oxidized cytoplasmic constituents specifically concerned in unidirectional (here invardly directed), diffetial translocation of a particular material X. rC = reduced cytoplasmic constituents specifically concerned. XF = specific free energy (2) of a constituent component in in external or internal phases or in cytoplasm. D = diffusion (4). EA = exchange adsorption (4). MA= metabolic accumulation (4), CI = differentially characteristic cytoplasmic interaction (4) between oC and X, determined by the genetic constitution of the biological species. ▬▬▬>= migration, where permeability to the material involved is relatively high; and ~~~~->, where relatively low. <▬▬▬>= chemical reactions. ▬▬▬>= energy changes of X; diffusion is characteristically with the direction in which the concentration or activity of the constituent decreases, exchange adsorption may be with or against the direction of concentration or activity decrease.

Host genetic factors in American cutaneous leishmaniasis: a critical appraisal of studies conducted in an endemic area of Brazil

American cutaneous leishmaniasis (ACL) is a vector-transmitted infectious disease with an estimated 1.5 million new cases per year. In Brazil, ACL represents a significant public health problem, with approximately 30,000 new reported cases annually, representing an incidence of 18.5 cases per 100,000 inhabitants. Corte de Pedra is in a region endemic for ACL in the state of Bahia (BA), northeastern Brazil, with 500-1,300 patients treated annually. Over the last decade, population and family-based candidate gene studies were conducted in Corte de Pedra, founded on previous knowledge from studies on mice and humans. Notwithstanding limitations related to sample size and power, these studies contribute important genetic biomarkers that identify novel pathways of disease pathogenesis and possible new therapeutic targets. The present paper is a narrative review about ACL immunogenetics in BA, highlighting in particular the interacting roles of the wound healing gene FLI1 with interleukin-6 and genes SMAD2 and SMAD3 of the transforming growth factor beta signalling pathway. This research highlights the need for well-powered genetic and functional studies on Leishmania braziliensis infection as essential to define and validate the role of host genes in determining resistance/susceptibility regarding this disease.

Gerenciamento de resíduos laboratoriais: recuperação de elementos e preparo para descarte final

This work shows some laboratory waste management developed in order to recover some elements or to prepare the waste for a correct final disposal. The 25 elements chosen cover basically all chemical behaviors found for the metals in the Periodic Table. The treatments adopted were based on the classical behavior in aqueous solution (wet chemistry) but an important condition for a full success was the previous knowledge of the qualitative composition of the wastes treated. Some general trends were found: the final liquid waste was always saline and normally presented a higher volume than the original waste; most original wastes were acid in nature; steps such as solid-liquid separation, washing, evaporating and calcining were currently performed. This work was also a very good experience in chemistry in solution for students and showed them the need of treating wastes for a better environment.

O inacreditável emprego de produtos químicos perigosos no passado

This work describes an overview of the use of chemicals in several commercial applications along the XXth century. The use of chemicals by men was largely empirical for many centuries, since there was no organized chemical and toxicological knowledge. During the XIXth century the chemical industry gained a crucial role in the development of technology, as evidenced by the extraordinary increase of new products and their incorporation into everyday life. Chemistry was considered a science capable of solving any problem, little regard being paid to the consequences of the widespread use of new chemicals. Efficiency was more important than safety and consumer information. From tragedies and the development of knowledge on toxicology men adopted more careful protocols before a new chemical was proposed for use. Modern life could not exist without the large-scale employment of a variety of chemicals but information on their responsible and conscious use is now essential. Products that were once considered the "last word in technology" have eventually proven dangerous to humans and the environment in the short or long time range. Previous knowledge on the toxicological dangers and the properties of a given substance or product before commercialization is necessary for safe handling.

Recuperação de chumbo, mercúrio e elementos dos grupos 4 a 7 da tabela periódica de seus resíduos

This work shows routes to recover some elements from their laboratory wastes and broken apparatus (thermometers and densimeters). Most elements chosen present a chemical behavior in aqueous solution which is not currently studied in the ordinary experimental classes. The routes were based on the previous knowledge of the qualitative composition of the wastes treated. Wastes containing chromium were the most difficult to treat. The elements were recovered in good yields and can be reused in new experiments. This work was a very good experience in chemistry for students and shows the need of managing wastes for a better environment.

The modulation of simple reaction time by the spatial probability of a visual stimulus

Simple reaction time (SRT) in response to visual stimuli can be influenced by many stimulus features. The speed and accuracy with which observers respond to a visual stimulus may be improved by prior knowledge about the stimulus location, which can be obtained by manipulating the spatial probability of the stimulus. However, when higher spatial probability is achieved by holding constant the stimulus location throughout successive trials, the resulting improvement in performance can also be due to local sensory facilitation caused by the recurrent spatial location of a visual target (position priming). The main objective of the present investigation was to quantitatively evaluate the modulation of SRT by the spatial probability structure of a visual stimulus. In two experiments the volunteers had to respond as quickly as possible to the visual target presented on a computer screen by pressing an optic key with the index finger of the dominant hand. Experiment 1 (N = 14) investigated how SRT changed as a function of both the different levels of spatial probability and the subject's explicit knowledge about the precise probability structure of visual stimulation. We found a gradual decrease in SRT with increasing spatial probability of a visual target regardless of the observer's previous knowledge concerning the spatial probability of the stimulus. Error rates, below 2%, were independent of the spatial probability structure of the visual stimulus, suggesting the absence of a speed-accuracy trade-off. Experiment 2 (N = 12) examined whether changes in SRT in response to a spatially recurrent visual target might be accounted for simply by sensory and temporally local facilitation. The findings indicated that the decrease in SRT brought about by a spatially recurrent target was associated with its spatial predictability, and could not be accounted for solely in terms of sensory priming.

Galictis cuja (Mammalia): an update of current knowledge and geographic distribution

The lesser grison (Galictis cuja) is one of the least-known mustelids in the Neotropics, despite its broad range across South America. This study aimed to explore current knowledge of the distribution of the species to identify gaps in knowledge and anticipate its full geographic distribution. Eighty-nine articles have mentioned G. cuja since 1969, but only 13 focused on the species. We generated a detailed model of the species' potential distribution that validated previous maps, but with improved detail, supporting previous southernmost records, and providing a means of identifying priority sites for conservation and management of the species.

Skin cancer in rural workers: nursing knowledge and intervention

OBJECTIVETo identify the exposure of rural workers to the sun's ultraviolet radiation and pesticides; to identify previous cases of skin cancer; and to implement clinical and communicative nursing actions among rural workers with a previous diagnosis of skin cancer.METHODObservational-exploratory study conducted with rural workers exposed to ultraviolet radiation and pesticides in a rural area in the extreme south of Brazil. A clinical judgment and risk communication model properly adapted was used to develop interventions among workers with a previous history of skin cancer.RESULTSA total of 123 (97.7%) workers were identified under conditions of exposure to the sun's ultraviolet radiation and pesticides; seven (5.4%) were identified with a previous diagnosis of skin cancer; four (57.1%) of these presented potential skin cancer lesions.CONCLUSIONThis study's results enabled clarifying the combination of clinical knowledge and risk communication regarding skin cancer to rural workers.

Basic life support knowledge of first-year university students from Brazil

We aimed to evaluate knowledge of first aid among new undergraduates and whether it is affected by their chosen course. A questionnaire was developed to assess knowledge of how to activate the Mobile Emergency Attendance Service - MEAS (Serviço de Atendimento Móvel de Urgência; SAMU), recognize a pre-hospital emergency situation and the first aid required for cardiac arrest. The students were also asked about enrolling in a first aid course. Responses were received from 1038 of 1365 (76.04%) new undergraduates. The questionnaires were completed in a 2-week period 1 month after the beginning of classes. Of the 1038 respondents (59.5% studying biological sciences, 11.6% physical sciences, and 28.6% humanities), 58.5% knew how to activate the MEAS/SAMU (54.3% non-biological vs 61.4% biological, P=0.02), with an odds ratio (OR)=1.39 (95%CI=1.07-1.81) regardless of age, sex, origin, having a previous degree or having a relative with cardiac disease. The majority could distinguish emergency from non-emergency situations. When faced with a possible cardiac arrest, 17.7% of the students would perform chest compressions (15.5% non-biological vs 19.1% biological first-year university students, P=0.16) and 65.2% would enroll in a first aid course (51.1% non-biological vs 74.7% biological, P<0.01), with an OR=2.61 (95%CI=1.98-3.44) adjusted for the same confounders. Even though a high percentage of the students recognized emergency situations, a significant proportion did not know the MEAS/SAMU number and only a minority had sufficient basic life support skills to help with cardiac arrest. A significant proportion would not enroll in a first aid course. Biological first-year university students were more prone to enroll in a basic life support course.

Linking strategy and the knowledge of the firm

Discovering the ways through which firms develop and maintain competitive advantage is a central research stream in management theory. The objective of this paper is to present a contribution to the discussion of the knowledge of the firm as a source of competitive advantage. The paper states that a firm's success is a consequence of its ability in the continuous development of core competencies that will sustain its competitiveness over time. Core competencies are understood as the sets of knowledge that differentiate a company strategically. The firm must discover, develop, share and update the knowledge that sustains the present and future core competencies. Knowledge management, through processes of knowledge creation and integration, is one way of doing this.

Knowledge and policy action in urban development: if we know so much, why is the urban condition not improving?

In spite of the wealth generation potential of the world's large metropolitan cities, poor living conditions for much of the world's urban population persist. Although the city has been widely studied, urban policy often remains ineffective. The paper adopts a policy process approach to analyze the relationship between knowledge and governmental action. Impediments to improving urban policy are found in the inadequate capacity of government to act and in the politics of democratic decision-making. The paper recommends that a pragmatic view of knowledge generation be adopted.

Knowledge cities: a taxonomy for analyzing software and information service clusters

Software and information services (SIS) have become a field of increasing opportunities for international trade due to the worldwide diffusion of a combination of technological and organizational innovations. In several regions, the software industry is organized in clusters, usually referred to as "knowledge cities" because of the growing importance of knowledge-intensive services in their economy. This paper has two primary objectives. First, it raises three major questions related to the attractiveness of different cities in Argentina and Brazil for hosting software companies and to their impact on local development. Second, a new taxonomy is proposed for grouping clusters according to their dominant business segment, ownership pattern and scope of operations. The purpose of this taxonomy is to encourage further studies and provide an exploratory analytical tool for analyzing software clusters.