Municipalities of higher vulnerability to Sylvatic Yellow Fever occurrence in the São Paulo State, Brazil

Until 1999 the endemic cases of Sylvatic Yellow Fever were located in the states of northern, midwestern and pre-Amazon regions. Since then, the disease progressively expanded its territory of occurrence, cases being registered beyond the traditional boundaries of endemism. The São Paulo State is considered to be part of this context, since after decades without registration of autochthonous cases of the disease, it reported, in 2000 and 2008-2009, epizootic occurrence in non-human primates and 30 cases in humans. Facts like these, added to the increase in incidences of serious adverse effects resulting from the Yellow Fever vaccination, have highlighted the importance of defining priority municipalities for vaccination against the disease in the state. Two groups of municipalities, some affected and some non-affected by YF, were compared for environmental variables related to the eco-epidemiology of the disease according to literature. The Multiple Correspondence Analysis (MCA) was used to pinpoint the factor able to differentiate the two groups of municipalities and define the levels of risk. The southeast region of the São Paulo State was considered to be the area with a higher number of municipalities classified as high risk and should be considered a priority for the application of prevention measures against Yellow Fever.

Malaria in the state of Rio de Janeiro, Brazil, an Atlantic Forest area: an assessment using the health surveillance service

The lethality of malaria in the extra-Amazonian region is more than 70 times higher than in Amazonia itself. Recently, several studies have shown that autochthonous malaria is not a rare event in the Brazilian southeastern states in the Atlantic Forest biome. Information about autochthonous malaria in the state of Rio de Janeiro (RJ) is scarce. This study aims to assess malaria cases reported to the Health Surveillance System of the State of Rio de Janeiro between 2000-2010. An average of 90 cases per year had parasitological malaria confirmation by thick smear. The number of malaria notifications due to Plasmodium falciparum increased over time. Imported cases reported during the period studied were spread among 51% of the municipalities (counties) of the state. Only 35 cases (4.3%) were autochthonous, which represents an average of 3.8 new cases per year. Eleven municipalities reported autochthonous cases; within these, six could be characterised as areas of residual or new foci of malaria from the Atlantic Forest system. The other 28 municipalities could become receptive for transmission reintroduction. Cases occurred during all periods of the year, but 62.9% of cases were in the first semester of each year. Assessing vulnerability and receptivity conditions and vector ecology is imperative to establish the real risk of malaria reintroduction in RJ.

Waterborne toxoplasmosis investigated and analysed under hydrogeological assessment: new data and perspectives for further research

We present a set of data on human and chicken Toxoplasma gondiiseroprevalence that was investigated and analysed in light of groundwater vulnerability information in an area endemic for waterborne toxoplasmosis in Brazil. Hydrogeological assessment was undertaken to select sites for water collection from wells for T. gondii oocyst testing and for collecting blood from free-range chickens and humans for anti-T. gondiiserologic testing. Serologic testing of human specimens was done using conventional commercial tests and a sporozoite-specific embryogenesis-related protein (TgERP), which is able to differentiate whether infection resulted from tissue cysts or oocysts. Water specimens were negative for the presence of viable T. gondii oocysts. However, seroprevalence in free-range chickens was significantly associated with vulnerability of groundwater to surface contamination (p < 0.0001; odds ratio: 4.73, 95% confidence interval: 2.18-10.2). Surprisingly, a high prevalence of antibodies against TgERP was detected in human specimens, suggesting the possibility of a continuous contamination of drinking water with T. gondiioocysts in this endemic setting. These findings and the new proposed approach to investigate and analyse endemic toxoplasmosis in light of groundwater vulnerability information associated with prevalence in humans estimated by oocyst antigens recognition have implications for the potential role of hydrogeological assessment in researching waterborne toxoplasmosis at a global scale.

Brazil's strategic partnerships: an assessment of the Lula era (2003-2010)

This article examines the priority bilateral relations of Brazil, named "strategic partnerships", both because of their tradition and historical relevance and due to the existence of political and economic cooperation projects. An assessment of these relationships, especially under Lula's administration, is made in this work, bearing in mind the concept of "strategic partnerships" and its development in Brazilian foreign policy. There will be considered partnerships with the US; Argentina; Japan; China; India; South Africa and the European Union. In the article, the meaning of the increase in these relationships is interpreted on the grounds of its significance to the international insertion strategy of Brazil

Multi-level governance and social cohesion in the European Union: the assessment of local agents, a study case inside Galicia

Implementing multi-level governance has been a key priority in EU cohesion policy. This study assesses the perceived achievements and shortcomings in implementing European Social Fund by analyzing the deficits and weaknesses as well as the poor participation of local agents who are in direct contact with the beneficiaries in order to design and implement this fund, which is the main financial instrument of EU social policy.

Student stress and quality of education

Today, managers are increasingly interested in knowing how the work in organizations aftects employees' health. Less common is the interest in stress erupting in the academic community - among students, faculty and administrators. The authors present a reflection paper focused on student stress. In this paper, they first examine McLean 's model of context, vulnerability and stressors. This model provides the framework for the student surveys and for the entire paper. Based on the students surveys, an assessment is made of how asma" group of students are coping with stress. The paper fina"y suggests what can be done by students, faculty, and administrators to insta" and/or improve social support systems that might reduce the harmful eftects of stress on students and thus impact the quality of education.

Neoinstitutionalism and the appropriation of bourdieu's work: a critical assessment

Despite the still present hegemony of the structural-functionalist orthodoxy, the mid 1980's witnesses the insurgence of new philosophical approaches. This body of work had become a vital intellectual and ideological resource for those who wanted to confront the functionalist dominance in organization studies, such as structuration theory, labour process theory and neoinstitutionalist theory. The purpose of this paper is to review the incorporation of Bourdieu's work into neoinstitutionalism. I argue that this appropriation has resulted in a significant loss of theoretical strength. By giving place to the cognitivist metaphors of mental models, "scripts" and "schemas", instead of adopting the notion of habitus, neoinstitutionalism reinforces some of the ever-present dichotomies in social sciences, especially those of agency/structure and individual/society. While neoinstitutionalism was refining the cognitive approach in the 1990's, Bourdieu was moving towards psychoanalysis. Some indications for future research are provided in the concluding notes.

Access to information: assessment of the use of automated interaction technologies in call centers

With the purpose of at lowering costs and reendering the demanded information available to users with no access to the internet, service companies have adopted automated interaction technologies in their call centers, which may or may not meet the expectations of users. Based on different areas of knowledge (man-machine interaction, consumer behavior and use of IT) 13 propositions are raised and a research is carried out in three parts: focus group, field study with users and interviews with experts. Eleven automated service characteristics which support the explanation for user satisfaction are listed, a preferences model is proposed and evidence in favor or against each of the 13 propositions is brought in. With balance scorecard concepts, a managerial assessment model is proposed for the use of automated call center technology. In future works, the propositions may become verifiable hypotheses through conclusive empirical research.

Sustainable Tourism and Eradication of Poverty (Step): impact assessment of a tourism development program in Brazil

This paper aims to evaluate the social impacts of the Tourism Development Program (Prodetur) in the northeastern town of Porto Seguro, Bahia, Brazil. The method used is based on the difference in difference technique applied to the 1991 and 2000 Census microdata. The results suggest social advances following from poverty relief based on income - where the benefits are distributed, generally, in a relatively equal manner between the native and migrant population. There is a relative deterioration in the sanitary situation, which consists of a very serious problem in the mid- and long-term, whose costs are mostly borne by the native population. Therefore, maintaining the natural capital is the main aspect that distances Porto Seguro’s tourism supply from the concept of sustainability. The article also relies on difference in difference estimators to assess the impacts of local public policies related to the sector.

A gestão do conhecimento na administração pública municipal em Curitiba com a aplicação do método OKA - Organizational Knowledge Assessment

O presente artigo objetiva analisar como a gestão do conhecimento se manifesta na administração pública da Prefeitura Municipal de Curitiba; para tanto, buscou-se a aplicação do método Organizational Knowledge Assessment (OKA), criado pelo Banco Mundial e organizado pela Escola Nacional de Administração Pública (Enap). No que tange aos procedimentos metodológicos, utilizou-se o estudo de caso como instrumento de pesquisa e coleta dos dados. Como resultado, identificaram-se o processo de avaliação organizacional, indicando as similaridades e distinções do desenvolvimento do método de cada área-fim, e a importância de implantar sistematicamente um processo de avaliação aliado ao planejamento da organização pública com estratégias para disseminar, compartilhar e aplicar o conhecimento produzido.

Assessment and prediction of asthma and its severity in the pediatric community

Seventy four asthmatic children aged 7 to 11 years were examined along with controls matched by age and sex. Clinical and laboratory investigations preceded a 28-day follow-up where data about morning and evening peak expiratory flow rate (PEF), symptoms and treatment were recorded. The coefficient of variation of PEF was found to be an objective measurement of asthma severity that has statistically significant correlation with both symptoms (r s= .36) and treatment (r s= .60). Moreover, it separates mild and severe asthmatics, as confirmed by statistically significant differences (p= .008 or less) in symptoms, treatment, skin allergy and airways response to exercise. Skin allergy and airways responsiveness to exercise were found to be predictors of both disease and severity. By means of logistic regression analysis it was possible to establish the probabilities for both asthma and severe asthma when children presenting and not presenting these characteristics are compared. One single positive skin test represent a probability of 88% for the development of asthma and a probability of 70% for severe disease. A PEF reduction of 10% after an exercise test implies a probability of 73% for disease and a probability of 64% for severe disease. Increases in these variables imply geometrically increased risks and their presence together have a multiplicative effect in the final risk.

Assessment of a strategy for the control of respiratory diseases in children

A programme for the control of respiratory diseases in children was conceived for the State of S. Paulo, Brazil, in 1986. Its progress thereafter and the epidemiology of the diseases concerned are examined. Apart from an inquiry into the 64 existing State local health authorities, a sample of 18,255 cases of children assisted by the programme at different levels, including both in-patient and outpatient care, is analysed. Each case record included information about identification (child, doctor and health facility), reasons for calling, diagnoses made and outcome of treatment. Further data were also sought from hospitals and from State mortality records. The programme was found to be poorly implemented in the State but, where implemented, it showed itself capable of resolving problems (only 0.5% of the cases could not be handled) as also of changing ongoing trends (more than 50% reduction in hospital admission rates). Individual assessment of each item of the programme indicated its bottlenecks. Regarding the epidemiology of respiratory diseases, it is observed that the major burden to health services comes from children aged less than five, and that the most important diseases are wheezing illnesses and pneumonia. Morevoer, they were found to be significantly associated (p = 0.000) so that a child in the community presenting wheezing diseases is 5 times more likely to develop pneumonia than a child with any other respiratory diagnosis. Similarly, among the under five deaths it was found that the risk for pneumonia is 3 times greater for children who died presenting wheezing diseases than it is for children with any other sort of diagnosis. In conclusion, the programme is deemed to be efficient and effective but its efficacy is marred by administrative flaws. The successful control of respiratory problems in childhood is related to a proper appreciation of the importance of wheezing diseases.

Psychiatric assessment in transplantation

The implementation of the presumptive donor law in Brazil is expected to increase the availability of organs for transplantation. As medical management of end-stage organ dysfunction continues to improve, increasing numbers of potential transplant recipients will be available to meet this supply. There is mounting evidence that supports the involvement of skilled psychiatric practitioners in the selection of transplant candidates. Data supporting the influence of psychosocial factors on compliance and therefore medical outcomes continues to grow. The literature review allows delineating the components and rationale for comprehensive psychosocial evaluations as a component of preoperative transplantation evaluation.