31 resultados para universal coding

em Scielo Saúde Pública - SP


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The study of public administration has been characterized as a strong international focus, as both governments and scholars have sought to learn from the experience of other societies. While in a perfect world, one would expect a sort of pragmatic universalism, instead, many scholars tend to bring lessons from one country, or from a single cultural reality. This modest contribution lies in showing a series of national experiences rarely brought to the discourse about public administration in Brazil: Canada, Australia, India and the Philippines. Special emphasis will be given to the following: the origins and the development of public administration; the influence of ideology; and the complex tension between global theory and local practices.

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OBJECTIVE: To describe the patterns of deliveries in a birth cohort and to compare vaginal and cesarean section deliveries. METHODS: All children born to mothers from the urban area of Pelotas, Brazil, in 2004, were recruited for a birth cohort study. Mothers were contacted and interviewed during their hospital stay when extensive information on the gestation, the birth and the newborn, along with maternal health history and family characteristics was collected. Maternal characteristics and childbirth care financing - either private or public healthcare (SUS) patients - were the main factors investigated along with a description of C-sections distribution according to day of the week and delivery time. Standard descriptive techniques, Χ² tests for comparing proportions and Poisson regression to explore the independent effect of C-section predictors were the methods used. RESULTS: The overall C-section rate was 45%, 36% among SUS and 81% among private patients, where 35% of C-sections were reported elective. C-sections were more frequent on Tuesdays and Wednesdays, reducing by about a third on Sundays, while normal deliveries had a uniform distribution along the week. Delivery time for C-sections was markedly different among public and private patients. Maternal schooling was positively associated with C-section among SUS patients, but not among private patients. CONCLUSIONS: C-sections were almost universal among the wealthier mothers, and strongly related to maternal education among SUS patients. The patterns we describe are compatible with the idea that C-sections are largely done to suit the doctor's schedule. Drastic action is called for to change the current situation.

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The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities.

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Numerous proteinase activities have been shown to be essential for the survival of Plasmodium falciparum. One approach to antimalarial chemotherapy, would be to block specifically one or several of these activities, by using compounds structurally analogous to the substrates of these proteinases. Such a strategy requires a detailed knowledge of the active site of the proteinase, in order to identify the best substrate for the proteinase. Aiming at developing such a strategy, two proteinases previously identified in our laboratory, were chosen for further characterization of their molecular structure and properties: the merozoite proteinase for erythrocytic invasion (MPEI), involved in the erythrocyte invasion by the merozoites, and the Pf37 proteinase, which hydrolyses human spectrin in vitro.

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Two allelic genomic fragments containing ribosomal protein S4 encoding genes (rpS4) from Trypanosoma cruzi (CL-Brener strain) were isolated and characterized. One allele comprises two complete tandem repeats of a sequence encoding an rpS4 gene. In the other, only one rpS4 gene is found. Sequence comparison to the accessed data in the genome project database reveals that our two-copy allele corresponds to a variant haplotype. However, the deduced aminoacid sequence of all the gene copies is identical. The rpS4 transcripts processing sites were determined by comparison of genomic sequences with published cDNA data. The obtained sequence data demonstrates that rpS4 genes are expressed in epimastigotes, amastigotes, and trypomastigotes. A recombinant version of rpS4 was found to be an antigenic: it was recognized by 62.5% of the individuals with positive serology for T. cruzi and by 93.3% of patients with proven chronic chagasic disease.

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Concerns have been raised that universal availability of antiretroviral agents in resource-limited settings might lead to the emergence and spread of resistant strains. We present the largest survey on human immunodeficiency virus type 1 (HIV-1) resistance among treatment-naïve and experienced patients followed in small, relatively underprivileged cities in Brazil with universal availability to standard of care antiretroviral combinations. Samples were collected between 2004 and 2006 from 95 patients followed in the cities of Saquarema and Santo Antonio de Pádua, state of Rio de Janeiro. A proviral fragment encompassing protease and reverse transcriptase (RT) regions was generated and drug susceptibility level was inferred. Among 50 strains from drug-naïve subjects, one (2%) had intermediate-level resistance to RT inhibitors. Among 38 patients on therapy as of sampling, 28 (73.7%) had plasma viral load (PVL) below detection limit (26 of whom without evidence of resistance mutations) and 11 (28.9%) harbored strains with reduced susceptibility. Only two strains harbored both protease and RT inhibitor mutations. Among seven patients who were off-treatment as of sampling, two (28.5%) harbored strains with reduced susceptibility to RT inhibitors. The relatively high frequency of undetectable PVL among patients on treatment and the overall low prevalence of resistance-associated mutations are reassuring. Continued surveillance, however, is necessary.

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The global emergence and spread of malaria parasites resistant to antimalarial drugs is the major problem in malaria control. The genetic basis of the parasite's resistance to the antimalarial drug chloroquine (CQ) is well-documented, allowing for the analysis of field isolates of malaria parasites to address evolutionary questions concerning the origin and spread of CQ-resistance. Here, we present DNA sequence analyses of both the second exon of the Plasmodium falciparum CQ-resistance transporter (pfcrt) gene and the 5' end of the P. falciparum multidrug-resistance 1 (pfmdr-1) gene in 40 P. falciparum field isolates collected from eight different localities of Odisha, India. First, we genotyped the samples for the pfcrt K76T and pfmdr-1 N86Y mutations in these two genes, which are the mutations primarily implicated in CQ-resistance. We further analyzed amino acid changes in codons 72-76 of the pfcrt haplotypes. Interestingly, both the K76T and N86Y mutations were found to co-exist in 32 out of the total 40 isolates, which were of either the CVIET or SVMNT haplotype, while the remaining eight isolates were of the CVMNK haplotype. In total, eight nonsynonymous single nucleotide polymorphisms (SNPs) were observed, six in the pfcrt gene and two in the pfmdr-1 gene. One poorly studied SNP in the pfcrt gene (A97T) was found at a high frequency in many P. falciparum samples. Using population genetics to analyze these two gene fragments, we revealed comparatively higher nucleotide diversity in the pfcrt gene than in the pfmdr-1 gene. Furthermore, linkage disequilibrium was found to be tight between closely spaced SNPs of the pfcrt gene. Finally, both the pfcrt and the pfmdr-1 genes were found to evolve under the standard neutral model of molecular evolution.

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A modified and improved model of a mechanical manipulator for observation of pinned and mounted insects is described. This device allows movement of the observed object around three perpendicular axes in the field of vision at all magnifications of stereomicroscopes. The main improvement of this new model is positioning of the guiding knobs for rotating around two of the axes next to each other, allowing faster and easier manipulation of the studied object. Thus, one of the main advantages of this device is the possibility to rotate the specimen without the need to refocus. The device enables easily reaching a precession deviation in the intersection point of axes up to 0.5 mm in the process of assembling.

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Métodos de representação espacial para o cálculo do fator topográfico (LS) da Equação Universal de Perda de Solo Revisada (RUSLE) têm sido utilizados para estimar a erosão do solo e a produção de sedimentos em bacias hidrográficas. Esses procedimentos baseiam-se nas equações tradicionalmente empregadas para determinação do fator LS e em informações que caracterizam a forma das vertentes derivadas do modelo numérico de elevação (MNE). Neste estudo foram analisados dois métodos de representação espacial utilizados no cálculo do fator LS em modelos matemáticos de erosão e produção de sedimentos em bacias hidrográficas. A análise foi realizada em quatro bacias rurais de relevo movimentado. Os valores de LS obtidos pelos métodos de representação espacial foram comparados entre si e com valores de LS determinados pelo método tradicional com levantamento em campo. Resultados mostraram que os valores de LS gerados pelos métodos de representação espacial apresentam diferenças significativas entre si, sendo dependentes do procedimento de cálculo e do método utilizado para determinar a direção de fluxo no MNE. Também foi verificado que os valores numéricos do fator LS determinados pelos métodos de representação espacial apresentam diferenças em relação àqueles estimados pelo método tradicional.

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Modelos hidrossedimentológicos são úteis na análise ambiental de bacias hidrográficas não monitoradas. Entretanto, para que as suas predições sejam confiáveis, é necessário que os modelos sejam adequadamente calibrados e validados para as condições locais. O objetivo do presente trabalho foi calibrar o coeficiente a da MUSLE para as condições da bacia do ribeirão Pipiripau, usando dados hidrossedimentológicos locais, bem como validar a equação calibrada, com uma série de dados diferente da usada na calibração. O coeficiente a da MUSLE foi calibrado por meio do ajuste entre os valores observados e calculados de aporte de sedimento de eventos individuais, correspondentes ao período entre 1999 e 2005, usando dados hidrológicos (Q e q p) observados. Para validação do modelo calibrado, a série usada correspondeu aos anos de 1998 e 2006-2009 (N.A.: dados corretos, ver p. 12), onde apenas os dados pluviométricos locais e os fatores CN, K, L, S, C e P da bacia, previamente obtidos, foram usados. Os resultados indicam que a MUSLE calibrada apresenta melhor acurácia na estimativa do aporte de sedimento total anual (R² = 0,68 e E = 0,61) do que em nível mensal (R² = 0,44 e E = 0,43). Como o coeficiente de ajuste a da MUSLE foi proporcional ao volume de precipitação pluvial anual, este poderá ser usado para melhorar as predições do modelo.

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This paper reviews the methods for the inventory of below-ground biotas in the humid tropics, to document the (hypothesized) loss of soil biodiversity associated with deforestation and agricultural intensification at forest margins. The biotas were grouped into eight categories, each of which corresponded to a major functional group considered important or essential to soil function. An accurate inventory of soil organisms can assist in ecosystem management and help sustain agricultural production. The advantages and disadvantages of transect-based and grid-based sampling methods are discussed, illustrated by published protocols ranging from the original "TSBF transect", through versions developed for the alternatives to Slash-and-Burn Project (ASB) to the final schemes (with variants) adopted by the Conservation and Sustainable Management of Below-ground Biodiversity Project (CSM-BGBD). Consideration is given to the place and importance of replication in below-ground biological sampling and it is argued that the new sampling protocols are inclusive, i.e. designed to sample all eight biotic groups in the same field exercise; spatially scaled, i.e. provide biodiversity data at site, locality, landscape and regional levels, and link the data to land use and land cover; and statistically robust, as shown by a partial randomization of plot locations for sampling.