Usage analysis of the Nursing Activities Score in two Spanish ICUS

The aim of this study was to analyze the discourse of health managers on aspects related to delay in tuberculosis diagnosis. This was a qualitative research study, conducted with 16 Family Health Unit managers. The empirical data were obtained through semi-structured interviews. The analysis was based on the theoretical framework of the French school of discourse analysis. According to the managers’ statements, the delay in tuberculosis diagnosis is related to patient and health service aspects. As for patient aspects, managers report fear, prejudice and lack of information as factors that may promote a delayed diagnosis. Regarding health service aspects, structural problems and lack of professional skills were reported. The discourse of managers should be considered to qualify tuberculosis control actions and to prevent delays in diagnosis.

Clinical evaluation of enalapril maleate and furosemide usage in dogs with degenerative myxomatous mitral valve, CHF functional class Ib

Degenerative myxomatous mitral valve (DMMV) is a heart disease of high incidence in small animal clinical medicine, affecting mainly older dogs and small breeds. Thus, a scientific investigation was performed in order to evaluate the clinical use of the medicines furosemide and enalapril maleate in dogs with this disease in CHF functional class Ib before and after the treatment was established. For this purpose 16 dogs with the given valve disease were used, separated into two groups: the first received furosemide (n=8) and the second received enalapril maleate (n=8) throughout 56 days. The dogs were evaluated in four stages (T0, T14, T28 and T56 day) in relation to clinical signs, hematological, biochemical and serum assessment, which included serum angiotensin converting enzyme (ACE) and aldosterone, as well as radiography, electrocardiography, Doppler-echocardiography and blood pressure. The results regarding the clinical, hematological and serum chemistry evaluations revealed no significant changes in both groups, but significant reductions in the values of ACE and aldosterone in the group receiving enalapril maleate were verified. The radiographic examination revealed reductions of VHS values and variable Pms wave of the electrocardiogram in both groups, but no changes in blood pressure values were identified. The echocardiogram showed a significant decrease of the variables LVDd/s in the studied groups and the FS% in animals that received only enalapril. Therefore, analysis of results showed that monotherapy based on enalapril maleate showed better efficiency of symptoms control in patients with CHF functional class Ib.

Spatial variability in nutritional status of arabic coffee based on dris index

The combined use of precision agriculture and the Diagnosis and Recommendation Integrated System (DRIS) allows the spatial monitoring of coffee nutrient balance to provide more balanced and cost-effective fertilizer recommendations. The objective of this work was to evaluate the spatial variability in the nutritional status of two coffee varieties using the Mean Nutritional Balance Index (NBIm) and its relationship with their respective yields. The experiment was conducted in eastern Minas Gerais in two areas, one planted with variety Catucaí and another with variety Catuaí. The NBIm of the two varieties and their yields were analyzed through geostatistics and, based on the models and parameters of the variograms, were interpolated to obtain their spatial distribution in the studied areas. Variety Catucai, with grater spatial variability, was more nutritional unbalanced than variety Catuai, and consequently produced lower yields. Excess of Fe and Mn makes these elements limiting yield factors.

Aloe vera-based formula as emollient on horses' hooves

The present study aimed at developing an Aloe vera-based formula for topical use on horse hoof and evaluating whether the treatment affects hooves growth and balance. Six healthy male horses between the ages of 3 and 17 years (12±5.25) were used, all semi-confined animals for breeding purposes. Before beginning A. vera treatment, animals underwent two trimming procedures with a 45 days-interval. After the second trimming, one of the forelimbs and one of the hindlimbs of 4 horses was weekly treated by topical application of the glycolic extract of A. vera at 20%. The contralateral limb, randomly chosen, received the extract at 50%. The hooves of the other animals were treated with propylene glycol. Treatment was done for 225 days and, during this time, animals underwent periodic trimming. Variables related to growth and balance of the hooves were measured before and after trimming. Data were analyzed using chi-square test and regression analysis at 5% significance. Growth rate of the hooves was not related to treatment. On the other hand, the 50% extract was related to the majority of the hooves in balance (p<0.05). Results suggest that a weekly topical treatment with A. vera glycolic extract does not improve the growth rate of the hooves; however, when applied at a high concentration, it improves their balance.

Agronomic performance of 27 cocoa progenies and plant selection based on productivity, self-compatibility and disease resistance

The objective of the present work was to evaluate 27 progenies of cocoa crosses considering the agronomic traits and select F1 plants within superior crosses. The experiment was installed in March 2005, in the Experimental Station Joaquim Bahiana (ESJOB), in Itajuipe, Bahia. The area of the experiment is of approximately 3 ha, with a total of 3240 plants. Thirteen evaluations of vegetative brooms, five of cushion brooms and 15 of number of pods per plant were accomplished. Thirty pollinations were made for each selected plant to test for self-compatibility. The production, based on the number of pods per plant, and resistance to witches´ broom indicated CEPEC 94 x CCN 10, RB 39 x CCN 51 and CCN 10 x VB 1151 as superior progenies. All selections tested were self-compatible. The analyses of progenies and individual tree data, associated to visual field observations, allowed the selection of 17 plants which were included in a network of regional tests to determine the phenotypic stability.

Applications of artificial intelligence to condition-based maintenance

In this paper we discuss interesting developments of expert systems for machine diagnosis and condition-based maintenance. We review some elements of condition-based maintenance and its applications, expert systems for machine diagnosis, and an example of machine diagnosis. In the last section we note some problems to be resolved so that expert systems for machine diagnosis may gain wider acceptance in the future.

Difficulties encountered in a community-based study of acute respiratory infections in Uruguay

A cohort study on acute respiratory infections, involving 270 children observed by pediatricians in their homes every 10 days over a period of 32 months, gave the opportunity to experience logistic and methodological problems seldom described in the literature. The purpose of this article is to alert researchers as to the difficulties faced when performing community-based studies in developing countries. Although a carefully planned project was undertaken, problem areas included the establishment of the target population, population dynamics, field related problems, laboratory aspects and data management. It is hoped that other investigators may benefit from the extensive experience gained from our program in foreseeing and coping with the difficulties involved.

The Bambuí health and ageing study (BHAS): methodological approach and preliminary results of a population-based cohort study of the elderly in Brazil

OBJECTIVE: A cohort study has been designed to identify predictors of adverse health events in the elderly. The methodology of the study and preliminary descriptive results are presented. METHODS: The study population comprises all residents of Bambuí (Minas Gerais, Brazil), aged 60 or more years (n=1.742). From these, 92.2% were interviewed and 85.9% underwent clinical examination, consisting of haematological and biochemical tests, serology for Trypanosoma cruzi, anthropometric and blood pressure measures and electrocardiogram. Aliquots of serum, plasma and DNA were stored for future investigations. The baseline interview included sociodemographic characteristics, self-referred health condition and history of selected diseases, medication use, health service use, source of medical care, physical activities, smoking, drinking and eating habits, reproductive history, physical functioning, life events, social support and mental health. Individuals are being followed up annually. RESULTS: The following characteristics predominated among participants: women (60,0%), married (48.9%) or widowed (35.4%), people living in households with up to 2 residents (73.8%), heads of family (76.7%), people with monthly income between 1.00 and 2.99 Brazilian minimum wages (62.0%) and people with up to 4 years of schooling (89.1%). The median age was 68 years. Among the cohort members, only 1.7% were lost in the first follow-up. CONCLUSIONS: In general, the characteristics of the study population were very similar to those from other epidemiological studies of the elderly based on large Brazilian cities. The small number of losses to follow-up indicates that the choice of Bambuí was adequate, assuring the feasibility of a long term cohort study.

Probabilistic linkage in household survey on hospital care usage

OBJECTIVE: To evaluate the potential advantages and limitations of the use of the Brazilian hospital admission authorization forms database and the probabilistic record linkage methodology for the validation of reported utilization of hospital care services in household surveys. METHODS: A total of 2,288 households interviews were conducted in the county of Duque de Caxias, Brazil. Information on the occurrence of at least one hospital admission in the year preceding the interview was obtained from a total of 10,733 household members. The 130 records of household members who reported at least one hospital admission in a public hospital were linked to a hospital database with 801,587 records, using an automatic probabilistic approach combined with an extensive clerical review. RESULTS: Seventy-four (57%) of the 130 household members were identified in the hospital database. Yet only 60 subjects (46%) showed a record of hospitalization in the hospital database in the study period. Hospital admissions due to a surgery procedure were significantly more likely to have been identified in the hospital database. The low level of concordance seen in the study can be explained by the following factors: errors in the linkage process; a telescoping effect; and an incomplete record in the hospital database. CONCLUSIONS: The use of hospital administrative databases and probabilistic linkage methodology may represent a methodological alternative for the validation of reported utilization of health care services, but some strategies should be employed in order to minimize the problems related to the use of this methodology in non-ideal conditions. Ideally, a single identifier, such as a personal health insurance number, and the universal coverage of the database would be desirable.

Outpatient health service utilization and associated factors: a population-based study

OBJECTIVE: To identify factors that lead people to visit a doctor in Brazil and assess differences between socioeconomic groups. METHODS: A cross-sectional study comprising 1,260 subjects aged 15 or more was carried out in southern Brazil. Demographic, socioeconomic, health needs and regular source of care data were analyzed concerning visits to a doctor within two months from the interview. Adjusted prevalence ratios and 95% confidence intervals were calculated using Poisson regression. RESULTS: Adjusted PR showed that women having stressful life events, health insurance, and a regular doctor increased the outcome. A dose-related response was found with self-reported health, and the probability of visiting a doctor increased with health needs. Analysis in the chronic disease group revealed that uneducated lower income subjects had a 62% reduction in the chance of visiting a doctor compared to uneducated higher income ones. However, as it was seen a significant interaction between income and education, years of schooling increased utilization in this group. CONCLUSIONS: Results suggest the existence of health inequity in the poorest group that could be overcome with education. Specific measures reinforcing the importance of having a regular doctor may also improve access in the underserved group.

Fluoride and aluminum in teas and tea-based beverages

OBJECTIVE: To evaluate fluoride and aluminum concentration in herbal, black, ready-to-drink, and imported teas available in Brazil considering the risks fluoride and aluminum pose to oral and general health, respectively. METHODS: One-hundred and seventy-seven samples of herbal and black tea, 11 types of imported tea and 21 samples of ready-to-drink tea were divided into four groups: I-herbal tea; II-Brazilian black tea (Camellia sinensis); III-imported tea (Camellia sinensis); IV-ready-to-drink tea-based beverages. Fluoride and aluminum were analyzed using ion-selective electrode and atomic absorption, respectively. RESULTS: Fluoride and aluminum levels in herbal teas were very low, but high amounts were found in black and ready-to-drink teas. Aluminum found in all samples analyzed can be considered safe to general health. However, considering 0.07 mg F/kg/day as the upper limit of fluoride intake with regard to undesirable dental fluorosis, some teas exceed the daily intake limit for children. CONCLUSIONS: Brazilian and imported teas made from Camellia sinensis as well as some tea-based beverages are sources of significant amounts of fluoride, and their intake may increase the risk of developing dental fluorosis.

Conflicts between employee preferences and ergonomic recommendations in shift scheduling: regulation based on consent is not sufficient

OBJECTIVE: Contribution to the discussion of the role of participation/consent of employees in working hours regulation. METHODS: Exploratory analysis of conflicts between preferences of employees and ergonomic recommendations in shift scheduling by analysing a large number of participative shift scheduling projects. RESULTS: The analysis showed that very often the pursuit of higher income played the major role in the decision making process of employees and employees preferred working hours in conflict with health and safety principles. CONCLUSIONS: First, the consent of employees or the works council alone does not ensure ergonomically sound schedules. Besides consent, risk assessment procedures seem to be a promising but difficult approach. Secondly, more research is necessary to check the applicability of recommendations under various settings, to support the risk assessment processes and to improve regulatory approaches to working hours.

Prevalence of alcohol abuse and associated factors in a population-based study

OBJECTIVE: To estimate the prevalence of alcohol abuse/dependence and identify associated factors among demographic, family, socioeconomic and mental health variables. METHODS: A household survey was carried out in the urban area of Campinas, southeastern Brazil, in 2003. A total of 515 subjects, aged 14 years or more were randomly selected using a stratified cluster sample. The Self-Report Questionnaire and the Alcohol Use Disorder Identification Test were used in the interview. Prevalences were calculated, and univariate and multivariate logistic analyses performed by estimating odds ratios and 95% confidence intervals. RESULTS: The estimated prevalence of alcohol abuse/dependence was 13.1% (95% CI: 8.4;19.9) in men and 4.1% (95% CI: 1.9;8.6) in women. In the final multiple logistic regression model, alcohol abuse/dependence was significantly associated with age, income, schooling, religion and illicit drug use. The adjusted odds ratios were significantly higher in following variables: income between 2,501 and 10,000 dollars (OR=10.29); income above 10,000 dollars (OR=10.20); less than 12 years of schooling (OR=13.42); no religion (OR=9.16) or religion other than Evangelical (OR=4.77); and illicit drug use during lifetime (OR=4.47). Alcohol abuse and dependence patterns were different according to age group. CONCLUSIONS: There is a significantly high prevalence of alcohol abuse/dependence in this population. The knowledge of factors associated with alcohol abuse, and differences in consumption patterns should be taken into account in the development of harm reduction strategies.

Determinants of salivary cotinine level: a population-based study in Brazil

OBJECTIVE: A cross-sectional population-based study was conducted to assess, in active smokers, the relationship of number of cigarettes smoked and other characteristics to salivary cotinine concentrations. METHODS: A random sample of active smokers aged 15 years or older was selected using a stepwise cluster sample strategy, in the year 2000 in Rio de Janeiro, Brazil. The study included 401 subjects. Salivary cotinine concentration was determined using gas chromatography with nitrogen-phosphorus detection. A standard questionnaire was used to collect demographic and smoking behavioral data. The relation between the number of cigarettes smoked in the last 24h and cotinine level was examined by means of a nonparametric fitting technique of robust locally weighted regression. RESULTS: Significantly (p<0.05) higher adjusted mean cotinine levels were found in subjects smoking their first cigarette within five minutes after waking up, and in those smoking 1-20 cigarettes in the last 24h who reported inhaling more than ½ the time. In those smoking 1-20 cigarettes, the slope was significantly higher for those subjects waiting for more than five minutes before smoking their first cigarette after waking up, and those smoking "light" cigarettes when compared with their counterparts. These heterogeneities became negligible and non-significant when subjects with cotinine >40 ng/mL per cigarette were excluded. CONCLUSIONS: There was found a positive association between self-reporting smoking five minutes after waking up, and inhaling more than ½ the time are consistent and higher cotinine levels. These can be markers of dependence and higher nicotine intake. Salivary cotinine proved to be a useful biomarker of recent smoking and can be used in epidemiological studies and smoking cessation programs.