Factors associated to infection by Toxoplasma gondii in pregnant women attended in Basic Health Units in the city of Rolândia, Paraná, Brazil

The aim of the present work was to determine the prevalence of IgG and IgM anti-Toxoplasma gondii antibodies and the factors associated to the infection in pregnant women attended in Basic Health Units in Rolândia, Paraná, Brazil. The sample was divided in two groups: group I (320 pregnant women who were analyzed from July 2007 to February 2008) and group II (287 pregnant women who were analyzed from March to October 2008). In group I, it was found 53.1% of pregnant women with IgG reactive and IgM non-reactive, 1.9% with IgG and IgM reactive, 0.3% with IgG non-reactive and IgM reactive and 44.7% with IgG and IgM non-reactive. In group II, it was found 55.1% with IgG reactive and IgM non-reactive and 44.9% with IgG and IgM non-reactive. The variables associated to the presence of IgG antibodies were: residence in rural areas, pregnant women between 35-40 years old, low educational level, low family income, more than one pregnancy, drinking water which does not originate from the public water supply system and the habit of handling soil or sand. Guidance on primary prevention measures and the quarterly serological monitoring of the pregnant women in the risk group are important measures to prevent congenital toxoplasmosis.

Management of basic health units in municipalities of different size: profile and management instruments

Objective To identify the characteristics of managers and their use of management instruments in primary care and to analyze differences in these features among municipalities of different sizes. Method The present cross-sectional descriptive study was conducted at 108 basic health units from 21 municipalities in northern Paraná, Brazil. The data were collected using a semi-structured questionnaire during the second half of 2010. Results Most managers had graduate degrees and were female and nurses. The managers from the small municipalities were younger, their payment was lower, and they had less work experience. The use of management instruments was expressive for both the organization and work management; however, the instruments were used less in the small municipalities. Conclusion The managers were committed to their role; it is recommended that policies and guidance should be formulated at the federal and state levels to support small municipalities.

Spoken Greek : basic course, units 1-12 /

"A 635" stamped on cover.

French basic course : units 1- revised /

Based on the 1960 ed. by the Foreign Service Institute.

Uma investigação histórica sobre os logaritmos com sugestões didáticas para a sala de aula

This study was conducted from a preliminary research to identify the conceptual and didactic approach to the logarithms given in the main textbooks adopted by the Mathematics teachers in state schools in the School of Natal, in Rio Grande do Norte. I carried out an historical investigation of the logarithms in order to reorient the math teacher to improve its educational approach this subject in the classroom. Based on the research approach I adopted a model of the log based on three concepts: the arithmetic, the geometric and algebraic-functional. The main objective of this work is to redirect the teacher for a broad and significant understanding of the content in order to overcome their difficulties in the classroom and thus realize an education that can reach the students learning. The investigative study indicated the possibility of addressing the logarithms in the classroom so transversalizante and interdisciplinary. In this regard, I point to some practical applications of this matter are fundamental in the study of natural phenomena as earthquakes, population growth, among others. These practical applications are connected, approximately, Basic Problematization Units (BPUs) to be used in the classroom. In closing, I offer some activities that helped teachers to understand and clarify the meaningful study of this topic in their teaching practice

Um estudo de práticas matemáticas históricas e sugestões de uso na matemática escolar

This dissertation aims to contribute on teaching of mathematics for enabling learning connected to the relationship among science, society, culture and cognition. To this end, we propose the involvement of our students with social practices found in history, since. Our intention is to create opportunities for school practices that these mathematical arising from professional practice historical, provide strategies for mathematical thinking and reasoning in the search for solutions to problematizations found today. We believe that the propose of producing Basic Problematization Units, or simply UBPs, in math teacher formation, points to an alternative that allows better utilization of the teaching and learning process of mathematics. The proposal has the aim of primary education to be, really forming the citizen, making it critical and society transformative agent. In this sense, we present some recommendations for exploration and use of these units for teachers to use the material investigated by us, in order to complement their teaching work in mathematics lessons. Our teaching recommendations materialized as a product of exploration on the book, Instrumentos nuevos de geometria muy necessários para medir distancia y alturas sem que interuengan numeros como se demuestra em la practica , written by Andrés de Cespedes, published in Madrid, Spain, in 1606. From these problematizations and the mathematics involved in their solutions, some guidelines for didactic use of the book are presented, so that the teacher can rework such problematizations supported on current issues, and thus use them in the classroom

Global Homogeneous Response Units

The concept of homogenous response units (HRU) was designed as a general concept for the delineation of basic spatial units. Only those characteristics of landscape, which are relatively stable over time (even under climate change) and largely unsusceptible to anthropogenic influence, were selected. The HRU can be seen as a basic spatial framework for the implementation of climate change and land management alternative scenarios into global modeling and therefore is a basic input for delineation of landscape units. HRUs are defined based on classifications of altitude (five classes: 1 (0 - 300m), 2 (300 - 600m), 3 (600 - 1100m), 4 (1100 - 2500m), 5 (> 2500m)), slope (seven classes(degrees): 1 (0 - 3), 2 (3 - 6), 3 (6 - 10), 4 (10 - 15), 5 (15 - 30), 6 (30 - 50), 7 (> 50)) and soil composition (five classes: 1 (sandy), 2 (loamy), 3 (clay), 4 (stony), 5 (peat)). e.g. HRU111 refers to Altitude class 1: 0-300m; Slope class 1: 0-3 degrees; and Soil class 1: sandy. Areas of non-soil are assigned 88. HRUs have a spatial resolution of approximately 10 km**2.

TectoRNA: modular assembly units for the construction of RNA nano-objects

Structural information on complex biological RNA molecules can be exploited to design tectoRNAs or artificial modular RNA units that can self-assemble through tertiary interactions thereby forming nanoscale RNA objects. The selective interactions of hairpin tetraloops with their receptors can be used to mediate tectoRNA assembly. Here we report on the modulation of the specificity and the strength of tectoRNA assembly (in the nanomolar to micromolar range) by variation of the length of the RNA subunits, the nature of their interacting motifs and the degree of flexibility of linker regions incorporated into the molecules. The association is also dependent on the concentration of magnesium. Monitoring of tectoRNA assembly by lead(II) cleavage protection indicates that some degree of structural flexibility is required for optimal binding. With tectoRNAs one can compare the binding affinities of different tertiary motifs and quantify the strength of individual interactions. Furthermore, in analogy to the synthons used in organic chemistry to synthesize more complex organic compounds, tectoRNAs form the basic assembly units for constructing complex RNA structures on the nanometer scale. Thus, tectoRNA provides a means for constructing molecular scaffoldings that organize functional modules in three-dimensional space for a wide range of applications.

Descrições estruturais cristalinas de zeólitos

Crystalline structures of zeolites can be studied using different representations: the internal symmetry obtained by X-Ray or neutron diffraction crystallography techniques or a systematic analysis of the basic structural units which can be arranged to build the geometries of each kind of zeolite. In this work the basic concepts of three building units, SBU (Secondary Building Units), SSU (Structural SubUnits) and PBU (Periodic Building Units) are presented. The properties of the resulting crystalline structures are discussed (pores, cavities, channels), describing the influence of each one of these properties in processes of physical-chemical interest. Representative case studies of known zeolite crystalline structures are also discussed in terms of their space group classification.

Avaliação da qualidade da atenção básica utilizando a doença respiratória da infância como traçador, em um distrito sanitário do município de São Paulo

OBJECTIVES: to assess quality of the primary care using respiratory diseases as a tracer. METHODS: the evaluative approach is based on Donabedian's referencial connected to Kessner's tracers methodology. The sample is formed by 768 children from 0 to 5 years old, presenting respiratory symptoms, attended at seven basic health units from the Sanitary District of Brasilândia, in the city of São Paulo, State of São Paulo, Brazil. Medical registrations and interviews with mothers or responsibles were the information sources. RESULTS: more accurate child medical examination evidences significant association with favorable evolution, mainly on moderate clinical forms. Although aspects related to the accessibility demonstrated by the health team seem to influence decisively on care quality evaluated by users, mainly the medical doctor. Mothers education level appears to have no influence in the favorable evolution. CONCLUSIONS: the tracer methodology has the potentiality to facilitate the critical analysis of the health care. It is important to focus on the outcome of the health care. The children respiratory diseases are important tracer for the quality assessment on health services.

Tendência de crescimento de filhos de mães adolescentes

OBJETIVO: comparar o crescimento de lactentes filhos de mães adolescentes com o de filhos de mães adultas nos primeiros dois anos de vida. MÉTODOS: estudo de coorte histórica realizado entre 1998 e 2000, comparando o crescimento de dois grupos de crianças do nascimento até completar dois anos de idade. Um dos grupos era constituído por filhos de mães adolescentes (n:127) e o outro por filhos de mães adultas (n:181). Ambos os grupos eram acompanhados regularmente nas duas Unidades Básicas de Saúde da Universidade de São Paulo, integradas ao sistema de público de saúde. Os dados de peso e comprimento, coletados sistematicamente, foram analisados sob a forma de escore Z (NCHS/OMS, 1978). Equações (curvas) de regressão descrevendo o crescimento individual de cada criança foram definidas a partir dos dados coletados. Posteriormente, os valores de escore Z de peso e comprimento em idades exatas (mensais) foram estimados por interpolação, utilizando-se as equações individuais obtidas. RESULTADOS: ao nascimento e aos 24 meses os dois grupos não apresentaram diferença nas médias dos escores Z de peso e comprimento que, contudo, eram inferiores às do referencial (p<0,001). Neste período, apresentaram desempenhos diferentes de crescimento, com uma tendência pior para os filhos de adolescentes, que se afastava da mediana do referencial de maneira significante, (p=0,0008). CONCLUSÃO: Os lactentes de mães adolescentes apresentaram um pior desempenho de crescimento até os dois anos de vida, quando comparados com o dos filhos de mães adultas

The burden of physical activity on type 2 diabetes public healthcare expenditures among adults: a retrospective study

Background: Determinants of public healthcare expenditures in type 2 diabetics are not well investigated in developing nations and, therefore, it is not clear if higher physical activity decreases healthcare costs. The purpose of this study was to analyze the relationship between physical activity and the expenditures in public healthcare on type 2 diabetes mellitus treatment. Methods: Cross-sectional study carried out in Brazil. A total of 121 type 2 diabetics attended to in two Basic Healthcare Units were evaluated. Public healthcare expenditures in the last year were estimated using a specific standard table. Also evaluated were: socio-demographic variables; chronological age; exogenous insulin use; smoking habits; fasting glucose test; diabetic neuropathy and anthropometric measures. Habitual physical activity was assessed by questionnaire. Results: Age (r = 0.20; p = 0.023), body mass index (r = 0.33; p = 0.001) and waist-to-hip ratio (r = 0.20; p = 0.025) were positively related to expenditures on medication for the treatment of diseases other than diabetes. Insulin use was associated with increased expenditures. Higher physical activity was associated with lower expenditure, provided medication for treatment of diseases other than diabetes (OR = 0.19; p = 0.007) and medical consultations (OR = 0.26; p = 0.029). Conclusions: Type 2 diabetics with higher enrollment in physical activity presented consistently lower healthcare expenditures for the public healthcare system.

Assessing morbidity in the paediatric community

INTRODUCTION: Morbidity information is easily available from medical records but its scope is limited to the population attended by the health services. Information on the prevalence of diseases requires community surveys, which are not always feasible. These two sources of information represent two alternative assessments of disease occurrence, namely demand morbidity and perceived morbidity. The present study was conceived so as to elicit a potential relationship between them so that the former could be used in the absence of the latter. METHODS: A community of 13,365 families on the outskirts of S. Paulo, Brazil, was studied during the period from 15/Nov/1994 to 15/Jan/1995. Data regarding children less than 5 years old were collected from a household survey and from the 2 basic health units in the area. Prevalence of diseases was ascertained from perceived morbidity and compared to estimates computed from demand morbidity. RESULTS: Data analysis distinguished 2 age groups, infants less than 1 year old and children 1 to less than 5. The most important groups of diseases were respiratory diseases, diarrhoea, skin problems and infectious & parasitical diseases. Basic health units presented a better coverage for infants. Though disease frequencies were not different within or outside these units, a better coverage was found for diarrhoea and infectious & parasitical diseases in the infant group, and for diarrhoea in the older age group. Equivalence between the two types of morbidity was found to be limited to the infant group and concerned only the best covered diseases. The odds of a disease being seen at the health service should be of at least 4:10 to ensure this equivalence. CONCLUSION: It was concluded that, provided that health service coverage is good, demand morbidity can be taken as a reliable estimate of community morbidity.

Toxocariasis in children attending a Public Health Service Pneumology Unit in Paraná State, Brazil

The enzyme-linked immunosorbent assay (ELISA) is the most widely used tool to detect anti-Toxocara IgG antibodies for both serodiagnostic and seroepidemiological surveys on human toxocariasis. In the last eight years a high prevalence of toxocariasis (32.2-56.0%) has been reported in children attending public health units from municipalities in the state of Paraná, Brazil. Therefore, the aim of this work was to compare the frequency found among the general child population with that of children attending a public pneumology service in Maringá, Paraná, Brazil and describe the laboratorial, clinical and epidemiological findings. The research was conducted at the Consórcio Público Intermunicipal de Saúde do Setentrião Paranaense (CISAMUSEP) from July 2009 to July 2010 among children aged between one and 15 years. From a total of 167 children studied, only 4.2% (7/167) tested positive for anti-Toxocara spp. IgG antibodies and presented mild eosinophilia (2/7), increased serum IgE levels (6/7) and a positive allergy test for mites (5/7). The presence of pets (dogs or cats) at home did not correlate with the seroprevalence. In conclusion, cases of toxocariasis involving the respiratory tract are rare in children attending a public health pneumology unit in the northwestern region of Paraná State, despite the high prevalence of this type of toxocariasis among the infantile population attending Basic Health Units in the same geographical area.

PREVALENCE OF HERPES SIMPLEX VIRUS TYPE 2 AND RISK FACTORS ASSOCIATED WITH THIS INFECTION IN WOMEN IN SOUTHERN BRAZIL

SUMMARY The herpes simplex virus type 2 (HVS-2) is the most prevalent infection worldwide. It is a cofactor in the acquisition of human immunodeficiency virus (HIV) and the persistence of human papillomavirus (HPV). This study evaluated the prevalence of HSV-2, using the polymerase chain reaction (PCR), and associated factors in patients treated at the Federal University of Rio Grande (FURG) and Basic Health Units (BHU) in Rio Grande, Brazil. The observed prevalence of HSV-2 was 15.6%. Among the 302 women studied, 158 had received assistance in BHU and 144 were treated at FURG. The prevalence of HSV-2 in these groups was 10.8% and 20.8%, respectively, RR 1.9 and p = 0.012. Knowledge about the Pap smear, and the presence of lesions showed no association with HSV-2 infection. Multivariate analysis showed that the variable that most influenced the risk of HSV-2 infection was the presence of HIV infection, with a relative risk of 1.9 and p = 0.04. Discussion: Genital ulcers are an important entry point for HIV, and condom use is an important strategy to reduce transmission of HIV and HSV-2.