School and Community Screening Shows Malawi, Africa, to Have a High Prevalence of Latent Rheumatic Heart Disease

Rheumatic heart disease (RHD) is the largest cardiac cause of morbidity and mortality in the world's youth. Early detection of RHD through echocardiographic screening in asymptomatic children may identify an early stage of disease, when secondary prophylaxis has the greatest chance of stopping disease progression. Latent RHD signifies echocardiographic evidence of RHD with no known history of acute rheumatic fever and no clinical symptoms.

OBJECTIVE: Determine the prevalence of latent RHD among children ages 5-16 in Lilongwe, Malawi.

DESIGN: This is a cross-sectional study in which children ages 5 through 16 were screened for RHD using echocardiography.

SETTING: Screening was conducted in 3 schools and surrounding communities in the Lilongwe district of Malawi between February and April 2014.

OUTCOME MEASURES: Children were diagnosed as having no, borderline, or definite RHD as defined by World Heart Federation criteria. The primary reader completed offline reads of all studies. A second reader reviewed all of the studies diagnosed as RHD, plus a selection of normal studies. A third reader served as tiebreaker for discordant diagnoses. The distribution of results was compared between gender, location, and age categories using Fisher's exact test.

RESULTS: The prevalence of latent RHD was 3.4% (95% CI = 2.45, 4.31), with 0.7% definite RHD and 2.7% borderline RHD. There was no significant differences in prevalence between gender (P = .44), site (P = .6), urban vs. peri-urban (P = .75), or age (P = .79). Of those with definite RHD, all were diagnosed because of pathologic mitral regurgitation (MR) and 2 morphologic features of the mitral valve. Of those with borderline RHD, most met the criteria by having pathological MR (92.3%).

CONCLUSION: Malawi has a high rate of latent RHD, which is consistent with other results from sub-Saharan Africa. This study strongly supports the need for a RHD prevention and control program in Malawi.

Challenges for a shared European countryside of uncertain future. Towards a modern community based landscape perspective

This paper addresses current changes in the highly diverse European landscape, and the way these transitions are being treated in policy and landscape management in the fragmented, heterogeneous and dynamic context of today’s Europe. It appears that intersecting driving forces are increasing the complexity of European landscapes and causing polarising developments in agricultural land use, biodiversity conservation and cultural landscape management. On the one hand, multifunctional rural landscapes, especially in peri-urban regions, provide services and functions that serve the citizens in their demand for identity, support their sense of belonging and offer opportunities for recreation and involvement in practical landscape management. On the other hand, industrial agricultural production on increasingly large farms produces food, feed, fibre and energy to serve expanding international markets with rural live ability and accessibility as a minor issue. The intermediate areas of traditionally dominant small and family farms in Europe seem to be gradually declining in profitability. The paper discusses the potential of a governance approach that can cope with the requirement of optimising land-sharing conditions and community-based landscape development, while adapting to global market conditions.

Preferência alimentar e identificação das principais fontes de repasto sanguíneo de fêmeas Lutzomyia (Diptera: Psychodidae) em áreas endêmicas para leishmaniose visceral na grande Natal

Leishmaniasis are endemic diseases wild spread in the New and Old World, caused by the flagelated protozoan Leishmania. In the New World, the distribution of different forms of leishmaniasis is mostly in tropical regions. In the State of Rio Grande do Norte, Northeast Brazil, 85% of the captured sand flies fauna is Lutzomyia longipalpis. The distribution of the sand fly vector in the state overlaps with the disease distribution, where the presence of sand flies is associated with presence of animals shelters. The aim of this study was to analyse the blood meal preference of sand flies vector from the genus Lutzomyia spp. in laboratory conditions, to verify the vector life cicle at different temperatures sets and to identify the main blood meal source in endemic areas for visceral leishmaniasis (VL) at peri-urban regions of Natal. Sand flies samples were collected from the municipalities of São Gonçalo do Amarante and Nísia Floresta where female sand flies were grouped for the colony maintenance in the laboratory and for the analysis of the preferred source of sand fly blood meal in natural environment. The prevalence of blood meal preference and oviposition for the females sand flies was 97% for Cavia porcellus with oviposition of 19 eggs/female; 97% for Eqqus caballus with 19 eggs/female; 98% for human blood with 14 eggs/female; 71.3% for Didelphis albiventris with 8.4 eggs/female; 73% for Gallus gallus with 14 eggs/female; 86% for Canis familiaris with 10.3 eggs/female; 81.4% for Galea spixii with 26 eggs/female; 36% for Callithrix jachus with 15 eggs/female; 42.8% for Monodelphis domestica with 0% of oviposition. Female sand flies did not take a blood meal from Felis catus. Sand flies life cycle ranged from 32-40 days, with 21-50 oviposition rates approximately. This study also showed that at 32°C the life cycle had 31 days, at 28° C it had 50 days and at 22°C it increased to 79 days. Adjusting the temperature to 35°C the eggs did not hatch, thus blocking the life cycle. A total of 1540 sand flies were captured, among them, 1.310 were male and 230 were female. Whereas 86% of the sand flies captured were Lu. longipalpis as compared to 10.5% for Lu. evandroi and, 3.2% for L. lenti and 0.3% for Lu whitmani. The ratio between female and male sandfly was approximately 6 males to 1 female. In Nísia Floresta, 50.7% of the collected females took their blood meal from armadillo, 12.8% from human. Among the female sand flies captured in São Gonçalo do Amarante, 80 of them were tested for the Leishmania KDNA infectivity where 5% of them were infected with Leishmania chagasi. Female Lutzomyia spp. showed to have an opportunistic blood meal characteristic. The behavioral parameters seem to have a higher influence in the oviposition when compared to the level of total proteins detected in the host s bloodstream. A higher Lu. longipalpis life cycle viability was observed at 28°C. The increase of temperature dropped the life cycle time, which means that the life cycle is modified by temperature range, source of blood meal and humidity. Lu longipalpis was the most specie found in the inner and peridomiciliar environment. In Nísia Floresta, armadillos were the main source of blood meal for Lutzomyia spp. At São Gonçalo do Amarante, humans were the main source of blood meal due to CDC nets placed inside their houses

Avaliação da disponibilidade de espaços verdes públicos no contexto urbano e a sua relação com a perceção dos residentes. Um estudo para a cidade de Bragança

Os espaços verdes públicos urbanos são muito importantes no contexto urbano. Influenciam de diversas formas na qualidade de vida das populações, proporcionando benefícios ambientais, sociais e econômicos. A fim de avaliar a disponibilidade destes espaços na cidade de Bragança, foram realizadas análises utilizando indicadores, com apoio dos software ArcGIS 9.3 e QGis 2.14.0-Essen, que permitiram avaliar a oferta destes espaços nas suas diferentes tipologias e categorias dimensionais. Para o efeito foram aplicados os indicadores: Percentagem de espaços verdes, Espaços verdes per capita, Distância média, Índice de Área Verde por Área de Implantação e Índice de Área Verde por Área Coberta. Posteriormente, procedeu-se à aplicação de inquéritos a fim de avaliar as perceções e atitudes de uma amostra da população de Bragança, realizando análises descritivas e estatísticas, com recurso ao software SPSS17, buscando descrever a atual relação com os espaços verdes e usando testes não paramétricos para identificar diferenças entre subgrupos da amostra, numa análise centrada em dois níveis: a escala urbana e a escala de Bairro. Procurando avaliar possíveis alterações futuras, foram testados cenários realistas, um correspondendo à introdução de espaços verdes em terrenos na posse da Autarquia e outro considerando a ampliação das áreas verdes previstas no Plano de Urbanização de Bragança de 2010. Os Resultados permitiram identificar diferenças relevantes na oferta de espaços verdes da cidade. Aplicando os indicadores foi possível verificar que existe a concentração de espaços verdes de maior dimensão na zona central da cidade, denotando um claro desequilíbrio na introdução de novos espaços em zonas de expansão urbana. Os inquéritos aplicados possibilitaram constatar que os inquiridos que possuem maior disponibilidade de espaços verdes em seu bairro de residência apresentam respostas mais satisfatórias em relação a acessibilidade e a aparência visual e paisagística dos bairros. Da análise de cenários resulta que com a implantação de novos espaços verdes, para as duas análises, ocorreria uma melhoria da oferta e distribuição dos espaços verdes na cidade permitindo um maior reequilíbrio face à concentração na zona central, melhorando a acessibilidade para toda a população.

O aqueduto das águas livres como elemento dinamizador e regenerador do eixo Lisboa-Sintra

Dissertação para obtenção do grau de Mestre em Arquitectura com especialização em Urbanismo, apresentada na Universidade de Lisboa - Faculdade de Arquitetura. Assuntos:

Pesquisa de ovos de helmintos e cistos de protozoários parasitos em recursos hídridos destinados à irrigação agrícola e/ou consumo animal na região peri-urbana de Botucatu-SP-Brasil

Pós-graduação em Medicina Veterinária - FMVZ

Air pollution levels measured at traffic hot spots : Brisbane urban corridor study

Air pollution levels were monitored continuously over a period of 4 weeks at four sampling sites along a busy urban corridor in Brisbane. The selected sites were representative of industrial and residential types of urban environment affected by vehicular traffic emissions. The concentration levels of submicrometer particle number, PM2.5, PM10, CO, and NOx were measured 5-10 meters from the road. Meteorological parameters and traffic flow rates were also monitored. The data were analysed in terms of the relationship between monitored pollutants and existing ambient air quality standards. The results indicate that the concentration levels of all pollutants exceeded the ambient air background levels, in certain cases by up to an order of magnitude. While the 24-hr average concentration levels did not exceed the standard, estimates for the annual averages were close to, or even higher than the annual standard levels.

How can land and urban development make houses healthier?

Traditionally, the main focus of the professional community involved with indoor air quality has been indoor pollution sources, preventing or reducing their emissions, as well as lowering the impact of the sources by replacing the polluted indoor air with "fresh" outdoor air. However, urban outdoor air cannot often be considered "fresh", as it contains high concentrations of pollutants emitted from motor vehicles - the main outdoor pollution sources in cities. Evidence from epidemiological studies conducted worldwide demonstrates that outdoor air quality has considerable effects on human health, despite the fact that people spend the majority of their time indoors. This is because pollution from outdoors penetrates indoors and becomes a major constituent of indoor pollution. Urban land and transport development has significant impact on the overall air quality of the urban airshed as well as the pollution concentration in the vicinity of high-density traffic areas. Therefore, an overall improvement in indoor air quality would be achieved by lowering urban airshed pollution, as well as by lowering the impact of the hot spots on indoor air. This paper explores the elements of urban land and vehicle transport developments, their impact on global and local air quality, and how the science of outdoor pollution generation and transport in the air could be utilized in urban development towards lowering indoor air pollution.