TOWARDS THE JOINT USE OF ICD AND ICF: A CALL FOR CONTRIBUTION

Background: To optimize patient functioning, rehabilitation professionals often rely on measurements of functioning as well as on classifications. Although the International Classification of Diseases (ICD) and the International Classification of Functioning, Disability and Health (ICF) are used, their joint use has yet to become an established practice. To encourage their joint use in daily practice, the World Health Organization (WHO) has invited all rehabilitation practitioners worldwide to support the ICD-11 revision process by identifying the ICF categories that correspond to specific rehabilitation-relevant health conditions. The first step in completing this task, generating the list of these health conditions, was taken at a February 2012 workshop in Sao Paulo, Brazil. Objectives: The objectives of this paper are to present the results of the Sao Paulo workshop, and to invite practitioners to participate in the ICD-ICF joint use initiative. Discussion: Alternating plenary and small working group sessions were held and 103 rehabilitation-relevant health conditions were identified. With this list available, WHO together with the International Society of Physical and Rehabilitation Medicine (ISPRM), is reaching out to clinicians of all rehabilitation disciplines to take on the challenge of identifying the ICF categories for at least one of the health conditions listed.

A new species of Pseudopaludicola Miranda-Ribeiro (Leiuperinae: Leptodactylidae: Anura) from the Cerrado of southeastern Brazil with a distinctive advertisement call pattern

A new species of Pseudopaludicola is described from the Cerrado of southeastern Brazil. The new taxon is diagnosed from the P. pusilla species group by the absence of either T-shaped terminal phalanges or toe tips expanded, and promptly distinguished from all (13) recognized taxa currently assigned to Pseudopaludicola by possessing isolated (instead of regular call series), long (117-187 ms) and non-pulsed advertisement calls.

Risk factors for computer visual syndrome (CVS) among operators of two call centers in Sao Paulo, Brazil

The aims of this study were to investigate work conditions, to estimate the prevalence and to describe risk factors associated with Computer Vision Syndrome among two call centers' operators in Sao Paulo (n = 476). The methods include a quantitative cross-sectional observational study and an ergonomic work analysis, using work observation, interviews and questionnaires. The case definition was the presence of one or more specific ocular symptoms answered as always, often or sometimes. The multiple logistic regression model, were created using the stepwise forward likelihood method and remained the variables with levels below 5% (p < 0.05). The operators were mainly female and young (from 15 to 24 years old). The call center was opened 24 hours and the operators weekly hours were 36 hours with break time from 21 to 35 minutes per day. The symptoms reported were eye fatigue (73.9%), "weight" in the eyes (68.2%), "burning" eyes (54.6%), tearing (43.9%) and weakening of vision (43.5%). The prevalence of Computer Vision Syndrome was 54.6%. Associations verified were: being female (OR 2.6, 95% CI 1.6 to 4.1), lack of recognition at work (OR 1.4, 95% CI 1.1 to 1.8), organization of work in call center (OR 1.4, 95% CI 1.1 to 1.7) and high demand at work (OR 1.1, 95% CI 1.0 to 1.3). The organization and psychosocial factors at work should be included in prevention programs of visual syndrome among call centers' operators.

The 193 call center, a meaningful public service!

This article is the first part of an on-going ergonomic work analysis with the emergency services call center set up by the Fire Department of the Military Police of Sao Paulo. The final objective of the research is to identify the prescribed task, the real work executed and strategies used by workers to meet the demands of the job. Starting by identifying the tasks and activities developed, this article analyzes the work of the emergency services call center which is of vital importance to the organizational structure, since it is the start point for the process that results in fulfilling the corporation's mission.

Medication reconciliation and adherence: a call for clinical pharmacist

Introduction and Objectives: With the population ageing, there is a growing number of people who have several comorbidities and make use of a variety of drugs. These factors lead to a greater predisposition to adverse drug events, as well as to medication errors. The clinical pharmacist is the most indicated health professional to target these issues. The aims of this study were to analyze the profile of medication reconciliation and assess the role of the clinical pharmacist regarding medication adherence. Material and Methods: Prospective observational cohort study conducted from Jan-Mar 2013 at the Surgical Clinic of the University Hospital of the University of Sao Paulo. 117 admitted patients - over the age of 18 years, under continuous medication use and with length of hospitalization up to 120h - were included. Discrepancies were classified as intentional/unintentional and according to their risk to cause harm, and interventions were divided into accepted/not accepted. Medication adherence was measured by Morisky questionnaire. Results and Conclusions: Only 30% of hospital prescriptions showed no discrepancies between the medications that the patient was using at home and those which were being prescribed at the hospital and more than one third of those had the potential to cause moderate discomfort or clinical deterioration. One third of total discrepancies were classified as unintentional. About 90% of the interventions were accepted by the medical staff. In addition, about 63% of patients had poor adherence to drug therapy. The study revealed the importance of the medication reconciliation at patient admission, ensuring greater safety and therapeutic efficacy of the treatment during hospitalization, and orienting the patient at discharge, assuring the therapy safety.

Processi di deposizione di blocking layers di TiO2 per Dye - Sensitized Solar Cells (DSSC)

Le Dye – Sensitized Solar Cells (DSSC) sono attualmente considerate tra le alternative più promettenti al fotovoltaico tradizionale. I ridotti costi di produzione e l’elevata versatilità di utilizzo rappresentano i punti di forza di questi dispositivi innovativi. Ad oggi la ricerca è concentrata prevalentemente sull’incremento delle prestazioni delle DSSC, ottenibile solamente attraverso un miglioramento delle funzioni dei singoli componenti e dell’interazione sinergica tra questi. Tra i componenti, ha recentemente assunto particolare interesse il blocking layer (BL), costituito generalmente da un film sottile di TiO2 depositato sulla superficie dell’anodo (FTO) e in grado di ottimizzare i fenomeni all’interfaccia FTO/TiO2/elettrolita. Nel corso di questo lavoro di tesi si è rivolta l’attenzione prevalentemente sulle caratteristiche del BLs (ad esempio proprietà morfologico – strutturali) cercando di mettere in correlazione il processo di deposizione con le caratteristiche finali del film ottenuto. A questo scopo è stato ottimizzato un processo di deposizione dei film via spin coating, a partire da soluzioni acquosa o alcolica di precursore (TiCl4). I film ottenuti sono stati confrontati con quelli depositati tramite un processo di dip coating riportato in letteratura. I BLs sono stati quindi caratterizzati tramite microscopia (SEM – AFM), spettrofotometria (UV.- Vis) e misure elettrochimiche (CV – EIS). I risultati ottenuti hanno messo in evidenza come i rivestimenti ottenuti da soluzione acquosa di precursore, indipendentemente dalla tecnica di deposizione utilizzata (spin coating o dip coating) diano origine a film disomogenei e scarsamente riproducibili, pertanto non idonei per l’applicazione nelle DSSC. Viceversa, i BLs ottenuti via spin coating dalla soluzione alcolica di TiCl4 sono risultati riproducibili, omogenei, e uniformemente distribuiti sulla superficie di FTO. Infine, l’analisi EIS ha in particolare evidenziato un effettivo aumento della resistenza al trasferimento di carica tra elettrodo FTO ed elettrolita in presenza di questi BLs, fenomeno generalmente associato ad un efficace blocking effect.

An alternative blocking layer for titanium dioxide (TiO 2) solar cell applications

In hybrid organic solar cells a blocking layer between transparent electrode and nanocrystalline titania particles is essential to prevent short-circuiting and current loss through recombination at the electrode interface. Here the preparation of a uniform hybrid blocking layer which is composed of conducting titania nanoparticles embedded in an insulating polymer derived ceramic is presented. This blocking layer is prepared by sol-gel chemistry where an amphiphilic block copolymer is used as a templating agent. A novel poly(dimethylsiloxane) containing amphiphilic block copolymer poly(ethyleneglycol)methylethermethacrylate-block-poly(dimethylsiloxane)-block-poly(ethyleneglycol)methylethermethacrylate has been synthesized to act as the templating agent. Plasma treatment uncovered titania surface from any polymer. Annealing at 450°C under nitrogen resulted in anatase titania with polymer derived silicon oxycarbide ceramic. Electrical characterization by conductive scanning probe microscopy experiments revealed a percolating titania network separated by an insulating ceramic matrix. Scanning Kelvin probe force microscopy showed predominant presence of titania particles on the surface creating a large surface area for dye absorption. The uniformity of the percolating structures was proven by microbeam grazing incidence small angle x-ray scattering. First applications in hybrid organic solar cells in comparison with conventional titanium dioxide blocking layer containing devices revealed 15 fold increases in corresponding efficiencies. Poly(dimethylsiloxane)-block-poly(ethyleneglycol)methylethermethacrylate and poly(ethyleneoxide)-poly(dimethylsiloxane)methylmethacrylate diblock copolymers were also synthesized. Their titania nanocomposite films were compared with the integrated blocking layer. Liner poly(ethyleneoxide) containing diblock copolymer resulted in highly ordered foam like structures. The effect of heating temperature rise to 600°C and 1000°C on titania morphology was investigated by scanning electron and force microscopy and x-ray scattering. Sol-gel contents, hydrochloric acid, titania precursor and amphiphilic triblock copolymer were altered to see their effect on titania morphology. Increase in block copolymer content resulted in titania particles of diameter 15-20 nm.

Application of a hybrid blocking layer in dye-sensitized solar cells

In dye-sensitized solar cells a blocking layer between the transparent electrode and the mesoporous titanium dioxide film is used to prevent short-circuits between the hole-conductor and the front electrode. The conventional approach is to use a compact layer of titanium dioxide prepared by spin coating or spray pyrolysis. The thickness of the blocking layer is critical. On one hand, the layer has to be thick enough to cover the rough substrate completely. On the other hand, the serial resistance increases with increasing film thickness, because the layer acts as an ohmic resistance itself. In this thesis an amphiphilic diblock copolymer is used as a functional template to produce an alternative, hybrid blocking layer. The hybrid blocking layer is thinner than the conventional, compact titanium dioxide film and thereby possesses a higher conductivity. Still, this type of blocking layer covers the rough electrode material completely and avoids current loss through charge recombination. The novel blocking layer is prepared using a tailored, amphiphilic block copolymer in combination with sol-gel chemistry. While the hydrophilic poly(ethylene oxide) part of the polymer coordinates a titanium dioxide precursor to form a percolating network of titania particles, the hydrophobic poly(dimethylsiloxane) part turns into an insulating ceramic layer. With this technique, crack-free films with a thickness down to 24 nm are obtained. The presence of a conductive titanium dioxide network for current flow, which is embedded in an insulating ceramic material, is validated by conductive scanning force microscopy. This is the first time that such a hybrid blocking layer is implemented in a solar cell. With this approach the efficiency could be increased up to 27 % compared to the conventional blocking layer. Thus, it is demonstrated that the hybrid blocking layer represents a competitive alternative to the classical approach.

Overview of literature and information on "khat-related" mortality: a call for recognition of the issue and further research

During the past 20 years or so, more has become known about the properties of khat, its pharmacology, physiological and psychological effects on humans. However, at the same time its reputation of social and recreational use in traditional contexts has hindered the dissemination of knowledge about its detrimental effects in terms of mortality. This paper focuses on this particular deficit and adds to the knowledge-base by reviewing the scant literature that does exist on mortality associated with the trade and use of khat. We sought all peer-reviewed papers relating to deaths associated with khat. From an initial list of 111, we identified 15 items meeting our selection criteria. Examination of these revealed 61 further relevant items. These were supplemented with published reports, newspaper and other media reports. A conceptual framework was then developed for classifying mortality associated with each stage of the plant's journey from its cultivation, transportation, consumption, to its effects on the human body. The model is demonstrated with concrete examples drawn from the above sources. These highlight a number of issues for which more substantive statistical data are needed, including population-based studies of the physiological and psychological determinants of khat-related fatalities. Khat-consuming communities, and health professionals charged with their care should be more aware of the physiological and psychological effects of khat, together with the risks for morbidity and mortality associated with its use. There is also a need for information to be collected at international and national levels on other causes of death associated with khat cultivation, transportation, and trade. Both these dimensions need to be understood.

"Self" and "nonself" manipulation of interferon defense during persistent infection: bovine viral diarrhea virus resists alpha/beta interferon without blocking antiviral activity against unrelated viruses replicating in its host cells

Bovine viral diarrhea virus (BVDV), together with Classical swine fever virus (CSFV) and Border disease virus (BDV) of sheep, belongs to the genus Pestivirus of the Flaviviridae. BVDV is either cytopathic (cp) or noncytopathic (ncp), as defined by its effect on cultured cells. Infection of pregnant animals with the ncp biotype may lead to the birth of persistently infected calves that are immunotolerant to the infecting viral strain. In addition to evading the adaptive immune system, BVDV evades key mechanisms of innate immunity. Previously, we showed that ncp BVDV inhibits the induction of apoptosis and alpha/beta interferon (IFN-alpha/beta) synthesis by double-stranded RNA (dsRNA). Here, we report that (i) both ncp and cp BVDV block the induction by dsRNA of the Mx protein (which can also be induced in the absence of IFN signaling); (ii) neither biotype blocks the activity of IFN; and (iii) once infection is established, BVDV is largely resistant to the activity of IFN-alpha/beta but (iv) does not interfere with the establishment of an antiviral state induced by IFN-alpha/beta against unrelated viruses. The results of our study suggest that, in persistent infection, BVDV is able to evade a central element of innate immunity directed against itself without generally compromising its activity against unrelated viruses ("nonself") that may replicate in cells infected with ncp BVDV. This highly selective "self" and "nonself" model of evasion of the interferon defense system may be a key element in the success of persistent infection in addition to immunotolerance initiated by the early time point of fetal infection.