Situação vacinal infantil e características individuais e familiares do interior de São Paulo

The aim of this study was to describe and analyze individual and family characteristics of children and those of health services, as well as their relationship with the immunization status for different kinds of vaccines and doses. Three sources of information were used: records from the Municipal Health Information System, immunization charts, and interviews using closed-ended questions. The families interviewed still had one or two growing children; caretakers were usually young unemployed mothers with easy access to health services. Around 30% of them were not instructed on the vaccine being given, its reactions or when to return for the next shot. The greatest levels of tardiness occurred with the vaccines against measles (6.3%) and Haemophilus influenzae B (4.2%). It was possible to observe that tardiness or absence of vaccinations seem to have a stronger relationship with service characteristics than with population characteristics.

Fatores interferentes nas estratégias de controle do câncer do colo do útero com ênfase na infecção pelo HPV

O câncer do colo do útero é um dos graves problemas de saúde pública no mundo e no Brasil. O exame colpocitológico e a educação em saúde são estratégias fundamentais para o êxito do programa de prevenção do câncer do colo do útero nos serviços de saúde pública. Foi realizado um estudo transversal e analítico, com o objetivo de identificar e discutir os fatores interferentes nas estratégias de controle do câncer do colo do útero, com ênfase na infecção pelo vírus HPV, sob a perspectiva das clientes do programa. A população do estudo foi de 858 mulheres atendidas nas unidades de saúde pública, em duas estratégias de Saúde da Família e três unidades básicas de saúde, sendo uma um Centro de Saúde Escola, no Município de Belém/PA. Os dados foram coletados através de entrevista. Entre os fatores que interferem negativamente na efetividade das estratégias do respectivo programa estão incluídos: o perfil de clientela quanto a idade, grau de instrução e renda familiar; as características de atendimento e tipo de demanda do programa; o conhecimento de mulheres sobre câncer do colo do útero, neoplasia intraepitelial cervical, vírus HPV e vacina anti-hpv e; o uso das práticas educativas pelas unidades de saúde deste estudo. Conclui-se que intervenções na organização dos serviços de saúde pública podem contribuir na efetividade dessas estratégias, como a efetivação da busca ativa para melhorar o acesso das mulheres nas faixas etárias de maior prevalência de infecção pelo HPV e das mulheres em atraso com o exame colpocitológico anual. Assim como, o estabelecimento das práticas educativas como um recurso organizacional permanente para elevar o nível de conhecimento de mulheres sobre câncer do colo do útero e vírus HPV; além de tornar o monitoramento efetivo de mulheres sob controle anual. Enfim buscar ferramentas organizacionais na perspectiva da prevenção primária e secundária importantes para o controle do câncer do colo do útero e do vírus HPV.

Transportation theory and planning

The aim of this research is to analyze the transport system and its subcomponents in order to highlight which are the design tools for physical and/or organizational projects related to transport supply systems. A characteristic of the transport systems is that the change of their structures can recoil on several entities, groups of entities, which constitute the community. The construction of a new infrastructure can modify both the transport service characteristic for all the user of the entire network; for example, the construction of a transportation infrastructure can change not only the transport service characteristics for the users of the entire network in which it is part of, but also it produces economical, social, and environmental effects. Therefore, the interventions or the improvements choices must be performed using a rational decision making approach. This approach requires that these choices are taken through the quantitative evaluation of the different effects caused by the different intervention plans. This approach becomes even more necessary when the decisions are taken in behalf of the community. Then, in order to understand how to develop a planning process in Transportation I will firstly analyze the transport system and the mathematical models used to describe it: these models provide us significant indicators which can be used to evaluate the effects of possible interventions. In conclusion, I will move on the topics related to the transport planning, analyzing the planning process, and the variables that have to be considered to perform a feasibility analysis or to compare different alternatives. In conclusion I will perform a preliminary analysis of a new transit system which is planned to be developed in New York City.

Calibrating Wireless Sensor Network Simulation Models with Real-World Experiments

This paper studies the energy-efficiency and service characteristics of a recently developed energy-efficient MAC protocol for wireless sensor networks in simulation and on a real sensor hardware testbed. This opportunity is seized to illustrate how simulation models can be verified by cross-comparing simulation results with real-world experiment results. The paper demonstrates that by careful calibration of simulation model parameters, the inevitable gap between simulation models and real-world conditions can be reduced. It concludes with guidelines for a methodology for model calibration and validation of sensor network simulation models.

A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants

Background: Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011). Methods: A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results: We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions: Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.

Self-service technology and the moderating effects of consumer characteristics

The incidence of self-service technology, where the consumer delivers the service themselves using technology, is increasing in the service encounter. One area that is under-explored is the potential impact of self-service technology on consumer satisfaction and affective commitment. Accordingly, this paper presents an empirical study that investigates the relative impact of self-service technology on consumer satisfaction (both overall and transaction-specific) and affective commitment, accounting for the moderating effects of consumer characteristics. The results highlight the importance of personal service for evaluations of satisfaction and commitment, and the importance of social competency as a moderator in this relationship. An understanding of these consumer perceptions will allow organisations to develop strategies to deliver the services expected by their consumers, improving consumer satisfaction and commitment.

Health monitoring of buildings during construction and service stages using vibration characteristics

Columns and walls in buildings are subjected to a number of load increments during the construction and service stages. The combination of these load increments and poor quality construction can cause defects in these structural components. In addition, defects can also occur due to accidental or deliberate actions by users of the building during construction and service stages. Such defects should be detected early so that remedial measures can be taken to improve life time serviceability and performance of the building. This paper uses micro and macro model upgrading methods during construction and service stages of a building based on the mass and stiffness changes to develop a comprehensive procedure for locating and detecting defects in columns and walls of buildings. Capabilities of the procedure are illustrated through examples.

Offending behaviour and mental illness : characteristics of a mental health court liaison service

This paper begins with a brief review of recent literature about relationships between offending behaviour and mental illness, classifying studies by the settings within which they occurred. The establishment and role of a mental health court liaison (MHCL) service is then described, together with findings from a 3-year service audit, including an examination of relationships between clients’ characteristics and offence profiles, and comparisons with regional offence data. During the audit period, 971 clients (767 males, 204 females) were referred to the service, comprising 1139 service episodes, 35.5% of which involved a comorbid substance use diagnosis. The pattern of offences for MHCL clients was reasonably similar to the regional offence data, except that among MHCL clients there were proportionately more offences against justice procedures (e.g., breaches of apprehended violence orders [AVOs]) and fewer driving offences and “other offences”. Additionally, male MHCL clients had proportionately more malicious damage and robbery offences and lower rates of offensive behaviour and drug offences. A range of service and research issues is also discussed. Overall, the new service appears to have forged more effective links between the mental health and criminal justice systems.

A follow-up study of characteristics of young people that dropout and continue psychotherapy: service implications for a clinic in the community

Background: The paper reports the findings from a follow-up study of the factors that contribute to whether young people dropout or continue once-weekly psychotherapy at a voluntary sector psychotherapy service for young people aged 12 to 21 years. Method: The study uses data from an ongoing audit of the psychotherapy service that started in 1993; 882 young people were included in the study. Premature termination of treatment was defined as dropping out before the 21st session. Continuation in treatment was defined as remaining in therapy after 20 sessions. Measures and areas of interest used in the study include diagnostic measures, the Youth Self Report Form and Young Adult Self Report Form, demographic characteristics and treatment related information. Results: Young people who continued in treatment were more likely to be older, have anxieties about sexual and relationship issues and have higher scores on self-reported anxiety-depression. Young people who dropped out of treatment were more likely to be younger, have higher self-reported delinquency scores, have a diagnosis of hyperactivity-conduct disorder and be homeless. Conclusions: The study of treatment termination has demonstrated the value of service audit and has led to a significant change in clinical practice.

Epidemiological and clinical characteristics of injuries among adolescents attended at an emergency service in the city of Ribeirao Preto, Sao Paulo

CONTEXT AND OBJECTIVE: Injuries are an important cause of morbidity during adolescence, but can be avoided through learning about some of their characteristics. This study aimed to identify the most frequent injuries among adolescents attended at an emergency service. DESIGN AND SETTING: Retrospective descriptive study on adolescents attended at the emergency service of the Teaching Health Center, Faculdade de Medicina de Ribeirao Preto (FMRP), between January 1, 2009, and September 30, 2009. METHODS: Age, sex, type of injury, site, day and time of occurrence, part of body involved, care received, whether the adolescent was accompanied at the time of injury and whether any type of counseling regarding injury prevention had been given were analyzed. RESULTS: Among 180 adolescents attended, 106 (58.8%) were boys and 74 (41.1%) were girls. Their ages were: 10 to 12 (66/36.6%), 12 to 14 (60/33.3%) and 14 to 16 years (54/30%). The injuries had occurred in public places (47.7%) and at home (21.1%). The main types were bruises (45.1%) and falls (39.2%), involving upper limbs (46.1%), lower limbs (31%) and head/neck (13.1%). The injuries occurred in the afternoon (44.4%) and morning (30%), on Mondays (17.7%) and Thursdays (16.6%). Radiological examinations were performed on 53.8%. At the time of injury, 76.1% of the adolescents were accompanied. Some type of counseling about injury prevention had been received by 39.4%. CONCLUSIONS: Although the injuries were of low severity, preventive attitudes need to be incorporated in order to reduce the risks and provide greater safety for adolescents.

Epidemiological and clinical characteristics of injuries among adolescents attended at an emergency service in the city of Ribeirão Preto, São Paulo

CONTEXT AND OBJECTIVE: Injuries are an important cause of morbidity during adolescence, but can be avoided through learning about some of their characteristics. This study aimed to identify the most frequent injuries among adolescents attended at an emergency service. DESIGN AND SETTING: Retrospective descriptive study on adolescents attended at the emergency service of the Teaching Health Center, Faculdade de Medicina de Ribeirão Preto (FMRP), between January 1, 2009, and September 30, 2009. METHODS: Age, sex, type of injury, site, day and time of occurrence, part of body involved, care received, whether the adolescent was accompanied at the time of injury and whether any type of counseling regarding injury prevention had been given were analyzed. RESULTS: Among 180 adolescents attended, 106 (58.8%) were boys and 74 (41.1%) were girls. Their ages were: 10 to 12 (66/36.6%), 12 to 14 (60/33.3%) and 14 to 16 years (54/30%). The injuries had occurred in public places (47.7%) and at home (21.1%). The main types were bruises (45.1%) and falls (39.2%), involving upper limbs (46.1%), lower limbs (31%) and head/neck (13.1%). The injuries occurred in the afternoon (44.4%) and morning (30%), on Mondays (17.7%) and Thursdays (16.6%). Radiological examinations were performed on 53.8%. At the time of injury, 76.1% of the adolescents were accompanied. Some type of counseling about injury prevention had been received by 39.4%. CONCLUSIONS: Although the injuries were of low severity, preventive attitudes need to be incorporated in order to reduce the risks and provide greater safety for adolescents.

The Impact of Job Characteristics on Social and Human Service Workers

The work environment characteristics of job stress, job variety, job autonomy, and supervision are theorized to affect the job satisfaction and organizational commitment of social and human service workers. Most research to date has focused upon the impact of these variables on job satisfaction, with little attention being paid to organizational commitment. To determine the effects these characteristics have on both job satisfaction and organizational commitment, data from a survey of social and human service employees across Northwest Ohio were examined. In Ordinary Least Squares regression, all four job characteristics had a significant impact on job satisfaction, while only job variety and supervision had statistically significant effects on organizational commitment.