Access to childbirth care by adolescents and young people in the Northeastern region of Brazil

ABSTRACT OBJECTIVE To identify the factors that interfere with the access of adolescents and young people to childbirth care for in the Northeast region of Brazil. METHODS Cross-sectional study with 3,014 adolescents and young people admitted to the selected maternity wards to give birth in the Northeast region of Brazil. The sample design was probabilistic, in two stages: the first corresponded to the health establishments and the second to women who had recently given birth and their babies. The data was collected by means of interviews and consulting the hospital records, from pre-tested electronic form. Descriptive statistics were used for the univariate analysis, Pearson’s Chi-square test for the bivariate analysis and multiple logistic regressions for the multivariate analysis. Sociodemographic variables, obstetrical history, and birth care were analyzed. RESULTS Half of the adolescents and young people interviewed had not been given guidance on the location that they should go to when in labor, and among those who had, 23.5% did not give birth in the indicated health service. Furthermore, one third (33.3%) had to travel in search of assisted birth, and the majority (66.7%) of the postpartum women came to maternity by their own means. In the bivariate analysis, the variables marital status, paid work, health insurance, number of previous pregnancies, parity, city location, and type of health establishment showed a significant association (p < 0.20) with inadequate access to childbirth care. The multivariate analysis showed that married adolescents and young people (p < 0.015), with no health insurance (p < 0.002) and from the countryside (p < 0.001) were more likely to have inadequate access to childbirth care. CONCLUSIONS Adolescents and young women, married, without health insurance, and from the countryside are more likely to have inadequate access to birth care. The articulation between outpatient care and birth care can improve this access and, consequently, minimize the maternal and fetal risks that arise from a lack of systematic hospitalization planning.

The intersection of people, technology and local space. PPGIS and Web in practice for participatory planning

Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies

Pulsed electric field pre-treatment for apple juice extraction: Evaluation of monopolar and bipolar pulses effects

Additional apple juice extraction with pulsed electric field pretreated apple cubes towards control samples is evaluated. Monopolar and bipolar shaped pulses are compared and their effect is studied with variation of electric field, pulse width and number of pulses. Variation of electric field strength is ranged from 100 V/cm to 1300 V/cm, pulse width from 20 mu s to 300 mu s and number of pulses from 10 to 200, at frequency of 200Hz. Two pulse trains separated by 1 second are applied to all samples. Bipolar pulses showed higher apple juice yields with all studied parameters. Calculation of specific energies consumed was assessed and a threshold where higher energy inputs do not increase juice yield is found for a number of used parameters. Qualitative parameters of total soluble matter (Brix) and absorbance at 390 nm wavelength were determined for each sample and results show that no substantial differences are found for PEF pre-treated and control samples.

Trajectory planning of redundant manipulators using genetic algorithms

The trajectory planning of redundant robots is an important area of research and efficient optimization algorithms are needed. This paper presents a new technique that combines the closed-loop pseudoinverse method with genetic algorithms. The results are compared with a genetic algorithm that adopts the direct kinematics. In both cases the trajectory planning is formulated as an optimization problem with constraints.

Manipulator trajectory planning using a MOEA

Generating manipulator trajectories considering multiple objectives and obstacle avoidance is a non-trivial optimization problem. In this paper a multi-objective genetic algorithm based technique is proposed to address this problem. Multiple criteria are optimized considering up to five simultaneous objectives. Simulation results are presented for robots with two and three degrees of freedom, considering two and five objectives optimization. A subsequent analysis of the spread and solutions distribution along the converged non-dominated Pareto front is carried out, in terms of the achieved diversity.

Planning the medical workforce - an analysis of the third repport of the Medical Workforce Standing Advisory Committee

Arquivos de Medicina 1998; 12(4): 246-248

Aplicação de métodos estocásticos na gestão de custos de construção de condutas de saneamento

O trabalho apresentado centra-se na determinação dos custos de construção de condutas de pequenos e médios diâmetros em Polietileno de Alta Densidade (PEAD) para saneamento básico, tendo como base a metodologia descrita no livro Custos de Construção e Exploração – Volume 9 da série Gestão de Sistemas de Saneamento Básico, de Lencastre et al. (1994). Esta metodologia descrita no livro já referenciado, nos procedimentos de gestão de obra, e para tal foram estimados custos unitários de diversos conjuntos de trabalhos. Conforme Lencastre et al (1994), “esses conjuntos são referentes a movimentos de terras, tubagens, acessórios e respetivos órgãos de manobra, pavimentações e estaleiro, estando englobado na parte do estaleiro trabalhos acessórios correspondentes à obra.” Os custos foram obtidos analisando vários orçamentos de obras de saneamento, resultantes de concursos públicos de empreitadas recentemente realizados. Com vista a tornar a utilização desta metodologia numa ferramenta eficaz, foram organizadas folhas de cálculo que possibilitam obter estimativas realistas dos custos de execução de determinada obra em fases anteriores ao desenvolvimento do projeto, designadamente numa fase de preparação do plano diretor de um sistema ou numa fase de elaboração de estudos de viabilidade económico-financeiros, isto é, mesmo antes de existir qualquer pré-dimensionamento dos elementos do sistema. Outra técnica implementada para avaliar os dados de entrada foi a “Análise Robusta de Dados”, Pestana (1992). Esta metodologia permitiu analisar os dados mais detalhadamente antes de se formularem hipóteses para desenvolverem a análise de risco. A ideia principal é o exame bastante flexível dos dados, frequentemente antes mesmo de os comparar a um modelo probabilístico. Assim, e para um largo conjunto de dados, esta técnica possibilitou analisar a disparidade dos valores encontrados para os diversos trabalhos referenciados anteriormente. Com os dados recolhidos, e após o seu tratamento, passou-se à aplicação de uma metodologia de Análise de Risco, através da Simulação de Monte Carlo. Esta análise de risco é feita com recurso a uma ferramenta informática da Palisade, o @Risk, disponível no Departamento de Engenharia Civil. Esta técnica de análise quantitativa de risco permite traduzir a incerteza dos dados de entrada, representada através de distribuições probabilísticas que o software disponibiliza. Assim, para por em prática esta metodologia, recorreu-se às folhas de cálculo que foram realizadas seguindo a abordagem proposta em Lencastre et al (1994). A elaboração e a análise dessas estimativas poderão conduzir à tomada de decisões sobre a viabilidade da ou das obras a realizar, nomeadamente no que diz respeito aos aspetos económicos, permitindo uma análise de decisão fundamentada quanto à realização dos investimentos.

Innovative manufacturing process for hybrid pultruded products based on cork and polymeric pre-shapes

Pultruded products are being targeted by a growing demand due to its excellent mechanical properties and low chemical reactivity, ensuring a low level of maintenance operations and allowing an easier assembly operation process than equivalent steel bars. In order to improve the mechanical drawing process and solve some acoustic and thermal insulation problems, pultruded pipes of glass fibre reinforced plastics (GFRF) can be filled with special products that increase their performance regarding the issues previously referred. The great challenge of this work was drawing a new equipment able to produce pultruded pipes filled with cork or polymeric pre-shaped bars as a continuous process. The project was carried out successfully and the new equipment was built and integrated in the pultrusion equipment already existing, allowing to obtain news products with higher added-value in the market, covering some needs previously identified in the field of civil construction.

Conceção, seleção e implementação de um sistema de informação: ERP - enterprise resource planning

As organizações são entidades de natureza sistémica, composta, na sua maioria por várias pessoas que interagindo entre si, se propõem atingir objetivos comuns. Têm, frequentemente, de responder a alterações da envolvente externa através de processos de mudança organizacional, sendo fundamentalmente adaptativas, pois, para sobreviver, precisam de se reajustar continuamente às condições mutáveis do meio. O sucesso das organizações depende da sua capacidade de interação com o meio envolvente, ou seja, da sua capacidade de inovar e operar local ou globalmente, criando novas oportunidades de negócio que importa aproveitar. As tecnologias e os sistemas de informação e a forma como são utilizadas são fatores determinantes nesses processos de evolução e mudança. É necessário que a estratégia de TI esteja alinhada com os objetivos de negócio e que a sua utilização contribua para aumentos de produtividade e de eficiência no seu desempenho. Este trabalho descreve a análise, conceção, seleção e implementação de um Sistema de Informação na Portgás, S.A. baseado de um ERP - Enterprise Resource Planning, capaz de suportar a mudança organizacional e melhorar o desempenho global da organização. Promovendo numa primeira fase um crescimento exponencial do negócio e, de seguida, a adaptação da organização ao mercado concorrencial. O caso descreve o trabalho realizado pelo candidato e por equipas internas e externas, de levantamentos de requisitos gerais, técnicos e funcionais, desenvolvimento de um caderno de encargos, seleção, implementação e exploração de um ERP SAP. A apresentação e discussão do caso são enquadradas numa revisão de literatura sobre o papel das TI nos processos de mudança organizativa, alinhamento estratégico e vantagem competitiva das TI, contributo das TI para o aumento da produtividade, processos adoção e difusão das TI, fatores críticos de sucesso e BPM –Business Process Management

Strategic Planning and Organizational Effectiveness in Social Service Organizations in Portugal

This study aims to understand the reality of social service organizations, the level of implementation of the strategic planning as well as the impact of its application on organizational effectiveness. At first, we will group organizations in clusters according to the level of strategic planning implementation and its degree of effectiveness. Secondly, we will analyse all the different groups. Given the growing number of social service organizations and the consequent complexity of their structures, it turns out the need for these organizations adopt formal management techniques. Strategic planning is a valuable strategic management tool and one of its main objectives is to make organizations more effective. Therefore, the research has been conducted in order to determine if strategic planning is implemented in social service organizations and which effects has its application on organizational effectiveness. The survey, applied to 220 social service organizations, allowed us to gather them into different clusters, showing that different levels of strategic planning determine distinct degrees of organizational efficiency. Finally, it should be noted that findings of this research may be essential to decision makers of these organizations, because it was shown that the adoption of strategic planning has a positive influence on organizational effectiveness of social service organizations.

Pre-meal tomato (Lycopersicon esculentum) intake can have anti-obesity effects in young women?

The effect of pre-meal tomato intake in the anthropometric indices and blood levels of triglycerides, cholesterol, glucose, and uric acid of a young women population (n=35, 19.6 ± 1.3 years) was evaluated. During 4 weeks, daily, participants ingested a raw ripe tomato (~90 g) before lunch. Their anthropometric and biochemical parameters were measured repeatedly during the follow-up time. At the end of the 4 weeks, significant reductions were observed on body weight (-1.09 ± 0.12 kg on average), % fat (-1.54 ± 0.52%), fasting blood glucose (-5.29 ± 0.80 mg/dl), triglycerides (-8.31 ± 1.34 mg/dl), cholesterol (-10.17 ± 1.21 mg/ dl), and uric acid (-0.16 ± 0.04 mg/dl) of the participants. The tomato pre-meal ingestion seemed to interfere positively in body weight, fat percentage, and blood levels of glucose, triglycerides, cholesterol, and uric acid of the young adult women that participated in this study.

Planning smart cities using wireless low energy monitoring systems

Thesis to obtain the Master Degree in Electronics and Telecommunications Engineering

Studies on human anti-rabies immunization in Brazil: I - Evaluation of the 3 + 1 pre-exposure vaccination schedule under field conditions

The currently used pre-exposure anti-rabies immunization schedule in Brazil is the one called 3+1, employing suckling mouse brain vaccine (3 doses on alternate days and the last one on day 30). Although satisfactory results were obtained in well controlled experimental groups using this immunization schedule, in our routine practice, VNA levels lower than 0.5 IU/ml are frequently found. We studied the pre-exposure 3+1 schedule under field conditions in different cities on the State of São Paulo, Brazil, under variable and sometimes adverse circumstances, such as the use of different batches of vaccine with different titers, delivered, stored and administered under local conditions. Fifty out of 256 serum samples (19.5%) showed VNA titers lower than 0.5 IU/ml, but they were not distributed homogeneously among the localities studied. While in some cities the results were completely satisfactory, in others almost 40% did not attain the minimum VNA titer required. The results presented here, considered separately, question our currently used procedures for human pre-exposure anti-rabies immunization. The reasons determining this situation are discussed.

Studies on human anti-rabies immunization in Brazil: II - Preliminary evaluation of the 2-1-1 schedule for human pre-exposure anti-rabies immunization, employing suckling mouse brain vaccine

This study reports preliminary results of virus neutralizing antibody (VNA) titers obtained on different days in the course of human anti-rabies immunization with the 2-1-1 schedule (one dose is given in the right arm and one dose in the left arm at day 0, and one dose is apllied on days 7 and 21), recommended by WHO for post-exposure treatment with cell culture vaccines. A variant schedule (double dose on day zero and another on day 14) was also tested, both employing suckling mouse brain vaccine. A complete seroconversion rate was obtained after only 3 vaccine doses, and almost all patients (11 of 12) presented titers higher than 1.0 IU/ml. Both neutralizing response and seroconversion rates were lower in the group receiving only 3 doses, regardless of the sample collecting day. Although our results are lower than those found with cell culture vaccines, the geometry mean of VNA is fully satisfactory, overcoming the lower limit recommended by WHO of 0.5 IU/ml. The 2-1-1 schedule could be an alternative one for pre exposure immunization, shorter than the classical 3+1 regimen (one dose on days 0, 2, 4 and 30) with only three visits to the doctor, instead of four.

The influence of pre-departure training on expatriate adjustment: an empirical investigation with portuguese international assignees

This chapter examines the cross-cultural influence of training on the adjustment of international assignees. We focus on the pre-departure training (PDT) before an international assignment. It is an important topic because in the globalized world of today more and more expatriations are needed. The absence of PDT may generate the failure of the expatriation experience. Companies may neglect PDT due to cost reduction practices and ignorance of the need for it. Data were collected through semi-structured interviews to 42 Portuguese international assignees and 18 organizational representatives from nine Portuguese companies. The results suggest that companies should develop PDT programs, particularly when the cultural distance to the host country is bigger and when there is no previous experience of expatriation to that country in the company. The study is original because it details in depth the methods of PDT, its problems, and consequences. Some limitations linked to the research design and detailed in the conclusion should be overcome in future studies.