Atenção básica de saúde e a assistência em Hanseníase em serviços de saúde de um município do Estado de São Paulo

Este é um estudo descritivo desenvolvido em um município do Estado de São Paulo. Objetivo: identificar e caracterizar as ações do Programa de Controle da Hanseníase nos serviços de saúde municipais. Metodologia: entrevistas gravadas com gestor municipal de saúde e profissionais da assistência à hanseníase. Resultados: a política pública municipal em saúde prioriza o desenvolvimento da atenção básica com ênfase na saúde pública. As ações são realizadas por profissionais capacitados e experientes em hanseníase. Ve rificou-se a não realização da busca ativa dos casos, necessária para o real conhecimento da situação epidemiológica, e das ações de educação em saúde, importante para a redução do estigma e aproximação do sujeito à nova situação de vida e enfrentamento de limitações

Possible states in the flow around two circular cylinders in tandem with separations in the vicinity of the drag inversion spacing

The possible states in the flow around two identical circular cylinders in tandem arrangements are investigated for configurations in the vicinity of the drag inversion separation. By means of numerical simulations, the hysteresis in the transition between the shedding regimes is studied and the relationship between (three-dimensional) secondary instabilities and shedding regime determination is addressed. The differences observed in the behavior of two- and three-dimensional flows are analyzed, and the regions of bistable flow are delimited. Very good agreement is found between the proposed scenario and results available in the literature. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3420111]

Estudo da massa específica básica e da variação dimensional da madeira de três espécies de eucalipto para a indústria moveleira

The utilization of wood from reforested species by the furniture industry is a recent trend. Thus, the present study determined the specific gravity and shrinkage of wood of 18-year-old Eucalyptus grandis, Eucalyptus dunnii and Eucalyptus urophylla, for use as components in solid wood furniture making. The tests to evaluate the specific gravity and shrinkage of wood in the radial and axial variation of the eucalyptus trees were performed according to NBR 7190/96. The results of the analysis of wood from eucalypt species were subjected to the Homogeneity Test, ANOVA, Tukey and Pearson correlation and compared to the performance of sucupira wood (Bowdichia nitida) and cumaru wood (Dipteryx odorata), often used in the furniture industry. The following results were found: Eucalyptus grandis had a lower value of shrinkage, being more suitable for furniture components that require high dimensional stability, as well as parts of larger surface. The wood of this species showed a rate of dimensional variation compatible with the native species used in the furniture industry. The radial variation of the wood was also verified, and a high correlation between specific gravity and shrinkage was found. Longitudinally, the base of the trunk of the eucalyptus trees was shown to be the region of greatest dimensional stability.

Modelo de programação linear para otimização econômica do projeto de irrigação Baixo Acaraú - CE

The present work had as objective uses a model of lineal programming algorithm to optimize the use of the water in the District of Irrigation Baixo Acarau-CE proposing the best combination of crop types and areas established of 8,0 ha. The model aim maximize the net benefit of small farmer, incorporating the constraints in water and land availability, and constraints on the market. Considering crop types and the constraints, the study lead to the following conclusions: 1. The water availability in the District was not a limiting resources, while all available land was assigned in six of the seven cultivation plans analyzed. Furthermore, water availability was a restrictive factor as compared with land only when its availability was made to reduce to 60% of its actual value; 2. The combination of soursop and melon plants was the one that presented the largest net benefit, corresponding to R$ 5,250.00/ha/yr. The planting area for each crop made up to 50% of the area of the plot; 3. The plan that suggests the substitution of the cultivation of the soursop, since a decrease in annual net revenue of 5.87%. However, the plan that contemplates the simultaneous substitution of both soursop and melon produced the lowest liquid revenue, with reduction of 33.8%.

Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992-2003

Background: The objective of this study was to assess trends in cancer mortality by educational level in Barcelona from 1992 to 2003. Methods: The study population comprised Barcelona inhabitants aged 20 years or older. Data on cancer deaths were supplied by the system of information on mortality. Educational level was obtained from the municipal census. Age-standardized rates by educational level were calculated. We also fitted Poisson regression models to estimate the relative index of inequality (RII) and the Slope Index of Inequalities (SII). All were calculated for each sex and period (1992-1994, 1995-1997, 1998-2000, and 2001-2003). Results: Cancer mortality was higher in men and women with lower educational level throughout the study period. Less-schooled men had higher mortality by stomach, mouth and pharynx, oesophagus, larynx and lung cancer. In women, there were educational inequalities for cervix uteri, liver and colon cancer. Inequalities of overall and specific types of cancer mortality remained stable in Barcelona; although a slight reduction was observed for some cancers. Conclusion: This study has identified those cancer types presenting the greatest inequalities between men and women in recent years and shown that in Barcelona there is a stable trend in inequalities in the burden of cancer.

Inequalities in mortality of men by oral and pharyngeal cancer in Barcelona, Spain and Sao Paulo, Brazil, 1995-2003

Background: Large inequalities of mortality by most cancers in general, by mouth and pharynx cancer in particular, have been associated to behaviour and geopolitical factors. The assessment of socioeconomic covariates of cancer mortality may be relevant to a full comprehension of distal determinants of the disease, and to appraise opportune interventions. The objective of this study was to compare socioeconomic inequalities in male mortality by oral and pharyngeal cancer in two major cities of Europe and South America. Methods: The official system of information on mortality provided data on deaths in each city; general censuses informed population data. Age-adjusted death rates by oral and pharyngeal cancer for men were independently assessed for neighbourhoods of Barcelona, Spain, and Sao Paulo, Brazil, from 1995 to 2003. Uniform methodological criteria instructed the comparative assessment of magnitude, trends and spatial distribution of mortality. General linear models assessed ecologic correlations between death rates and socioeconomic indices (unemployment, schooling levels and the human development index) at the inner-city area level. Results obtained for each city were subsequently compared. Results: Mortality of men by oral and pharyngeal cancer ranked higher in Barcelona (9.45 yearly deaths per 100,000 male inhabitants) than in Spain and Europe as a whole; rates were on decrease. Sao Paulo presented a poorer profile, with higher magnitude (11.86) and stationary trend. The appraisal of ecologic correlations indicated an unequal and inequitably distributed burden of disease in both cities, with poorer areas tending to present higher mortality. Barcelona had a larger gradient of mortality than Sao Paulo, indicating a higher inequality of cancer deaths across its neighbourhoods. Conclusion: The quantitative monitoring of inequalities in health may contribute to the formulation of redistributive policies aimed at the concurrent promotion of wellbeing and social justice. The assessment of groups experiencing a higher burden of disease can instruct health services to provide additional resources for expanding preventive actions and facilities aimed at early diagnosis, standardized treatments and rehabilitation.

EPR study of local symmetry sites of Ce(3+) in Pb(1-x)Ce(x)A (A=S, Se, and Te)

The local site symmetry of Ce(3+) ions in the diluted magnetic semiconductors Pb(1-x)Ce(x)A (A=S, Se, and Te) has been investigated by electron-paramagnetic resonance (EPR). The experiments were carried out on single crystals with cerium concentration x ranging from 0.001 to 0.035. The isotropic line due to Ce(3+) ions located at the substitutional Pb cation site with octahedral symmetry was observed for all the studied samples. We determined the effective Lande factors to be g=1.333, 1.364, and 1.402 for A=S, Se, and Te, respectively. The small difference with the predicted Lande factor g of 10/7 for the Gamma(7) (J=5/2) ground state was attributed to crystal-field admixture. In addition, EPR lines from Ce(3+) ions located at sites with small distortion from the original octahedral symmetry were also observed. Two distinct sites with axial distortion along the < 001 > crystallographic direction were identified and a third signal in the spectrum was attributed to sites with the cubic symmetry distorted along the < 110 > direction. The distortion at these distinct Ce sites is attributed to Pb lattice vacancies near the cerium ions that compensate for its donor activity.

Late Entry into HIV Care: Estimated Impact on AIDS Mortality Rates in Brazil, 2003-2006

Background: Worldwide, a high proportion of HIV-infected individuals enter into HIV care late. Here, our objective was to estimate the impact that late entry into HIV care has had on AIDS mortality rates in Brazil. Methodology/Principal Findings: We analyzed data from information systems regarding HIV-infected adults who sought treatment at public health care facilities in Brazil from 2003 to 2006. We initially estimated the prevalence of late entry into HIV care, as well as the probability of death in the first 12 months, the percentage of the risk of death attributable to late entry, and the number of avoidable deaths. We subsequently adjusted the annual AIDS mortality rate by excluding such deaths. Of the 115,369 patients evaluated, 50,358 (43.6%) had entered HIV care late, and 18,002 died in the first 12 months, representing a 16.5% probability of death in the first 12 months (95% CI: 16.3-16.7). By comparing patients who entered HIV care late with those who gained timely access, we found that the risk ratio for death was 49.5 (95% CI: 45.1-54.2). The percentage of the risk of death attributable to late entry was 95.5%, translating to 17,189 potentially avoidable deaths. Averting those deaths would have lowered the 2003-2006 AIDS mortality rate by 39.5%. Including asymptomatic patients with CD4(+) T cell counts >200 and <= 350 cells/mm(3) in the group who entered HIV care late increased this proportion by 1.8%. Conclusions/Significance: In Brazil, antiretroviral drugs reduced AIDS mortality by 43%. Timely entry would reduce that rate by a similar proportion, as well as resulting in a 45.2% increase in the effectiveness of the program for HIV care. The World Health Organization recommendation that asymptomatic patients with CD4(+) T cell counts <= 350 cells/mm(3) be treated would not have a significant impact on this scenario.

Compton suppression instrumental neutron activation analysis performance in determining trace- and minor-element contents in foodstuff

In 2003-2004, several food items were purchased from large commercial outlets in Coimbra, Portugal. Such items included meats (chicken, pork, beef), eggs, rice, beans and vegetables (tomato, carrot, potato, cabbage, broccoli, lettuce). Elemental analysis was carried out through INAA at the Technological and Nuclear Institute (ITN, Portugal), the Nuclear Energy Centre for Agriculture (CENA, Brazil), and the Nuclear Engineering Teaching Lab of the University of Texas at Austin (NETL, USA). At the latter two, INAA was also associated to Compton suppression. It can be concluded that by applying Compton suppression (1) the detection limits for arsenic, copper and potassium improved; (2) the counting-statistics error for molybdenum diminished; and (3) the long-lived zinc had its 1115-keV photopeak better defined. In general, the improvement sought by introducing Compton suppression in foodstuff analysis was not significant. Lettuce, cabbage and chicken (liver, stomach, heart) are the richest diets in terms of human nutrients.

Sequential Injection Analysis (SIA) for Arsenic Speciation by Capillary Electrophoresis Hyphenated to Inductively Coupled Plasma Sector Field Mass Spectrometry (CE-ICP-SFMS)

Sequential injection analysis (SIA) is proposed for managing microvolumes of sample and arsenic species solutions for speciation analysis by capillary electrophoresis focusing on the reduction of hazardous waste residues. An electronically controlled hydrodynamic injector was projected to introduce microvolumes of solutions prepared by SIA into the CE capillary with precision better than 2%. The determination of arsenite, arsenate, monomethylarsonic acid, dimethylarsinic acid, and arsenobetaine was performed from 50 mu L volumes of lyophilized urine and extract of shrimp with the system hyphenated to inductively coupled plasma mass spectrometry (CE-ICP-SFMS).

Reliability-based evaluation of design code provisions for circular concrete-filled steel columns

This paper presents an investigation of design code provisions for steel-concrete composite columns. The study covers the national building codes of United States, Canada and Brazil, and the transnational EUROCODE. The study is based on experimental results of 93 axially loaded concrete-filled tubular steel columns. This includes 36 unpublished, full scale experimental results by the authors and 57 results from the literature. The error of resistance models is determined by comparing experimental results for ultimate loads with code-predicted column resistances. Regression analysis is used to describe the variation of model error with column slenderness and to describe model uncertainty. The paper shows that Canadian and European codes are able to predict mean column resistance, since resistance models of these codes present detailed formulations for concrete confinement by a steel tube. ANSI/AISC and Brazilian codes have limited allowance for concrete confinement, and become very conservative for short columns. Reliability analysis is used to evaluate the safety level of code provisions. Reliability analysis includes model error and other random problem parameters like steel and concrete strengths, and dead and live loads. Design code provisions are evaluated in terms of sufficient and uniform reliability criteria. Results show that the four design codes studied provide uniform reliability, with the Canadian code being best in achieving this goal. This is a result of a well balanced code, both in terms of load combinations and resistance model. The European code is less successful in providing uniform reliability, a consequence of the partial factors used in load combinations. The paper also shows that reliability indexes of columns designed according to European code can be as low as 2.2, which is quite below target reliability levels of EUROCODE. (C) 2009 Elsevier Ltd. All rights reserved.

Preloaded RC columns strengthened with high-strength concrete jackets under uniaxial compression

Although use of high-strength reinforced concrete (RC) jackets has become common practice worldwide, there are still two unresolved issues regarding the contribution of the original concrete and the effects of existing loads. Twelve RC-jacketed columns were tested with and without preloading under uniaxial compression. Tests showed the entire core to contribute to the capacity of the jacketed column, as long as adequate confinement is provided. Also, preloading does not adversely affect the capacity of the jacketed column, while it may increase its deformability, especially in square sections. Transverse reinforcement in the jacket directly improves ductility of the strengthened column, especially in circular sections.

Volumetric reconstruction of the mean flow around circular cylinders fitted with strakes

The volumetric reconstruction technique presented in this paper employs a two-camera stereoscopic particle image velocimetry (SPIV) system in order to reconstruct the mean flow behind a fixed cylinder fitted with helical strakes, which are commonly used to suppress vortex-induced vibrations (VIV). The technique is based on the measurement of velocity fields at equivalent adjacent planes that results in pseudo volumetric fields. The main advantage over proper volumetric techniques is the avoidance of additional equipment and complexity. The averaged velocity fields behind the straked cylinders and the geometrical periodicity of the three-start configuration are used to further simplify the reconstruction process. Two straked cylindrical models with the same pitch (p = 10d) and two different heights (h = 0.1 and 0.2d) are tested. The reconstructed flow shows that the strakes introduce in the wake flow a well-defined wavelength of one-third of the pitch. Measurements of hydrodynamic forces, fluctuating velocity, vortex formation length, and vortex shedding frequency show the interdependence of the wake parameters. The vortex formation length is increased by the strakes, which is an important effect for the suppression of vortex-induced vibrations. The results presented complement previous investigations concerning the effectiveness of strakes as VIV suppressors and provide a basis of comparison to numerical simulations.

On the wake-induced vibration of tandem circular cylinders: the vortex interaction excitation mechanism

The mechanism of wake-induced vibrations (WIV) of a pair of cylinders in a tandem arrangement is investigated by experiments. A typical WIV response is characterized by a build-up of amplitude persisting to high reduced velocities; this is different from a typical vortex-induced vibration (VIV) response, which occurs in a limited resonance range. We suggest that WIV of the downstream cylinder is excited by the unsteady vortex-structure interactions between the body and the upstream wake. Coherent vortices interfering with the downstream cylinder induce fluctuations in the fluid force that are not synchronized with the motion. A favourable phase lag between the displacement and the fluid force guarantees that a positive energy transfer from the flow to the structure sustains the oscillations. If the unsteady vortices are removed from the wake of the upstream body then WIV will not be excited. An experiment performed in a steady shear flow turned out to be central to the understanding of the origin of the fluid forces acting on the downstream cylinder.

Experimental investigation of flow-induced vibration on isolated and tandem circular cylinders fitted with strakes

The effect of varying the geometric parameters of helical strakes on vortex-induced vibration (VIV) is investigated in this paper. The degree of oscillation attenuation or even suppression is analysed for isolated circular cylinder cases. How a cylinder fitted with strakes behaves when immersed in the wake of another cylinder in tandem arrangement is also investigated and these results are compared to those with a single straked cylinder. The experimental tests are conducted at a circulating water channel facility and the cylindrical models are mounted on a low-damping air bearing elastic base with one degree-of-freedom, restricted to oscillate in the transverse direction to the channel flow. Three strake pitches (p) and heights (h) are tested: p = 5, 10, 15d, and h = 0.1, 0.2, 0.25d. The mass ratio is 1.8 for all models. The Reynolds number range is from 1000 to 10000, and the reduced velocity varies up to 21. The cases with h = 0.1d strakes reduce the amplitude response when compared to the isolated plain cylinder, however the oscillation still persists. On the other hand, the cases with h = 0.2, 0.25d strakes almost completely suppress VIV. Spanwise vorticity fields, obtained through stereoscopic digital particle image velocimetry (SDPIV), show an alternating vortex wake for the p = 10d and h = 0.1d straked cylinder. The p = 10d and h = 0.2d cylinder wake has separated shear layers with constant width and no roll-up close to the body. The strakes do not increase the magnitude of the out-of-plane velocity compared to the isolated plain cylinder. However, they deflect the flow in the out-of-plane direction in a controlled way, which can prevent the vortex shedding correlation along the span. In order to investigate the wake interference effect on the strake efficiency, an experimental arrangement with two cylinders in tandem is employed. The centre-to-centre distance for the tandem arrangement varies from 2 to 6. When the downstream p = 10d and h = 0.2d cylinder is immersed in the wake of an upstream fixed plain cylinder, it loses its effectiveness compared with the isolated case. Although the oscillations have significant amplitude, they are limited, which is a different behaviour from that of a tandem configuration with two plain cylinders. For this particular case, the amplitude response monotonically increases for all gaps, except one, a trait usually found in galloping-like oscillations. SDPIV results for the tandem arrangements show alternating vortex shedding and oscillatory wake. (C) 2010 Elsevier Ltd. All rights reserved.