Chagas disease in a community in Southeast Brazil: I. A serlogic follow-up study on a vectorcontrolled area

The prevalence of Trypanosoma cruzi infection was evaluated in Berilo, Minas Gerais (MG), Brazil, from January to July 1997. A serological survey using the indirect immunofluorescence test (IFT) in dried blood collected on filter-paper was performed in a sample of 2,261 individuals. The overall prevalence rate of T. cruzi infection was 18%, and reached 50% in individuals older than 30 years from rural areas. The percentage of seropositivity was 0.17% among individuals younger than 10 years old, suggesting that vectorial transmission is controlled in the area. A decrease in prevalence rates among people born after 1960 and 1970 was observed and this appears to be correlated with the beginning of control programs. A reduction in T. cruzi infection rates was observed when comparing our results with the rates estimated in a serologic study carried out in Berilo in 1983(11).

Impact of antihelminthic treatment on infection by Ascaris lumbricoides, Trichuris trichiura and hookworms in Covas, a rural community of Pernambuco, Brazil

This work aims to evaluate the impact of drug treatment on infection by Ascaris lumbricoides (Al), Trichuris trichiura (Tt) and hookworms (Hook) in a rural community from the sugar-cane zone of Pernambuco, Brazil. Four parasitological surveys were carried out from March 2001 to March 2002. Individual diagnosis was based on eight slides (four by the Kato-Katz method and four by the Hoffman method) per survey. Infected subjects were assigned to two groups for treatment with either albendazole (n = 62) or mebendazole (n = 57). Prevalence of infection fell significantly (p < 0.05) one month after treatment: Al (from 47.7% to 6.6%); Tt (from 45.7% to 31.8%) and Hook (from 47.7% to 24.5%). One year after treatment, infections by Tt and Hook remained significantly below pre-control levels. A substantial decrease in single-infection cases and multiple infections was found. Egg-negative rate was significant for Al (94.0%), Hook (68.3%) but not for Tt (45.5%), and did not differ significantly between subjects treated with mebendazole or albendazole. Egg counts fell significantly in the individuals remaining positive for Tt. It is recommended that antihelminthic treatment should be selective and given at yearly intervals preferably with albendazole, due to its cost-effectiveness.

Study of enteroparasites infection frequency and chemotherapeutic agents used in pediatric patients in a community living in Porto Alegre, RS, Brazil

Parasitic infections caused by intestinal protozoan and helminths affect more than two billion people worldwide and chemotherapy is the most commonly used therapeutic procedure. Considering the problems created by parasitic infections and the incorrect use of drugs, the aim of this work was to detect the frequency of enteroparasites infection and to estimate the use of chemotherapeutic agents in children living in the periphery of the city of Porto Alegre, RS, Brazil. Ninety-six preschool age children, who had parasitological exams and who used antiparasitic drugs, were analyzed. The efficacy of treatment was evaluated by stool examination repeated six months after treatment. The same diagnostic test was used to evaluate parasitological cure, which was defined as absence of eggs and cysts in the stool. From these children, 79 (82.3%) were contaminated by some species of parasite, the most prevalent were Ascaris lumbricoides, Trichuris trichiura and Giardia lamblia. The most commonly used drugs were mebendazole (86% of prescriptions) and metronidazole (30.3%). The cure rate in the 79 children, examined 6 months after treatment, was 65.3% for A. lumbricoides and 66.1% for T. trichiura. This study suggests that a continuous education program regarding the prevention and treatment of parasitic infections is an essential tool for their eradication.

Reabilitação no Acidente Vascular Cerebral: do Hospital à Comunidade

The field of action for rehabilitation is that of making use of the patient's maximum functional capacity with the purpose of adapting to life in relation to the environment. Rehabilitation must commence immediately, although it may be in different forms from the acute phase to sequelae. It is considered appropriate to call the physiatrist as soon as the neurologic condition has stabilised. A list is made of the measures to be taken for rehabilitation in the acute phase and sequelae, and the composition of the rehabilitation team is described. In what concerns location, where to rehabilitate the patient? The group of ambulatory patients should have their rehabilitation as outpatients. Our experience with house calls is briefly described. The group of patients who cannot walk, those that present an eminently motor condition, with the possibility of being able to walk, should be with their families, with transport provided to health and rehabilitation centres. The second group, with the capacity of walking within a reasonable time, especially if with multiple associated problems such as impaired communication, should be hospitalised in a rehabilitation department. The third group consists of severely handicapped patients, for whom a solution must be found that provides life with a minimum of dignity in centres or homes. From among the measures to be introduced, we point out following: acquisition of transport for patients who must travel, as outpatients, to the department; providing family doctors with complete freedom to refer their patients to rehabilitation centres.

Blastocystis hominis and other intestinal parasites in a community of Pitanga City, Paraná State, Brazil

The objective was to estimate the prevalence of Blastocystis hominis, to evaluate the effectiveness of different techniques for its diagnosis as well as to estimate the prevalence of other intestinal parasites in the community of Campo Verde, a district of Pitanga. The work was carried out from August to October 2004. Samples of feces from children and adults were collected and submitted to the techniques of direct wet mount, flotation in zinc sulphate solution, tube sedimentation, sedimentation in formalin-ether and staining by Kinyoun and iron hematoxylin methods. From 181 studied individuals, 128 (70.7%) showed protozoa and/or helminths in stool samples. The most prevalent species were Endolimax nana (33.7%); B. hominis (26.5%); Giardia lamblia (18.2%); Entamoeba coli (17.1%); Ascaris lumbricoides (16.6%); Iodamoeba bütschlii (9.4%); and ancylostomatidae (7.7%). B. hominis was only identified by the techniques of direct wet mount, sedimentation in formalin-ether and staining by iron hematoxylin, though the latter was less sensitive than the other methods. The high frequency of B. hominis demonstrated by this study indicates the need to include laboratory techniques that enable identification of the parasite on a routine basis.

BIWiki - Using a Business Intelligence Wiki to Form a Virtual Community of Practice for Portuguese Master's Students

Web 2.0 software in general and wikis in particular have been receiving growing attention as they constitute new and powerful tools, capable of supporting information sharing, creation of knowledge and a wide range of collaborative processes and learning activities. This paper introduces briefly some of the new opportunities made possible by Web 2.0 or the social Internet, focusing on those offered by the use of wikis as learning spaces. A wiki allows documents to be created, edited and shared on a group basis; it has a very easy and efficient markup language, using a simple Web browser. One of the most important characteristics of wiki technology is the ease with which pages are created and edited. The facility for wiki content to be edited by its users means that its pages and structure form a dynamic entity, in permanent evolution, where users can insert new ideas, supplement previously existing information and correct errors and typos in a document at any time, up to the agreed final version. This paper explores wikis as a collaborative learning and knowledge-building space and its potential for supporting Virtual Communities of Practice (VCoPs). In the academic years (2007/8 and 2008/9), students of the Business Intelligence module at the Master's programme of studies on Knowledge Management and Business Intelligence at Instituto Superior de Estatistica e Gestao de Informacao of the Universidade Nova de Lisboa, Portugal, have been actively involved in the creation of BIWiki - a wiki for Business Intelligence in the Portuguese language. Based on usage patterns and feedback from students participating in this experience, some conclusions are drawn regarding the potential of this technology to support the emergence of VCoPs; some provisional suggestions will be made regarding the use of wikis to support information sharing, knowledge creation and transfer and collaborative learning in Higher Education.

Seroprevalence of toxoplasmosis in a low-income community in the São Paulo municipality, SP, Brazil

Toxoplasmosis is one of the most common zoonoses worldwide. The seroprevalence for T. gondii in human population from Brazil might range from 40 to 80%. The aim of this paper was to study the seroprevalence of T. gondii infection in children from age one to 15 living in a low socioeconomic community, named community of Jardim São Remo in the year of 2002. The community is located in the West area of São Paulo municipality, São Paulo State, Brazil. Antibodies to T. gondii were found in 110 (32.4%, CI 95%: 27.5 - 37.7) of the 339 children tested with indirect immunofluorescent antibody test. The titration of the samples revealed 29 children with serum titer equal to 16, 14 children with 32, 18 children with 64, 21 children with 128, 20 children with 256 and eight children with serum titer > 512. The age dependence of the prevalence of T. gondii infection and the association between seroprevalence for T. gondii and seroprevalence for T. canis suggest that the infection is chiefly postnatal. Seroconversion in infant population of community Jardim São Remo occurs in children as young as two years old, earlier than in the children attended at health centers of São Paulo city. The seroprevalence of T. gondii in children from Jardim São Remo was compared to the prevalence in children from other urban centers of Brazil.

Influence of Firms’ Environmental Management and Community Involvement Programs in their Employees and in the Community

To assure enduring success, firms need to generate economic value with respect for the environment and social value. They also need to be aware of the needs and expectations of relevant stakeholders and incorporate them in their business strategies and programs. These challenges imply that engineers should take into consideration societal, health and safety,environmental and commercial issues in their professional activity. This investigation accesses the influence of firms’ environmental management programs and community involvement programs on their own employees and in the community, with a focus on small and medium companies. Based on a quantitative research, the findings suggest that firms that invest both in environmental management programs and in community involvement programs have a higher involvement of their own employees with the community, while at the same time receiving more feedback (positive, but also negative) from the community, stressing the need to pay special attention to their communication policies.

Is mental practice an effective adjunct therapeutic strategy for upper limb motor restoration after stroke? A systematic review and meta- analysis

Stroke is one of the most common conditions requiring rehabilitation, and its motor impairments are a major cause of permanent disability. Hemiparesis is observed by 80% of the patients after acute stroke. Neuroimaging studies showed that real and imagined movements have similarities regarding brain activation, supplying evidence that those similarities are based on the same process. Within this context, the combination of mental practice (MP) with physical and occupational therapy appears to be a natural complement based on neurorehabilitation concepts. Our study seeks to investigate if MP for stroke rehabilitation of upper limbs is an effective adjunct therapy. PubMed (Medline), ISI knowledge (Institute for Scientific Information) and SciELO (Scientific Electronic Library) were terminated on 20 February 2015. Data were collected on variables as follows: sample size, type of supervision, configuration of mental practice, setting the physical practice (intensity, number of sets and repetitions, duration of contractions, rest interval between sets, weekly and total duration), measures of sensorimotor deficits used in the main studies and significant results. Random effects models were used that take into account the variance within and between studies. Seven articles were selected. As there was no statistically significant difference between the two groups (MP vs control), showed a - 0.6 (95% CI: -1.27 to 0.04), for upper limb motor restoration after stroke. The present meta-analysis concluded that MP is not effective as adjunct therapeutic strategy for upper limb motor restoration after stroke.

Self-diagnosis of active head lice infestation by individuals from an impoverished community: high sensitivity and specificity

To compare sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of self-diagnosis for head lice infestation with visual inspection, we conducted a study in an urban slum in Brazil. Individuals were asked about active head lice infestation (self-diagnosis); we performed visual inspection and thereafter wet combing (gold standard). Of the 175 individuals included, 77 (44%) had an active head lice infestation. For self-diagnosis, sensitivity (80.5%), specificity (91.8%), PPV (88.6%) and NPV (85.7%) were high. Sensitivity of visual inspection was 35.1%. Public health professionals can use self-diagnosis as a diagnostic tool, to estimate accurately prevalence of pediculosis in a community, and to monitor ongoing intervention strategies.

Ankle anticipatory postural adjustments during gait initiation in healthy and post-stroke subjects

Background: Anticipatory postural adjustments during gait initiation have an important role in postural stability but also in gait performance. However, these first phase mechanisms of gait initiation have received little attention, particularly in subcortical post-stroke subjects, where bilateral postural control pathways can be impaired. This study aims to evaluate ankle anticipatory postural adjustments during gait initiation in chronic post-stroke subjects with lesion in the territory of middle cerebral artery. Methods: Eleven subjects with post-stroke hemiparesis with the ability to walk independently and twelve healthy controls participated in this study. Bilateral electromyographic activity of tibialis anterior, soleus and medial gastrocnemius was collected during gait initiation to assess the muscle onset timing, period of activation/deactivation and magnitude of muscle activity during postural phase of gait initiation. This phase was identified through centre of pressure signal. Findings: Post-stroke group presented only half of the tibialis anterior relative magnitude observed in healthy subjects in contralesional limb (t=2.38, p=0.027) and decreased soleus deactivation period (contralesional limb, t=2.25, p=0.04; ipsilesional limb, t=3.67, p=0.003) as well its onset timing (contralesional limb, t=3.2. p=0.005; ipsilesional limb, t=2.88, p=0.033) in both limbs. A decreased centre of pressure displacement backward (t=3.45, p=0.002) and toward the first swing limb (t=3.29, p=0.004) was observed in post-stroke subjects. Interpretation: These findings indicate that chronic post-stroke subjects with lesion at middle cerebral artery territory present dysfunction in ankle anticipatory postural adjustments in both limbs during gait initiation.

Reliability of Two Methods for Identifying the Postural Phase of Gait Initiation in Healthy and Post-stroke Subjects

This study aims to compare two methods of assessing the postural phase of gait initiation as to intrasession reliability, in healthy and post-stroke subjects. As a secondary aim, this study aims to analyse anticipatory postural adjustments during gait initiation based on the centre of pressure (CoP) displacements in post-stroke participants. The CoP signal was acquired during gait initiation in fifteen post-stroke subjects and twenty-three healthy controls. Postural phase was identified through a baseline-based method and a maximal displacement based method. In both healthy and post-stroke participants higher intra-class correlation coefficient and lower coefficient of variation values were obtained with the baseline-based method when compared to the maximal displacement based method. Post-stroke participants presented decreased CoP displacement backward and toward the first swing limb compared to controls when the baseline-based method was used. With the maximal displacement based method, there were differences between groups only regarding backward CoP displacement. Postural phase duration in medial-lateral direction was also increased in post-stroke participants when using the maximal displacement based method. The findings obtained indicate that the baseline-based method is more reliable detecting the onset of gait initiation in both groups, while the maximal displacement based method presents greater sensitivity for post-stroke participants.

Ankle antagonist coactivation in the double-support phase of walking: Stroke vs. healthy subjects

Introduction: Lesions at ipsilateral systems related to postural control at ipsilesional side, may justify the lower performance of stroke subjects during walking. Purpose: To analyse bilateral ankle antagonist coactivation during double-support in stroke subjects. Methods: Sixteen (8 females; 8 males) subjects with a first isquemic stroke, and twenty two controls (12 females; 10 males) participated in this study. The double support phase was assessed through ground reaction forces and electromyography of ankle muscles was assessed in both limbs. Results: Ipsilesional limb presented statistical significant differences from control when assuming specific roles during double support, being the tibialis anterior and soleus pair the one in which this atypical behavior was more pronounced. Conclusion: The ipsilesional limb presents a dysfunctional behavior when a higher postural control activity was demanded.

Seroepidemiology of toxoplasmosis in women of childbearing age from a marginal community of Maracaibo, Venezuela

The aim of this study was to determine the prevalence of anti-T. gondii total and IgM antibodies in women of childbearing age. One hundred serum samples of women were studied with age range from 11 to 45 years old. Samples were chosen by random. The determination of total antibodies was carried out through the indirect hemagglutination technique and IgM antibodies by ELISA's technique. The statistical analysis was carried out through the Chi square and the Spearman correlation tests. The theoretical estimated incidence of congenital toxoplasmosis was calculated, according to the annual increment of antibody prevalence among the age groups. The overall prevalence of toxoplasmosis was 33%, while only six individuals (18.2%) were positive to IgM. The highest prevalence was observed in the 11-35 year-old age group. The theoretical estimated incidence was 1.5 for 100 pregnancies in women of 21-25 year-old group; it decreased until 0.1% in the 41-45 year-old age group. The findings show a high prevalence of toxoplasmosis in this community with a high infection risk in women of the studied age group and the high cat population observed, suggesting that the transmission way by contaminated soils may play a main role in the spreading of toxoplasmosis in this community.

Intestinal parasites in a quilombola community of the Northern State of Espírito Santo, Brazil

The aim of this study was to determine the occurrence of intestinal parasites in a quilombola community from the northern Espírito Santo, Brazil. Descendants of slaves who arrived in Brazil in the sixteenth century, this population settled in the municipality of São Mateus in 1858. Fresh fecal samples from 82 individuals who agreed to participate in the study were collected between August 2009 and July 2010, and immediately sent to the Clinical Laboratory of the Centro Universitário Norte do Espírito Santo of the Universidade Federal do Espírito Santo for analysis. Out of all the participants, 36 (43.9%) were male and 46 (56.1%) were female, whose ages ranged from six to 85 years. The study of the occurrence of intestinal parasites indicated that 35 individuals (42.7%) were infected with at least one intestinal parasite. Among helminths, the most frequent were hookworms, with a rate of 14.6%. With regard to protozoa, Entamoeba coli, Entamoeba histolytica/Entamoeba dispar and Endolimax nana stood out, with frequencies of 23.2%, 8.5% and 4.9%, respectively. The occurrence of biparasitism was observed in 13 of the 82 subjects, accounting for 15.8%, and no cases of multiple parasitic infections were observed. It was concluded that the reduction of cases of intestinal diseases due to parasites will only be achieved with the improvement of basic sanitation and quality of life of quilombola populations.