Methodological contributions towards the study of health care production: lessons from a research study on barriers and access in mental health

This article presents methodological contributions and a conceptual innovation for thinking about the production of health care, stemming from a study on access and barriers in mental health carried out in the municipality of Campinas (São Paulo, Brazil). The study used a cartographic approach and, after an initial identification of the most complex cases (on the part of the teams of workers), adopted the users as guides to explore the different levels of production of their lives and to evaluate the possibility of forming a network of existential connections that produce life as a fundamental analyzer of access or barriers to care.

Habitat heterogeneity and use of physical acoustic space in anuran communities in southeastern Brazil.

We intended to verify if structural and physiognomical characteristics of water bodies influence on the degree of overlap among calling sites of 23 anurans species, if anuran species use different calling sites in different water bodies, and if there is some relationship between the degree of advertisement call (based on seven call features) and calling site differentiation. Then, we determined calling sites (based in four variables) and recorded the advertisement call for anuran species that occurred in 10 water bodies of northwestern São Paulo State. We also determined the environmental heterogeneity (based in four environmental descriptors) for each water body. Males of most species used similar calling sites in each water body, probably because of the high uniformity of the environment, as a consequence of agricultural impacts on edge vegetation of the studied ponds. Most species (18 out of 19 species) called from different sites in the ponds where they occurred, which can be associated with differences in horizontal and vertical distribution of vegetation in the studied ponds. From the 19 species analyzed, only males of Pseudopaludicola aff. saltica called in sites with the same characteristics in different ponds. Advertisement call of Hylidae species was more similar to each other than were Leiuperidae and Leptodactylidae among themselves. The aquatic/terrestrial anurans (Bufonidae, Leiuperidae, Leptodactylidae and Microhylidae) occupied similar calling sites but presented quite distinct advertisement calls, while Hylidae species presented an inverse pattern: a high similarity on advertisement call features but used different calling sites, which indicates a niche complementarity between physical (calling site use) and acoustic (advertisement call) space use.

CMOS-based active pixel for low-light-level detection: Analysis and measurements

An analysis of the active pixel sensor (APS), considering the doping profiles of the photodiode in an APS fabricated in a 0.18 μm standard CMOS technology, is presented. A simple and accurate model for the junction capacitance of the photodiode is proposed. An analytic expression for the output voltage of the APS obtained with this capacitance model is in good agreement with measurements and is more accurate than the models used previously. A different mode of operation for the APS based on the dc level of the output is suggested. This new mode has better low-light-level sensitivity than the conventional APS operating mode, and it has a slower temporal response to the change of the incident light power. At 1μW/cm2 and lower levels of light, the measured signal-to-noise ratio (SNR) of this new mode is more than 10 dB higher than the SNR of previously reported APS circuits. Also, with an output SNR of about 10 dB, the proposed dc level is capable of detecting light powers as low as 20 nW/cm2, which is about 30 times lower than the light power detected in recent reports by other groups. © 2007 IEEE.

Habitat heterogeneity and use of physical and acoustic space in anuran communities in Southeastern Brazil

Habitat heterogeneity and use of physical and acoustic space in anuran communities in Southeastern Brazil. We intended to verify if structural and physiognomical characteristics of water bodies influence on the degree of overlap among calling sites of 23 anurans species, if anuran species use different calling sites in different water bodies, and if there is some relationship between the degree of advertisement call (based on seven call features) and calling site differentiation. Then, we determined calling sites (based in four variables) and recorded the advertisement call for anuran species that occurred in 10 water bodies of northwestern São Paulo State. We also determined the environmental heterogeneity (based in four environmental descriptors) for each water body. Males of most species used similar calling sites in each water body, probably because of the high uniformity of the environment, as a consequence of agricultural impacts on edge vegetation of the studied ponds. Most species (18 out of 19 species) called from different sites in the ponds where they occurred, which can be associated with differences in horizontal and vertical distribution of vegetation in the studied ponds. From the 19 species analyzed, only males of Pseudopaludicola aff. saltica called in sites with the same characteristics in different ponds. Advertisement call of Hylidae species was more similar to each other than were Leiuperidae and Leptodactylidae among themselves. The aquatic/terrestrial anurans (Bufonidae, Leiuperidae, Leptodactylidae and Microhylidae) occupied similar calling sites but presented quite distinct advertisement calls, while Hylidae species presented an inverse pattern: a high similarity on advertisement call features but used different calling sites, which indicates a niche complementarity between physical (calling site use) and acoustic (advertisement call) space use. © 2008 Departamento de Ciências Biológicas.

Application of information and communication technologies for health systems in Belgium, Denmark, Spain, the United Kingdom and Sweden

Incluye Bibliografía

Ethnicity and the use of health services in Belize

Includes bibliography

Information and communication technologies in health care: enabling projects and applications in Chile

Includes bibliography

Envelhecimento e doenças neurodegenerativas crônicas na Amazônia brasileira: implantação de novas metodologias de avaliação em pacientes com declínio cognitivo leve e doença de Alzheimer

Em 2025 o número de idosos no mundo irá dobrar e por volta de 2050 alcançará dois bilhões de indivíduos, estando a maioria em países desenvolvidos. A doença de Alzheimer (DA) é a quarta doença que mais compromete a qualidade de vida dos idosos. Este trabalho pretende sugerir novas metodologias de avaliação de pacientes com declínio cognitivo e doença de Alzheimer, apresentando uma versão brasileira a partir da versão original em língua inglesa intitulada “Test Your Memory” TYM (“teste sua memória- TSM), bem como mostrar os resultados do desempenho dos idosos na bateria de testes neuropsicológicos de Cambridge (CANTAB). Trata-se de estudo analítico, transversal retrospectivo do tipo caso-controle, realizado em pacientes do ambulatório de Geriatria do Hospital Universitário João de Barros Barreto, e em voluntários da comunidade no período de janeiro de 2009 a janeiro de 2011. Participaram 95 indivíduos com 65 ou mais anos de idade, divididos em 3 grupos: Alzheimer (DA, n=21), declínio cognitivo (DCL, n=31) e controle (n=43). Foram excluídos pacientes com história de acidente vascular encefálico (AVE), depressão primária, trauma cranioencefálico, outras demências, outras patologias neuropsiquiátricas e déficits visuo-auditivos limitantes. Os participantes foram submetidos à avaliação inicial, triagem com GDS-5 e DSM-IV, ao Questionário Internacional de Atividades Físicas (IPAQ), testes neuropsicológicos da bateria CERAD, teste do relógio, TSM (versão adaptada para o Português) e a bateria de Alzheimer do CANTAB. A análise estatística foi realizada empregando-se ANOVA, um critério, definindo-se o valor p<0,05 como significante. Houve predomínio em todos os grupos de indivíduos do gênero feminino, de cor parda, na faixa etária de 70 a 79 anos. A média de pontuação do MEEM entre os três grupos foi diferente (controle: 26,6±2,2; DCL: 25,1±2,6; DA: 17,3±4,9; p<0,05), entretanto o TSM mostrou ser uma ferramenta de triagem mais confiável para distinguir os pacientes DCL dos DA (controle: 42,4±5; DCL: 35,5±7,7; DA: 25,7±8; p<0,01). Na lista de palavras do CERAD, teste do relógio, TNBR e na fluência verbal fonológica os três grupos apresentaram diferenças significantes na média de pontos obtidos. A média da pontuação total no TSM foi significativamente menor nos grupos DCL e DA do que no grupo controle, e no grupo DA em relação ao DCL. Os testes e medidas do CANTAB que separam os três grupos pelo desempenho obtido são: RVP A‟, número de tentativas para o sucesso e total de erros na fase de 6 figuras do PAL. Foram encontradas boas correlações entre o TSM e outros testes, principalmente com o MEEM (Coeficiente de Pearson, r = 0,79; p<0,0001) e teste do relógio (r = 0,76; p<0,0001), bem como boa correlação entre as medidas do PAL e a pontuação do TSM e o MEEM. O nível de atividade física no grupo controle foi maior do que em todos os outros grupos. Ao ser correlacionado o nível de atividade física e o desempenho nos testes cognitivos, não foram observadas diferenças significativas nos diferentes grupos, exceto pela evocação de palavras no grupo DCL. Tomados em conjunto os resultados sugerem que a aplicação de testes neuropsicológicos automatizados associados aos testes da rotina clínica e ao TSM aumentam a resolução e a confiabilidade das análises particularmente no estágio inicial das síndromes demenciais onde a precocidade e a precisão diagnóstica são fundamentais para orientar as ações terapêuticas, sejam elas medicamentosas e/ou comportamentais.

Cephalometric analysis for the diagnosis of sleep apnea: a comparative study between reference values and measurements obtained for Brazilian subjects

OBJECTIVE: To verify if the reference values of Sleep Apnea cephalometric analysis of North American individuals are similar to the ones of Brazilian individuals presenting no craniofacial anomalies. The study also aimed to identify craniofacial alterations in Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) patients in relation to individuals without clinical characteristics of the disease through this cephalometric analysis. METHOD: It were used 55 lateral cephalograms consisting of 29 for the control group of adult individuals without clinical characteristics of OSAHS and 26 apneic adults. All radiographs were submitted to Sleep Apnea cephalometric analysis through Radiocef Studio 2.0. The standard values of this analysis were compared, by means of z test, to the ones obtained from the control group and these were compared to values from apneic group through Student's t test. RESULTS: There were no significant differences between values obtained from control group and standard values. On the group of OSAHS patients it was observed a decrease on the dimensions of upper airways and an increase on the soft palate length. CONCLUSIONS: The standard values of Sleep Apnea analysis can be used as reference in Brazilian individuals. Besides, through lateral cephalograms it was possible to identify craniofacial alterations in OSAHS patients.

Synergistic effect of green coffee oil and synthetic sunscreen for health care application

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Extrusion of blends of cassava leaves and cassava flour: physical characteristics of extrudates

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Atmospheric pollutants in São Paulo state, Brazil and effects on human health – a review

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)