Seroepidemiological markers of enterically transmitted viral hepatitis A and E in individuals living in a community located in the North Area of Rio de Janeiro, RJ, Brazil

We investigated the seroprevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) infection in subjects living in the community of Manguinhos, Rio de Janeiro, Brazil, and assisted at the Health Unit of Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz. After formal consent, individuals were submitted to an interview using a standardized questionnaire. Anti-HAV and anti-HEV antibodies were detected by ELISA. Statistical analysis was carried out using the Epi-Info 6.04b software, to investigate possible associations between serological markers and risk factors. Results were regarded as significant when p value < 0.05. Although a high prevalence of anti-HAV was observed (87%), almost 50% of subjects under the age of 10 were susceptible to HAV infection, an unexpected rate in endemic areas. This fact could be attributed to improvements in environmental sanitation, occurring in this area in the last years. The increasing proportion of susceptible people may result in outbreaks of HAV infection, since the virus still circulates in this area, as verified by the detection of anti-HAV IgM in some individuals. No statistical association was met between HAV infection and the risk factors here assessed. The anti-HEV IgG prevalence found in this population was 2.4%, consistent with the one found in non-endemic areas.

Community Pharmacy Contractor Agreement for Provision of Community Pharmacy Services Under the Health Act 1970

MEMORANDUM OF AGREEMENT BETWEEN THE DEPARTMENT OF HEALTH AND THE IRISH PHARMACEUTICAL UNION IN RESPECT OF THE PROVISION OF COMMUNITY PHARMACY SERVICES UNDER THE HEALTH ACT, 1970 Read the memorandum  

Hepatitis A virus subgenotypes dissemination during a community outbreak in a surrounding region of Rio de Janeiro

From December 1999 to December 2001, many cases of hepatitis A were notified in the county of Belford Roxo involving individuals aged 0 to 79 years. Serum samples were collected to evaluate the prevalence of anti-hepatitis A virus (HAV) antibodies, to detect HAV-RNA and to correlate with possible risk factors of HAV infection. Serum samples were screened by commercial IgM and total anti-HAV antibody ELISA and HAV-RNA was isolated and subsequently amplified by reverse transcription-polymerase chain reaction (RT-PCR) at VP1/2A region, sequenced and analyzed. Total anti-HAV prevalence was 87.9% (203/231) and IgM anti-HAV prevalence was 38.7% (89/231). Multivariate analysis showed that individuals under 20 years old are risks groups to acquire the infection suggesting that hygienic habits of young subjects are the principal factor of transmission and so they could be the target for vaccine programs. HAV-RNA was amplified from 29 (32.5%) IgM anti-HAV positive patients and 26 samples were sequenced and classified into subgenotypes IB (8 isolates) and IA (18 isolates). Isolates classified into subgenotype IB were identical representing one distinct strain. We could observe both subgenotypes circulating during the study which suggests different sources of infection. Prophylactic measures as vaccination strategies added to improvements in hygienic and sanitary conditions would be highly effective to reduction of infection.

Iowa Problem Indentification for Federal 402 State and Community Highway Safety Programs, Iowa Department of Public Safety, January, 2002

The major objective of this problem identification document is the determination of the relative severity of traffic safety problems in each of the 99 counties. The National Highway Traffic Safety Administration and the Iowa Governor's Traffic Safety Bureau are committed to the reduction of death and injury on the nation's roads. As part of its duty in administering federal traffic safety funds in the State of Iowa, the Governor's Traffic Safety Bureau conducts a comprehensive Problem Identification update each year.

Letter to the Colo-Nesco Community School District as a result of reaudit procedures performed at the request of the Superintendent pursuant to Chapter 11.6(4)(a)(2) of the Code of Iowa for the period July 1, 2007 through June 30, 2008

Letter to the Colo-Nesco Community School District as a result of reaudit procedures performed at the request of the Superintendent pursuant to Chapter 11.6(4)(a)(2) of the Code of Iowa for the period July 1, 2007 through June 30, 2008

Immunity to pneumococcal surface proteins in children with community-acquired pneumonia: a distinct pattern of responses to pneumococcal choline-binding protein A.

Clin Microbiol Infect ABSTRACT: The aetiological diagnosis of community-acquired pneumonia (CAP) is challenging in children, and serological markers would be useful surrogates for epidemiological studies of pneumococcal CAP. We compared the use of anti-pneumolysin (Ply) antibody alone or with four additional pneumococcal surface proteins (PSPs) (pneumococcal histidine triad D (PhtD), pneumococcal histidine triad E (PhtE), LytB, and pneumococcal choline-binding protein A (PcpA)) as serological probes in children hospitalized with CAP. Recent pneumococcal exposure (positive blood culture for Streptococcus pneumoniae, Ply(+) blood PCR finding, and PSP seroresponse) was predefined as supporting the diagnosis of presumed pneumococcal CAP (P-CAP). Twenty-three of 75 (31%) children with CAP (mean age 33.7 months) had a Ply(+) PCR finding and/or a ≥2-fold increase of antibodies. Adding seroresponses to four PSPs identified 12 additional patients (35/75, 45%), increasing the sensitivity of the diagnosis of P-CAP from 0.44 (Ply alone) to 0.94. Convalescent anti-Ply and anti-PhtD antibody titres were significantly higher in P-CAP than in non P-CAP patients (446 vs. 169 ELISA Units (EU)/mL, p 0.031, and 189 vs. 66 EU/mL, p 0.044), confirming recent exposure. Acute anti-PcpA titres were three-fold lower (71 vs. 286 EU/mL, p <0.001) in P-CAP children. Regression analyses confirmed a low level of acute PcpA antibodies as the only independent predictor (p 0.002) of P-CAP. Novel PSPs facilitate the demonstration of recent pneumococcal exposure in CAP children. Low anti-PcpA antibody titres at admission distinguished children with P-CAP from those with CAP with a non-pneumococcal origin.

Investigation of Earlham Community School District Employee’s Personal Use of a School Vehicle, July 6, 2012

We received a complaint in late September 2011 that an Earlham School District employee had borrowed a school vehicle for her personal use for one month, with the Superintendent’s permission. The school board had discussed the circumstances of the borrowed district vehicle in closed session. The complainant believed this was contrary to Iowa law and also believed no action had been taken against the school employee who borrowed the vehicle or the superintendent who allowed the personal use of the vehicle. He was aware the school district’s attorney reviewed the matter and determined the employee and superintendent violated no law or district policies. Since the school board discussed the matter only in closed session, it was unknown what, if any, discipline was taken against the employees and whether such actions were condoned by the district. We agreed to investigate to determine if the actions of school officials or employees violated Iowa law and if the response from the school board was appropriate.

Usefulness of betalactam therapy for community-acquired pneumonia in the era of drug-resistant Streptococcus pneumoniae: a randomized study of amoxicillin-clavulanate and ceftriaxone

Empirical antibiotic therapy of community-acquired pneumonia (CAP) has been complicated by the worldwide emergence of penicillin resistance among Streptococcus pneumoniae. The impact of this resistance on the outcome of patients hospitalized for CAP, empirically treated with betalactams, has not been evaluated in a randomized study. We conducted a prospective, randomized trial to assess the efficacy of amoxicillin-clavulanate (2 g/200 mg/8 hr) and ceftriaxone (1 g/24 hr) in a cohort of patients hospitalized for moderate-to-severe CAP. Three-hundred seventy-eight patients were randomized to receive amoxicillin-clavulanate (184 patients) or ceftriaxone (194 patients). Efficacy was assessed on Day 2, after completion of therapy and at long term follow-up. There were no significant differences in outcomes between treatment groups, both in intention-to-treat and per-protocol analysis. Overall mortality was 10.3% for amoxicillin-clavulanate and 8.8% for ceftriaxone (NS). There were 116 evaluable patients with proven pneumococcal pneumonia. Rates of high-level penicillin resistance (MIC of penicillin ≥2 µg/mL) were similar in the two groups (8.2 and 10.2%). Clinical efficacy at the end of therapy was 90.6% for amoxicillin-clavulanate and 88.9% for ceftriaxone (95% C.I. of the difference: -9.3 to +12.7%). No differences in outcomes were attributable to differences in penicillin susceptibility of pneumococcal strains. Sequential i.v./oral amoxicillin-clavulanate and parenteral ceftriaxone were equally safe and effective for the empirical treatment of acute bacterial pneumonia, including penicillin and cephalosporin-resistant pneumococcal pneumonia. The use of appropriate betalactams in patients with penumococcal pneumonia and in the overall CAP population, is reliable at the current level of resistance

Assessment of the water chemistry and the macroinvertebrate community changes produced during the creation of the new Llobregat river mouth (Barcelona, NE Spain)

In 1999, a set of coordinated projects and investments whose principal objective was to transform Barcelona into one of the main distribution points of southern Europe resulted in the relocation of the Llobregat River mouth. The mouth was relocated by draining the old river mouth and constructing a new one. The aim of this study was to characterise the physico-chemical properties and the aquatic macroinvertebrate communities of the new river mouth and to monitor the changes experienced by the estuarine environment during its creation. A sampling point was established in the river 1.8 km upstream from its connection with the new mouth, and two sampling points were established in the new mouth. Samples of water and macroinvertebrates were collected every two months from May 2004 to June 2005, covering the periods before (from May to September 2004) and after (from September 2004 to June 2005) the new mouth was connected to the river and the sea. During the period before its connection to the river and the sea, the new mouth was functionally similar to a lagoon, with clear waters, charophytes and a rich invertebrate community. After the connection was completed, seawater penetrated the river mouth and extended to the connection point with the river (approximately 3.9 km upstream). An increase in conductivity from 4-6 mS cm 1 to 24-30 mS cm 1 caused important changes in the macroinvertebrate community of the new mouth. An initial defaunation was followed by a colonisation of the new mouth by brackish-water and marine invertebrate species. Due to its design (which allows the penetration of the sea) and the decreased discharge from the lower part of the Llobregat River, the new mouth has become an arm of the sea

Thick XML client and technology of its construction

Nykyään kolmeen kerrokseen perustuvat client-server –sovellukset ovat suuri kinnostuskohde sekä niiden kehittäjille etta käyttäjille. Tietotekniikan nopean kehityksen ansiosta näillä sovelluksilla on monipuolinen käyttö teollisuuden eri alueilla. Tällä hetkellä on olemassa paljon työkaluja client-server –sovellusten kehittämiseen, jotka myös tyydyttävät asiakkaiden asettamia vaatimuksia. Nämä työkalut eivät kuitenkaan mahdollista joustavaa toimintaa graafisen käyttöliittyman kanssa. Tämä diplomityö käsittelee client-server –sovellusten kehittamistä XML –kielen avulla. Tämä lähestymistapa mahdollistaa client-server –sovellusten rakentamista niin, että niiden graafinen käyttöliittymä ja ulkonäkö olisivat helposti muokattavissa ilman ohjelman ytimen uudelleenkääntämistä. Diplomityö koostuu kahdesta ostasta: teoreettisesta ja käytännöllisestä. Teoreettinen osa antaa yleisen tiedon client-server –arkkitehtuurista ja kuvailee ohjelmistotekniikan pääkohdat. Käytannöllinen osa esittää tulokset, client-server –sovellusten kehittämisteknologian kehittämislähestymistavan XML: ää käyttäen ja tuloksiin johtavat usecase– ja sekvenssidiagrammit. Käytännöllinen osa myos sisältää esimerkit toteutetuista XML-struktuureista, jotka kuvaavat client –sovellusten kuvaruutukaavakkeiden esintymisen ja serverikyselykaaviot.

E-PORT. Improving efficiency of Finnish port community by intelligent systems Final report of the Mobile Port project

The management of port-related supply chains is challenging due to the complex and heterogeneous operations of the ports with several actors and processes. That is why the importance of information sharing is emphasised in the ports. However, the information exchange between different port-related actors is often cumbersome and it still involves a lot of manual work and paper. Major ports and port-related actors usually have advanced information systems in daily use but these systems are seldom interoperable with each other, which prevents economies of scale to be reached. Smaller ports and companies might not be equipped with electronic data transmission at all. This is the final report of the Mobile port (MOPO) project, which has sought ways to improve the management and control of port-related sea and inland traffic with the aid of ICT technologies. The project has studied port community systems (PCS) used worldwide, evaluated the suitability of a PCS for the Finnish port operating environment and created a pilot solution of a Finnish PCS in the port of HaminaKotka. Further, the dry port concept and its influences on the transportation system have been explored. The Mobile Port project comprised of several literature reviews, interviews of over 50 port-related logistics and/or ICT professionals, two different kinds of simulation models as well as designing and implementing of the pilot solution of the Finnish PCS. The results of these multiple studies are summarised in this report. Furthermore, recommendations for future actions and the topics for further studies are addressed in the report. The study revealed that the information sharing in a typical Finnish port-related supply chain contains several bottlenecks that cause delays in shipments and waste resources. The study showed that many of these bottlenecks could be solved by building a port community system for the Finnish port community. Almost 30 different kinds of potential services or service entities of a Finnish PCS were found out during the study. The basic requirements, structure, interfaces and operation model of the Finnish PCS were also defined in the study. On the basis of the results of the study, a pilot solution of the Finnish PCS was implemented in the port of HaminaKotka. The pilot solution includes a Portconnect portal for the Finnish port community system (available at https://www.portconnect.fi) and two pilot applications, which are a service for handling the information flows concerning the movements of railway wagons and a service for handling the information flows between Finnish ports and Finland-Russian border. The study also showed that port community systems can be used to improve the environmental aspects of logistics in two different ways: 1) PCSs can bring direct environmental benefits and 2) PCSs can be used as an environmental tool in a port community. On the basis of the study, the development of the Finnish port community system should be continued by surveying other potential applications for the Finnish PCS. It is also important to study if there is need and resources to extend the Finnish PCS to operate in several ports or even on a national level. In the long run, it could be reasonable to clarify whether there would be possibilities to connect the Finnish PCS as a part of Baltic Sea wide, European-wide or even worldwide maritime and port-related network in order to get the best benefit from the system

Weed community and growth under the canopy of trees adapted to the brazilian semi-arid region

The objectives of this work were to evaluate the floristic composition and dry biomass of weeds under the canopy of seven perennial species adapted to the Semi-Arid region of Brazil, and correlate these characteristics with growth traits of the perennial species. The following perennial species were evaluated in two experiments (E1 and E2): mesquite (Prosopis juliflora), jucá (Caesalpinia ferrea), white popinac (Leucaena leucocephala), mofumbo (Combretum leprosum), neem (Azadirachata indica), sabiá (Mimosa caesalpiniaefolia) and tamarind (Tamarindus indica). In E1, the seven species were evaluated in a random block design with four replicates and nine plants per plot. In E2, evaluation comprised four species (mesquite, jucá, white popinac, and tamarind) in a random block design with eight replicates and nine plants per plot. A circle with an area of 1.77 m² was established around the trunk of each plant, two years after they were transplanted to the permanent location. The weeds collected within this circle were cut even with the ground, classified and weighed. At this time, plant height, and crown and stem diameters were evaluated in all trees of each plot. In E1 there were no differences between tree species as to weed frequency under their canopies; however, weed growth was smaller under the canopy of sabiá trees. Mesquite and sabiá had the greatest plant height and crown diameter means, but only sabiá had the greatest stem diameter. In E2, the perennial species were not different with regard to weed frequency and growth under their canopies, but mesquite had the greatest growth, as measured by plant height (with significant results for jucá as well) and crown and stem diameter.