Empowering a group of seniors in a rural community

OBJECTIVE To describe the stages of the empowerment process of a group of seniors in a rural community. METHOD Convergent care research whose foundation is to use the scope of practice. Conducted with the proposal to change the practice of 21 seniors and nine health professionals, with the aim of health promotion empowerment. Data were collected during 22 meetings, and group interviews at the end of the intervention. RESULTS Showed that despite the initial impact of the change, the group was able to welcome the new change, taking advantage of the space to express anxieties, share joys, and build new knowledge, which led to the incorporation of changes that reflected in the development of healthy habits and improvements in interpersonal relationships. CONCLUSION The convergent care research consisted of strategy that changed the group's lives, empowering them with health promoting actions.

Educational Group Practices in Primary Care: Interaction Between Professionals, Users and Knowledge

OBJECTIVE To investigate the concept understood by Family Healthcare Strategy (ESF) professionals of knowledge, education and subjects participating in learning activities. METHOD Qualitative study carried out with the ESF professionals with university degree, members of the healthcare staff who undertook educational health group activities at Basic Healthcare Units (UBS) in Belo Horizonte. The following triangulation techniques were used: participant observation, photos and field notes; interviews with professionals; and document analysis. RESULTS We identified three interaction patterns that are different from each other. Firstly, the professional questions, listens and provides information to users, trusting in the transmission of knowledge; secondly, the professional questions and listens, trusting that users can learn from each other; thirdly, the professional questions, listens, discusses and produces knowledge with users, both teaching and learning from each other. CONCLUSION There are educational practices that include unique methods capable of creating a militant space for citizenship engagement.

Preliminary data on the geographical distribution of Drosophila species within morphoclimatic domains of Brazil. III. The cardini group

A reanalysis, based on museum specimens, of our previously published data on the geographical distribution of the species of Drosophila belonging to the cardini group in Brazil is presented and discussed. As previously recorded in several papers, including ours, the following four species were recognized: D. cardini, D. cardinoides, D. neocardini, and D. polymorpha. However, it was realized that most of the flies we have previously identified as Drosophila cardinoides belong in fact to Drosophila cardini. To facilitate the proper identification of these four near-sibling species, their holotypes were analyzed and their terminalia were described and illustrated. A key to the four species is also provided.

Phylogenetic relationships among four species of the guarani group of Drosophila (Diptera, Drosophilidae) as inferred by molecular and morphological analyses

Traditionally, the Drosophila guarani species group has been divided into two subgroups: the guarani and the guaramunu subgroups. Two, out of the four species included in this research, are members of the guarani subgroup (D. ornatifrons Duda, 1927 and D. subbadia Paterson & Mainland, 1943) and two are included in the guaramunu subgroup (D. maculifrons Duda, 1927 and D. griseolineata Duda, 1927). However, some authors have suggested that D. maculifrons and D. griseolineata are much closer to some species of the Drosophila tripunctata group than to some of the species of the guarani group. To add new data to the matter under dispute, Polyacrylamide Gel Eletrophoresis (PAGE-SDS) was used for the analysis and comparison of protein composition and Random Amplified Polymorphic DNA (RAPD) analysis to find differences in genomic DNA, in addition to the analysis of quantitative morphological characters previously described. Analysis of PAGE-SDS results in a dendrogram that pointed out D. subbadia as being the most distant within the Drosophila guarani group. However, these results were not supported either by RAPD analysis or by the analysis of continuous morphological characters, which supplied the clustering of D. subbadia with D. ornatifrons. Although our data give strong support to the clustering of D. subbadia and D. ornatifrons, none of the dendrograms provided a clade comprising D. maculifrons and D. griseolineata. Thus, this research does not support the traditional subdivision of the D. guarani group into those two subgroups.

The male of Mischocyttarus nomurae Richards, with a re-examination of the limits and contents of the M. cerberus species group (Hymenoptera, Vespidae, Polistinae, Mischocyttarini)

The male of Mischocyttarus nomurae Richards, 1978 is described for the first time, and relationships between this and other similar species are discussed in a context of redefining the limits of the M. cerberus species group.

Revision of the Leucosphyrus group of Anopheles (Cellia) (Diptera, Culicidae)

Revision of the Leucosphyrus Group of Anopheles (Cellia) (Diptera, Culicidae). This is a comprehensive revision of 20 species of the Leucosphyrus Group of the Neomyzomyia Series of Anopheles (Cellia). Morphological description of the adults, male and female, male genitalia, pupa and fourth-instar larva are provided for each taxon in addition to bionomics, distribution data and systematic discussion for each species, including diagnostic characters. Identification keys for females and fourth-instar larvae are provided. When possible medical importance of each species is included. Illustrations of of the adults, fourth-instar larvae and pupae are provided. Distribution maps for each species are mainly based on the material examined; however, when possible published data were also used. Tables on adult character variations, fourth-instar larval and pupal setal branching are included as appendices. A neotype for An. takasagoensis Morishita and An. sulawesi Koesoemawinangoen, and a lectotype for An. balabacensis Baisas, are designated. The authorship of An. sulawesi previously cited as Waktoedi is corrected to Koesoemawinangoen.

The small species of Belostoma Latreille (Heteroptera, Belostomatidae). III. A revision of oxyurum group, with a new species from Brazil and description of the male of B. noualhieri Montandon

Species of the oxyurum group (sensu Lauck) consist of five extant Neotropical small species, whose lengths range 15.0 to 20.0 mm. The anterior interocular width about 1.5 times the width of an eye and ventral diverticulum of phallus flattened, circular, and large are, in combination, diagnostic. The small species of the oxyurum group were included in the Lauck´s key to the identification of the species groups, without dealing with the species included in it because many of them are very similar in appearance. Therefore here we redescribe and key the Belostoma species of the oxyurum group. Belostoma oxyurum (Dufour) is newly recorded from Brazil (Paraná and Rio Grande do Sul). Holotype and lectotype are designated for B. oxyurum and B. sanctulum Montandon, respectively. The aspect of the prosternal keel, the ratio between the width of the ventral diverticulum of phallus and its length in ventral view, and the aspect of dorsal arms of ventral diverticulum have proven useful for better species delimitation. Based on specimens from Pará State (N. Brazil), Belostoma carajaensis Ribeiro & Estévez, sp. nov. is described and illustrated. This new species differs from B. sanctulum in having anteoculus shorter than interoculus and the dorsal arms of ventral diverticulum divergent and large. A male specimen of B. noualhieri Montandon was collected in São Paulo State and based mainly on features of male genitalia, this species is here also included under oxyurum group.

Veliidae (Insecta, Heteroptera, Gerromorpha) from southeastern Brazil: three new species from Rio de Janeiro State, a new species group for Neotropical Rhagovelia Mayr, and notes on distribution and synonymy

Microvelia nelsoni sp. nov., M. takiyae sp. nov., and Rhagovelia mangaratiba sp. nov. are described. Rhagovelia scitula and R. whitei are transferred from the robusta group to the new whitei group. Rhagovelia denticulata is synonymized under R. scitula. Microvelia longipes, Oiovelia brasiliensis, Rhagovelia sooretama, R. trianguloides, R. vaniniae, and Stridulivelia quadrispinosa are recorded for the first time from Rio de Janeiro State. Additional new municipality records in Rio de Janeiro State are presented for Microvelia braziliensis, M. ioana, M. mimula, M. pulchella, Paravelia basalis, P. itatiayana, Rhagovelia accedens, R. agra, R. aiuruoca, R. elegans, R. hambletoni, R. henryi, R. itatiaiana, R. lucida, R. macta, R. modesta, R. novana, R. scitula, R. tenuipes, R. tijuca, R. triangula, and R. zela. Corrections are presented for the previously published distributions of Rhagovelia aiuruoca, R. lucida, R. macta, and R. triangula.

A new Amazonian species from the Drosophila annulimana species group (Diptera, Drosophilidae)

Drosophila caxiuana sp. nov., Drosophila subgenus, is described and illustrated. This new species was collected in the Amazonian Biome (Caquajó river, Portel, Pará, Brazil) and is an atypical species to the group due the unusual morphology of the male terminalia.

Do fly parasites of bats and their hosts coevolve?speciation in Trichobius phyllostomae group (Diptera, Streblidae) and their hosts (Chiroptera, Phyllostomidae) suggests that they do not

We examined whether, like many parasite-host systems of coevolution, a group of obligate parasitic bat flies (Trichobius phyllostomae Kessel and related species) cospeciate with their hosts. We first did a cladistic analysis of the T. phyllostomae group and combined that analysis with a phylogenetic hypothesis from the literature for the Stenodermatinae bats. The cladistic analysis included, as outgroups, one species from each morphological group and complex of Trichobius Gervais, and one species from the following genera: Paratrichobius Miranda-Ribeiro, Megistopoda Macquart, Megistapophysys Dick & Wenzel, Neotrichobius Wenzel & Aitken, Speiseria Kessel and Strebla Wiedemann. The cladogram was rooted with a species of Strebla in the subfamily Streblinae. One cladogram was obtained and which found Trichobius to be polyphyletic. The phylogenetic hypothesis as follows: (Paratrichobius, (Neotrichobius, (Megistopoda, Megistapophysis)))) is the sister-group of the phyllostomae group and the following relationships within the ingroup, (((T. vampyropis Wenzel, Trichobius sp. 2) ((T. hispidus Wenzel, T. petersoni Wenzel) ((Trichobius sp. 1 (T. phyllostomae, T. brennani Wenzel))))). When we compared phylogenies through historical association analyses, cospeciation was uncommon, while host-switching was more common and better explained the association between the phyllostomae group and their bat hosts.

Notes on social wasps of the group of Mischocyttarus(Omega) punctatus (Ducke), with description of six new species (Hymenoptera, Vespidae, Polistinae)

ABSTRACTA revision of the taxonomic status and an identification key for wasp species of the genus Mischocyttarus related to M. punctatus (Ducke, 1904) are presented here. Six new species are proposed (M. tayrona Silveira sp. nov.; M. anchicaya Silveira sp. nov.; M. caxiuana Silveira sp. nov.; M. verissimoi Silveira sp. nov.; M. rodriguesi Silveira sp. nov.; M. ryani Silveira sp. nov.), raising to nine the number of species in the M. punctatus group. The highest diversity of the group concentrates in northern South America, in Andean areas and Amazonia. New information concerning the very peculiar nests of these wasps is also given.

A new species of Aguna Williams (Lepidoptera, Hesperiidae) from Panamá belonging to the “claxon group”

ABSTRACT A new species of Aguna Williams, 1927 from Panamá is described: Aguna prasinus Siewert, Leviski, Mielke & Casagrande, sp. nov. Illustrations of adults and male genitalia are provided. A dichotomous key for the male Aguna species for the “claxon group” is also provided.

How many diagnosis fields are needed to capture safety events in administrative data? Findings and recommendations from the WHO ICD-11 Topic Advisory Group on Quality and Safety

OBJECTIVE: As part of the WHO ICD-11 development initiative, the Topic Advisory Group on Quality and Safety explores meta-features of morbidity data sets, such as the optimal number of secondary diagnosis fields. DESIGN: The Health Care Quality Indicators Project of the Organization for Economic Co-Operation and Development collected Patient Safety Indicator (PSI) information from administrative hospital data of 19-20 countries in 2009 and 2011. We investigated whether three countries that expanded their data systems to include more secondary diagnosis fields showed increased PSI rates compared with six countries that did not. Furthermore, administrative hospital data from six of these countries and two American states, California (2011) and Florida (2010), were analysed for distributions of coded patient safety events across diagnosis fields. RESULTS: Among the participating countries, increasing the number of diagnosis fields was not associated with any overall increase in PSI rates. However, high proportions of PSI-related diagnoses appeared beyond the sixth secondary diagnosis field. The distribution of three PSI-related ICD codes was similar in California and Florida: 89-90% of central venous catheter infections and 97-99% of retained foreign bodies and accidental punctures or lacerations were captured within 15 secondary diagnosis fields. CONCLUSIONS: Six to nine secondary diagnosis fields are inadequate for comparing complication rates using hospital administrative data; at least 15 (and perhaps more with ICD-11) are recommended to fully characterize clinical outcomes. Increasing the number of fields should improve the international and intra-national comparability of data for epidemiologic and health services research, utilization analyses and quality of care assessment.

Oral Antibiotics for Fever in Low-Risk Neutropenic Patients With Cancer: A Double-Blind, Randomized, Multicenter Trial Comparing Single Daily Moxifloxacin With Twice Daily Ciprofloxacin Plus Amoxicillin/Clavulanic Acid Combination Therapy--EORTC Infectious Diseases Group Trial XV.

PURPOSE This double-blind, multicenter trial compared the efficacy and safety of a single daily oral dose of moxifloxacin with oral combination therapy in low-risk febrile neutropenic patients with cancer. PATIENTS AND METHODS Inclusion criteria were cancer, febrile neutropenia, low risk of complications as predicted by a Multinational Association for Supportive Care in Cancer (MASCC) score > 20, ability to swallow, and ≤ one single intravenous dose of empiric antibiotic therapy before study drug treatment initiation. Early discharge was encouraged when a set of predefined criteria was met. Patients received either moxifloxacin (400 mg once daily) monotherapy or oral ciprofloxacin (750 mg twice daily) plus amoxicillin/clavulanic acid (1,000 mg twice daily). The trial was designed to show equivalence of the two drug regimens in terms of therapy success, defined as defervescence and improvement in clinical status during study drug treatment (< 10% difference). Results Among the 333 patients evaluated in an intention-to-treat analysis, therapy success was observed in 80% of the patients administered moxifloxacin and in 82% of the patients administered combination therapy (95% CI for the difference, -10% to 8%, consistent with equivalence). Minor differences in tolerability, safety, and reasons for failure were observed. More than 50% of the patients in the two arms were discharged on protocol therapy, with 5% readmissions among those in either arm. Survival was similar (99%) in both arms. CONCLUSION Monotherapy with once daily oral moxifloxacin is efficacious and safe in low-risk febrile neutropenic patients identified with the help of the MASCC scoring system, discharged early, and observed as outpatients.

Soft tissue sarcomas of the trunk wall (STS-TW): a study of 343 patients from the French Sarcoma Group (FSG) database.

BACKGROUND: Soft tissue sarcomas of the trunk wall (STS-TW) are usually studied together with soft tissue sarcomas of other locations. We report a study on STS-TW forming part of the French Sarcoma Group database. PATIENTS AND METHODS: Three hundred and forty-three adults were included. We carried out univariate and multivariate analysis for overall survival (OS), metastasis-free survival (MFS) and local recurrence-free survival (LRFS). RESULTS: Tumor locations were as follows: thoracic wall, 82.5%; abdominal wall, 12.3% and pelvic wall, 5.2%. Median tumor size was 6.0 cm. The most frequent tumor types were unclassified sarcoma (27.7%) and myogenic sarcoma (19.2%). A total of 44.6% of cases were grade 3. In all, 21.9% of patients had a previous medical history of radiotherapy (PHR). Median follow-up was 7.6 years. The 5-year OS, MFS and LRFS rates were 60.4%, 68.9% and 58.4%, respectively. Multivariate analysis retained PHR and grade for predicting LRFS and PHR, size and grade as prognostic factors of MFS. Factors influencing OS were age, size, PHR, depth, grade and surgical margins. The predictive factors of incomplete response were PHR, size and T3. CONCLUSIONS: Our results suggest similar classical prognostic factors as compared with sarcomas of other locations. However, a separate analysis of STS-TW revealed a significant poor prognosis subgroup of patients with PHR.