The variability and predictors of quality of AIDS care services in Brazil

Background: Since establishing universal free access to antiretroviral therapy in 1996, the Brazilian Health System has increased the number of centers providing HIV/AIDS outpatient care from 33 to 540. There had been no formal monitoring of the quality of these services until a survey of 336 AIDS health centers across 7 Brazilian states was undertaken in 2002. Managers of the services were asked to assess their clinics according to parameters of service inputs and service delivery processes. This report analyzes the survey results and identifies predictors of the overall quality of service delivery.Methods: The survey involved completion of a multiple-choice questionnaire comprising 107 parameters of service inputs and processes of delivering care, with responses assessed according to their likely impact on service quality using a 3-point scale. K-means clustering was used to group these services according to their scored responses. Logistic regression analysis was performed to identify predictors of high service quality.Results: The questionnaire was completed by 95.8% (322) of the managers of the sites surveyed. Most sites scored about 50% of the benchmark expectation. K-means clustering analysis identified four quality levels within which services could be grouped: 76 services (24%) were classed as level 1 (best), 53 (16%) as level 2 (medium), 113 (35%) as level 3 (poor), and 80 (25%) as level 4 (very poor). Parameters of service delivery processes were more important than those relating to service inputs for determining the quality classification. Predictors of quality services included larger care sites, specialization for HIV/AIDS, and location within large municipalities.Conclusion: The survey demonstrated highly variable levels of HIV/AIDS service quality across the sites. Many sites were found to have deficiencies in the processes of service delivery processes that could benefit from quality improvement initiatives. These findings could have implications for how HIV/AIDS services are planned in Brazil to achieve quality standards, such as for where service sites should be located, their size and staffing requirements. A set of service delivery indicators has been identified that could be used for routine monitoring of HIV/AIDS service delivery for HIV/AIDS in Brazil (and potentially in other similar settings).

Evaluation of Laser Fluorescence in the Monitoring of the Initial Stage of the De-/Remineralization Process: An in vitro and in situ Study

This study aimed to evaluate laser fluorescence (LF) for monitoring the initial stage of subsurface de- and remineralization (<150 mu m depth). Ninety-six sound blocks of bovine enamel, selected according to surface hardness (SH) and LF were used in two experimental studies, in vitro and in situ. In vitro, blocks were exposed to a demineralizing solution, then remineralized by pH cycling for 6 days. In situ, 10 volunteers wore acrylic palatal appliances, each containing 4 dental enamel blocks that were demineralized for 14 days by exposure to 20% sucrose solution. Following this treatment, blocks were submitted to remineralization for 1 week with fluoride dentifrice (1,100 mu g F/g). In both experiments, SH and LH were measured after demineralization and after remineralization. Further, enamel blocks were selected after the demineralization/remineralization steps for measurement of cross-sectional hardness and integrated loss of subsurface hardness (Delta KHN). SH and Delta KHN showed significant differences among the phases in each study. LF values for sound, demineralized and remineralized enamel were: 5.2 +/- 1.1, 8.1 +/- 1.2 and 5.6 +/- 0.8, respectively, in the in vitro study, and 5.3 +/- 0.3, 16.5 +/- 4.7 and 6.5 +/- 2.5, respectively, in the in situ study, values for demineralized enamel being significantly higher than for sound and remineralized enamel in both studies. However, LF was correlated with Delta KHN only in situ. LF was capable of monitoring de- and remineralization in early lesions in situ, when bacteria are presumably present in the caries lesion body, but is not correlated with mineral changes in bacteria-free systems. Copyright (C) 2009 S. Karger AG, Basel

Genetic monitoring of the Amazonian fish matrincha (Brycon cephalus) using RAPD markers: insights into supportive breeding and conservation programmes

The importance of genetic evaluations in aquaculture programmes has been increased significantly not only to improve effectiveness of hatchery production but also to maintain genetic diversity. In the present study, wild and captive populations of a commercially important neotropical freshwater fish, Brycon cephalus (Amazonian matrincha), were analyzed in order to evaluate the levels of genetic diversity in a breeding programme at a Brazilian research institute of tropical fish. Random Amplified Polymorphic DNA fingerprinting was used to access the genetic variability of a wild stock from the Amazon River and of three captive stocks that correspond to consecutive generations from the fishery culture. Although farmed stocks showed considerably lower genetic variation than the wild population, a significantly higher level of polymorphism was detected in the third hatchery generation. The results seem to reflect a common breeding practice on several hatchery fish programmes that use a small number of parents as broodstocks, obtaining reproductive success with few non-identified mating couples. The obtained data were useful for discussing suitable strategies for the genetic management and biodiversity conservation of this species.

Occurrence and behavior of butyltins in intertidal and shallow subtidal surface sediments of an estuarine beach under different sampling conditions

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

Global stratigraphy, palaeobiogeography and palaeoecology of Albian-Maastrichtian pithonellid calcispheres: impact on Tethys configuration

This study reviews the stratigraphy, palaeobiogeography and palaeoecology of some important Albian-Maastrichtian pelagic calcispheres: Bonetocardiella conoidea, Pithonella ovalis, P. perlonga, P. sphaerica and P. trejoi. It also presents a significant new data set on these organisms from the western South Atlantic Ocean. The group reached its acme simultaneously all over the world during the highest Cretaceous sea level in late Albian to Coniacian times. A strong association also existed between the maximum temperature and the salinity of the Tethyan water mass and the climax of these opportunistic microfossils. Their remarkable presence along the Brazilian and west African margins during the Albian, in association with other typical Tethyan pelagic biotic elements, indicates that during this period the northern South Atlantic was a long, narrow arm of the Tethys Sea. (C) 2000 Academic Press.

SAXS and UV-Vis combined to Quick-XAFS monitoring of ZnO nanoparticles formation and growth

Time-resolved X-ray absorption-fine structure (Quick-XAFS) and UV-Vis absorption spectroscopies were combined for monitoring simultaneously the time evolution of Zn-based species and ZnO quantum dot (Qdot) formation and growth during the sol-gel synthesis from zinc oxy-acetate precursor solution. The time evolution of the nanostructural features of colloidal suspension was independently monitored in situ by small angle X-ray scattering (SAXS). In both cases, the monitoring was initialized just after the addition of NaOH solution (B = [OH]/[Zn] = 0.5) to the precursor solution at 40 degrees C. Combined time-resolved Quick-XAFS and UV-Vis data showed that the formation of ZnO colloids from the zinc oxy-acetate consumption achieves a quasi-steady-state chemical equilibrium in less than 200s. Afterwards, the comparison of the ZnO Qdots size and Guinier gyration radius evidences a limited aggregation process coupled to the Qdots growth. The analysis of the experimental results demonstrates that the nanocrystal coalescence and Ostwald ripening control the kinetics of the Qdot growth.

QEXAFS and UV/Vis Simultaneous Monitoring of the TiO2-Nanoparticles Formation by Hydrolytic Sol-Gel Route

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Frequency of the BCR/ABL rearrangements and associated alterations detected by FISH during monitoring of patients taking imatinib mesylate in isolation

A introdução do mesilato de imatinibe como tratamento da leucemia mielóide crônica tem salvado muitos pacientes, mas o sucesso da terapia tem sido prejudicado pela resistência e possível não destruição do clone maligno. Este artigo descreve a resposta citogenética e padrões citogenéticos anormais envolvendo os genes ABL e BCR detectados por FISH em pacientes em uso exclusivo de imatinibe. Os resultados mostraram que outras alterações envolvendo os genes BCR e ABL não parecem estar relacionadas à resistência à droga, elas ocorrem em baixas freqüências e podem não estar associadas à resposta citogenética ou ao tempo de tratamento. Contudo, a resposta ao imatinibe parece ser individual e imprevisível, independente do tempo e do início do tratamento após o diagnóstico.

Reliability and validation of a Brazilian version of the Oral Health Impact Profile for assessing edentulous subjects

The aims of this study were to evaluate the reliability and to validate a Brazilian version of Oral Health Impact Profile for assessing edentulous subjects (OHIP-EDENT), an inventory for measuring oral health-related quality of life of edentulous subjects. The sample comprised 65 complete denture wearers (23 men, mean age of 69.1 +/- 10.3 years). The translated OHIP-EDENT was applied on two occasions with a washout period of 3 months. Reliability was assessed by an internal consistency analysis and a test-retest approach. A preliminary validation process was conducted by a qualitative approach/interview. Results of internal consistency showed a Cronbach's alpha of 0.86 or 0.90 for the first or second appointment respectively. Through the test-retest analysis, an intra-class correlation coefficient of 0.57 was found, and individual answers reflected a broad range of agreement. Interviewed volunteers (n = 6) comprehended most questions well. In conclusion, the Brazilian version of OHIP-EDENT is adequate for assessing the oral health-related quality of life for edentulous subjects.

In Situ and Simultaneous UV-vis/SAXS and UV-vis/XAFS Time-Resolved Monitoring of ZnO Quantum Dots Formation and Growth

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

Selection of radio transmitter and attachment method for post-release monitoring of captive-bred reintroduced Red-billed Curassow Crax blumenbachii, Brazil

Long-term monitoring of reintroduced individuals is a central component of many endangered species reintroduction programs. Radio-telemetry techniques are rarely used to monitor reintroduced captive-bred Cracids and few data exist regarding possible adverse effects of radio-tagging Cracids. In this study, we identify an appropriate radio transmitter design and develop a suitable attachment method that minimizes anthropogenic influence and enables long-term, post-release monitoring (2-3 years) of reintroduced captive-bred Red-billed Curassows in the Brazilian Atlantic Rainforest. We also review studies about the effects of different VHF radio transmitter models on survival, reproduction, behavior, and physiology of Galliformes.

RESTRUCTURING of SYSTEMS and LOGISTICS of MOVEMENT and ITS IMPACT on URBAN and REGIONAL PLANNING PAULISTA

Report some of the changes in production and consumption occurring in the state of São Paulo. through the restructuring in motion systems, logistics and standards and taxation, as well as the impacts on urban spaces through new economic dynamics, imposed by the demands of corporate, is the purpose of this article. The decentralization of production and consumption towards the interior was made possible by the combination of hierarchical and ordered some basic elements such as technological innovations (ways and means of transport) and organizational (logistics, standards and taxation) which optimized the flow territorial state São Paulo. It is noteworthy, therefore: 1) the improvement of logistics as a strategy, planning and management of transport, storage and communications (including the granting of public services to private), 2) the technological improvement and expansion of motion systems (infrastructure, means of transport) and 3) the systems of rules and regulations through taxation and deregulation affect the circulatory system of a given space. Thus, both systems aims to disentangle the economic flows (goods, services, information, capital and people) and provide a more fluid territorial. The impacts on the State of São Paulo, mainly through its economic dynamics, revert positively and negatively, by changing the way one thinks and performs planning.

Trade and financial liberalization in the context of external shocks and inconsistent domestic policies

Includes bibliography

Millennium development goals. 2006 report: a look at gender equality and empowerment of women in Latin America and the Caribbean

Includes bibliography

Labour markets, worker protection and lifelong learning in a global economy: experiences and perspectives of Latin America and the Caribbean

Includes bibliography