How do driver compensation schemes affect bus system performance?: a comparison between fixed wage and "guerra por el boleto" in Santiago, Chile.

Two systems of bus driver compensation exist in Santiago, Chile. The majority of drivers are paid per passenger transported, which leads to drivers trying to maximize the number of passengers each one conveys. Some of these effects are beneficial, such as a more active effort to minimize the problem of bus bunching, while others, such as aggressive driving, can be harmful. Drivers are said to "race" and the term "War for the Fare" is commonly used. Drivers also pay freelance workers called "sapos" to provide spacing information. Similar phenomena occur in other Latin American capitals.The other system, a fixed wage, is used by 2 companies holding recently awarded concessions for routes feeding metro stations.This paper discusses, quantitatively and qualitatively, the effects of these two compensation systems on accidents, quality of service, attitudes of both users and drivers, and average waiting times for passengers.

Physical activity, adiposity and hypertension among patients of public healthcare system

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

Constraints on the teaching work: the use of experimental activities in a Municipal Public School System

O trabalho escolar pode ser concebido como o resultado de complexas relações entre as prescrições legais, os diversos atores e as condições materiais da realidade objetiva de determinada escola, apresentando diferentes dimensões que condicionam seu desenvolvimento, envolvendo aspectos de natureza organizacionalestrutural e de natureza político-ideológica. O presente trabalho é resultado do curso de extensão realizado com professoras de ciências naturais de uma rede escolar pública municipal. Utilizando a abordagem de pesquisa qualitativa do tipo estudo de caso, objetivamos identificar os principais condicionantes que atuam sobre o trabalho docente e que são responsáveis pela baixa frequência de utilização de atividades experimentais. Os condicionantes identificados no estudo realizado se enquadraram em quatro fatores: relacionados à organização da escola e das aulas; ligados às condições estruturais e materiais; relacionados ao professor; e relacionados ao comportamento do aluno.

Accumulation of domain-specific physical inactivity and presence of hypertension in brazilian public healthcare system

Hypertension is one of the most common noncommunicable diseases worldwide, and physical inactivity is a risk factor predisposing to its occurrence and complications. However, it is still unclear the association between physical inactivity domains and hypertension, especially in public healthcare systems. Thus, this study aimed to investigate the association between physical inactivity aggregation in different domains and prevalence of hypertension among users of Brazilian public health system. 963 participants composed the sample. Subjects were divided into quartiles groups according to three different domains of physical activity (occupational; physical exercises; and leisure-time and transportation). Hypertension was based on physician diagnosis. Physical inactivity in occupational domain was significantly associated with higher prevalence of hypertension (OR = 1.52 [1.05 to 2.21]). The same pattern occurred for physical inactivity in leisure-time (OR = 1.63 [1.11 to 2.39]) and aggregation of physical inactivity in three domains (OR = 2.46 [1.14 to 5.32]). However, the multivariate-adjusted model showed significant association between hypertension and physical inactivity in three domains (OR = 2.57 [1.14-5.79]). The results suggest an unequal prevalence of hypertension according to physical inactivity across different domains and increasing the promotion of physical activity in the healthcare system is needed.

Work conditions and occupational health of dentists in Brazilian public health system

Conselho Nacional de Desenvolvimento Ciêntífico e Tecnológico (CNPq)

Prevalence and Predictors of Potential Drug-Drug Interactions in the Elderly: A Cross-Sectional Study in the Brazilian Primary Public Health System

Purpose. The primary objective of this study was to investigate the prevalence of clinically important potential drug-drug interactions (DDIs) in elderly patients attending the public primary health care system in Brazil. The secondary objective was to investigate possible predictors of potential DDIs. Methods. A cross-sectional study was carried out in 5 Brazilian cities located in the Ourinhos Micro-region, Sao Paulo State, between November 2010 and April 2011. The selected sample was divided according to the presence (exposed) or absence (unexposed) of one or more potential DDIs (defined as the presence of a minimum 5-day overlap in supply of an interacting drug pair). Data were collected from medical prescriptions and patients' medical records. Potential DDIs (rated major or moderate) were identified using 4 DDI-checker programs. Logistic regression analysis was used to study potential DDI predictors. Results. The prevalence of clinically important potential DDIs found during the study period was 47.4%. Female sex (OR = 2.49 [95% CI 2.29-2.75]), diagnosis of = 3 diseases (OR = 6.43 [95% CI 3.25-12.44]), and diagnosis of hypertension (OR = 1.68 [95% CI 1.23-2.41]) were associated with potential DDIs. The adjusted OR increased from 0.90 [95% CI 0.82-1.03] in patients aged 60 - 64 years to 4.03 [95% CI 3.79 - 4.28] in those aged 75 years or older. Drug therapy regimens involving = 2 prescribers (OR = 1.39 [95% CI 1.17-1.67]), = 3 drugs (OR = 3.21 [95% CI 2.78-3.59]), = 2 ATC codes (OR = 1.19 [95% CI 1.12-1.29]), = 2 drugs acting on cytochrome P450 (OR = 2.24 [95% CI 2.07-2.46]), and ATC codes B (OR = 1.89 [95% CI 1.05-2.08]) and C (OR = 4.01 [95% CI 3.55-4.57]) were associated with potential DDIs. Conclusion. Special care should be taken with the prescription and therapeutic follow-up of patients who present characteristics identified as predictors. Knowledge of potential DDI predictors could aid in developing preventive practices and policies that allow public health services to better manage this situation.

Evaluation of quality of life in severely obese patients after bariatric surgery carried out in the public healthcare system

Objectives: To assess QoL of obese patients in the Brazilian public healthcare system, before and after bariatric surgery, and to determine the appropriateness of the Moorehead-Ardelt Questionnaire II (M-A-QoLQII) compared with the Short-Form Health Survey (SF-36). Subjects and methods: Forty-one severe obese patients in a waiting-list, and 84 patients who underwent bariatric surgery were included. Correlations were tested and reliability determined by the Cronbach's coefficient. Results: BMI differed between the pre- and post-surgery groups (52.3 +/- 8.3 kg/m(2) vs. 32.5 +/- 6.4 kg/m(2), p < 0.001). The latter showed better scores in the SF-36 domains than in the pre-surgery. SF-36 and M-A-QoLQII categories were correlated (r = 0.53, 0.49 and 0.47, for vitality, mental health, and general health domains, p < 0.001). In the logistic regression, age, previous BMI, and loss of excess weight were associated with functional capacity. Conclusions:The outcomes of bariatric surgery obtained in a Brazilian public healthcare center were successful. M-A-QoLII represents a useful tool to assess surgery outcomes, including QoL. Arq Bras Endocrinol Metab. 2012;56(1):33-8

Cardiometabolic risk reduction through lifestyle intervention programs in the Brazilian public health system

Public health strategies to reduce cardiovascular morbidity and mortality should focus on global cardiometabolic risk reduction. The efficacy of lifestyle changes to prevent type 2 diabetes have been demonstrated, but low-cost interventions to reduce cardiometabolic risk in Latin-America have been rarely reported. Our group developed 2 programs to promote health of high-risk individuals attending a primary care center in Brazil. This study compared the effects of two 9-month lifestyle interventions, one based on medical consultations (traditional) and another with 13 multi-professional group sessions in addition to the medical consultations (intensive) on cardiometabolic parameters. Adults were eligible if they had pre-diabetes (according to the American Diabetes Association) and/or metabolic syndrome (International Diabetes Federation criteria for Latin-America). Data were expressed as means and standard deviations or percentages and compared between groups or testing visits. A p-value < 0.05 was considered significant. Results: 180 individuals agreed to participate (35.0% men, mean age 54.7 ± 12.3 years, 86.1% overweight or obese). 83 were allocated to the traditional and 97 to the intensive program. Both interventions reduced body mass index, waist circumference and tumor necrosis factor-α. Only intensive program reduced 2-hour plasma glucose and blood pressure and increased adiponectin values, but HDL-cholesterol increased only in the traditional. Also, responses to programs were better in intensive compared to traditional program in terms of blood pressure and adiponectin improvements. No new case of diabetes in intensive but 3 cases and one myocardial infarction in traditional program were detected. Both programs induced metabolic improvement in the short-term, but if better results in the intensive are due to higher awareness about risk and self-motivation deserves further investigation. In conclusion, these low-cost interventions are able to minimize cardiometabolic risk factors involved in the progression to type 2 diabetes and/or cardiovascular disease.

How Does the Denver Public Library System Respond to its Customer's Requests for Global Information?

The interaction between globally available information and public library users is a changing one. Global information is readily available yet provider and user struggle to find efficiencies of time and resources. As a primary resource of global information the Denver Public Library (DPL) is approaching this challenge by providing changing technology to a changing user and by providing a customized approach to immigrant populations. DPL provides global information to library users through collections, programs and Internet. Internet and collections global information usage cannot be directly measured due to privacy restrictions. Only 12.5% of general user programs focus on global information. Four percent of budget serves the immigrant users. This is greater than national averages.

The crucial test of the public school system /

At head of title: University of Illinois.

Public land system of the United States. : Historical outline /

At head of title: Department of the interior. General land office.

Report of the survey of the public school system of Baltimore, Md.,

Mode of access: Internet.

Synopsis of a plan for the thoro reorganization of the American public school system on lines to be exemplified by a model school, tentatively designated "The people's new education advanced common school" /

Cover title.