Spatial distribution and socioeconomic context of tuberculosis in Rio de Janeiro, Brazil

OBJECTIVE To analyze the spatial distribution of risk for tuberculosis and its socioeconomic determinants in the city of Rio de Janeiro, Brazil.METHODS An ecological study on the association between the mean incidence rate of tuberculosis from 2004 to 2006 and socioeconomic indicators of the Censo Demográfico (Demographic Census) of 2000. The unit of analysis was the home district registered in the Sistema de Informação de Agravos de Notificação (Notifiable Diseases Information System) of Rio de Janeiro, Southeastern Brazil. The rates were standardized by sex and age group, and smoothed by the empirical Bayes method. Spatial autocorrelation was evaluated by Moran’s I. Multiple linear regression models were studied and the appropriateness of incorporating the spatial component in modeling was evaluated.RESULTS We observed a higher risk of the disease in some neighborhoods of the port and north regions, as well as a high incidence in the slums of Rocinha and Vidigal, in the south region, and Cidade de Deus, in the west. The final model identified a positive association for the variables: percentage of permanent private households in which the head of the house earns three to five minimum wages; percentage of individual residents in the neighborhood; and percentage of people living in homes with more than two people per bedroom.CONCLUSIONS The spatial analysis identified areas of risk of tuberculosis incidence in the neighborhoods of the city of Rio de Janeiro and also found spatial dependence for the incidence of tuberculosis and some socioeconomic variables. However, the inclusion of the space component in the final model was not required during the modeling process.

ERICA: smoking prevalence in Brazilian adolescents

ABSTRACT OBJECTIVE To estimate the prevalences of tobacco use, tobacco experimentation, and frequent smoking among Brazilian adolescents. METHODS We evaluated participants of the cross-sectional, nation-wide, school-based Study of Cardiovascular Risks in Adolescents (ERICA), which included 12- to 17-year-old adolescents from municipalities of over 100 thousand inhabitants. The study sample had a clustered, stratified design and was representative of the whole country, its geographical regions, and all 27 state capitals. The information was obtained with self-administered questionnaires. Tobacco experimentation was defined as having tried cigarettes at least once in life. Adolescents who had smoked on at least one day over the previous 30 days were considered current cigarette smokers. Having smoked cigarettes for at least seven consecutive days was an indicator for regular consumption of tobacco. Considering the complex sampling design, prevalences and 95% confidence intervals were estimated according to sociodemographic and socio-environmental characteristics. RESULTS We evaluated 74,589 adolescents. Among these, 18.5% (95%CI 17.7-19.4) had smoked at least once in life, 5.7% (95%CI 5.3-6.2) smoked at the time of the research, and 2.5% (95%CI 2.2-2.8) smoked often. Adolescents aged 15 to 17 years had higher prevalences for all indicators than those aged 12 to 14 years. The prevalences did not differ significantly between sexes. The highest prevalences were found in the South region and the lowest ones, in the Northeast region. Regardless of sex, the prevalences were found to be higher for adolescents who had had paid jobs, who lived with only one parent, and who reported having been in contact with smokers either inside or outside their homes. Female public school adolescents were found to smoke more than the ones from private schools. CONCLUSIONS Tobacco use among adolescents is still a challenge. Intending to reduce the prevalence of tobacco use among young people, especially the ones under socioeconomic vulnerability conditions, Brazil must consolidate and increase effective public health care measures.

Habitação modular evolutiva

Da necessidade de criação de habitações que se adaptem ao constante dinamismo do ser humano, surgiu a ideia da concepção de um edifício evolutivo com base na construção modular. A construção modular poderá ser entendida como sendo a principal resposta ao combate da construção de estruturas físicas e imóveis, com características inalteráveis ao longo do tempo. Com este trabalho idealizou-se uma habitação evolutiva, baseado nos conceitos da Coordenação Modular, identificando-se as suas especificações, exigências de desempenho e características funcionais. Foi considerada como medida modular base 0,10m. Os módulos foram pensados com o intuito de que o seu desempenho prático seja satisfatório. A sua base estrutural foi executada a partir do rearranjo de contentores marítimos. Previu-se ainda, o uso de coberturas verdes por serem uma solução comprovada de minorar notoriamente o efeito pernicioso que a construção tem sobre o meio ambiente, ao mesmo tempo que apresentam vantagens térmicas e acústicas. A questão do incentivo do uso da pré-fabricação em Portugal a uma maior escala, não poderia ser descurada. A apresentação de eventuais desenvolvimentos futuros é também relevante, dada a importância que é inerente ao âmbito da industrialização da construção. Do estudo realizado ficaram ainda, bem patentes, os benefícios da racionalização e da industrialização, tanto em termos económicos como em termos ambientais. É possível executar um projecto com níveis de perdas mais baixos e com índices de qualidade superiores a um menor preço.

Radiological impact associated to Technologically Enhanced Naturally Occurring Radioactive Materials (TENORM) from coal-fired power plants emissions

Certain materials used and produced in a wide range of non-nuclear industries contain enhanced activity concentrations of natural radionuclides. In particular, electricity production from coal is one of the major sources of increased human exposure to naturally occurring radioactive materials. A methodology was developed to assess the radiological impact due to natural radiation background. The developed research was applied to a specific case study, the Sines coal-fired power plant, located in the southwest coastline of Portugal. Gamma radiation measurements were carried out with two different instruments: a sodium iodide scintillation detector counter (SPP2 NF, Saphymo) and a gamma ray spectrometer with energy discrimination (Falcon 5000, Canberra). Two circular survey areas were defined within 20 km of the power plant. Forty relevant measurements points were established within the sampling area: 15 urban and 25 suburban locations. Additionally, ten more measurements points were defined, mostly at the 20-km area. The registered gamma radiation varies from 20 to 98.33 counts per seconds (c.p.s.) corresponding to an external gamma exposure rate variable between 87.70 and 431.19 nGy/h. The highest values were measured at locations near the power plant and those located in an area within the 6 and 20 km from the stacks. In situ gamma radiation measurements with energy discrimination identified natural emitting nuclides as well as their decay products (Pb-212, Pb-2142, Ra-226, Th-232, Ac-228, Th-234, Pa-234, U- 235, etc.). According to the results, an influence from the stacks emissions has been identified both qualitatively and quantitatively. The developed methodology accomplished the lack of data in what concerns to radiation rate in the vicinity of Sines coal-fired power plant and consequently the resulting exposure to the nearby population.

Measurements of environmental background radiation in the surrounding area of a coal-fired power plant

Certain materials used and produced in a wide range of non-nuclear industries contain enhanced activity concentrations of natural radionuclides. In particular, electricity production from coal is one of the major sources of increased exposure to man from enhanced naturally occurring materials. Over the past decades there has been some discussion about the elevated natural background radiation in the area near coal-fired power plants due to high uranium and thorium content present in coal. This work describes the methodology developed to assess the radiological impact due to natural radiation background increasing levels, potentially originated by a coal-fired power plant’s operation. Gamma radiation measurements have been done with two different instruments: a scintillometer (SPP2 NF, Saphymo) and a gamma ray spectrometer with energy discrimination (Falcon 5000, Canberra). A total of 40 relevant sampling points were established at locations within 20 km from the power plant: 15 urban and 25 suburban measured stations. The highest values were measured at the sampling points near to the power plant and those located in the area within the 6 and 20 km from the stacks. This may be explained by the presence of a huge coal pile (1.3 million tons) located near the stacks contributing to the dispersion of unburned coal and, on the other hand, the height of the stacks (225 m) which may influence ash’s dispersion up to a distance of 20 km. In situ gamma radiation measurements with energy discrimination identified natural emitting nuclides as well as their decay products (212Pb, 214Pb, 226Ra 232Th, 228Ac, 234Th 234Pa, 235U, etc.). This work has been primarily done to in order to assess the impact of a coal-fired power plant operation on the background radiation level in the surrounding area. According to the results, an increase or at least an influence has been identified both qualitatively and quantitatively.

Particulate matter flux deposition in the vicinity of a coal-fired power plant

This paper describes the methodology adopted to assess local air quality impact in the vicinity of a coal power plant located in the south of Portugal. Two sampling areas were selected to assess the deposition flux of dust fallout and its potential spatial heterogeneity. The sampling area was divided into two subareas: the inner, with higher sampling density and urban and suburban characteristics, inside a 6-km circle centered on the stacks, and an outer subarea, mainly rural, with lower sampling density within a radius of 20 km. Particulate matter deposition was studied in the vicinity of the coal fired power plant during three seasonal sampling campaigns. For the first one, the average annual flux of dust fallout was 22.51 g/(m2 yr), ranging from 4.20 to 65.94 g/(m2 yr); for the second one was 9.47 g/(m2 yr), ranging from 0.78 to 32.72 g/(m2 yr) and for the last one was 38.42 g/(m2 yr), ranging from 1.41 to 117.48 g/(m2 yr). The fallout during the second campaign turned out to be much lower than for others. This was in part due to meteorological local patterns but mostly due to the fact that the power plant was not working at full power during the second sampling campaign.155

Medication regimen complexity in institutionalized elderly people in an aging society

Background: Complex medication regimens may adversely affect compliance and treatment outcomes. Complexity can be assessed with the medication regimen complexity index (MRCI), which has proved to be a valid, reliable tool, with potential uses in both practice and research. Objective: To use the MRCI to assess medication regimen complexity in institutionalized elderly people. Setting: Five nursing homes in mainland Portugal. Methods: A descriptive, cross-sectional study of institutionalized elderly people (n = 415) was performed from March to June 2009, including all inpatients aged 65 and over taking at least one medication per day. Main outcome measure: Medication regimen complexity index. Results: The mean age of the sample was 83.9 years (±6.6 years), and 60.2 % were women. The elderly patients were taking a large number of drugs, with 76.6 % taking more than five medications per day. The average medication regimen complexity was 18.2 (±SD = 9.6), and was higher in the females (p < 0.001). The most decisive factors contributing to the complexity were the number of drugs and dosage frequency. In regimens with the same number of medications, schedule was the most relevant factor in the final score (r = 0.922), followed by pharmaceutical forms (r = 0.768) and additional instructions (r = 0.742). Conclusion: Medication regimen complexity proved to be high. There is certainly potential for the pharmacist's intervention to reduce it as part as the medication review routine in all the patients.

Transient Spaces: unsettling boundaries and norms at the cultural event Noc Noc, Guimarães, Portugal

Cities are increasingly expected to be creative, inventive and to exhibit intense expressivity. In the past decades many cities have experienced growing pressure to produce and stage cultural events of different sorts and to develop new strategies that optimize competitive advantages, in order to promote themselves and to boost and sell their image. Often these actions have relied on heavy public investment and major private corporation sponsoring, but it is not always clear or measured how successful and reproductive these investments have been. In the context of strained public finances and profound economic crisis of European peripheral countries, events that emerge from local communities and have low budgets, which manage to create significant fluxes of visitors and visibility, assume an increased interest. In order to reflect and sketch possible answers, we look to an emerging body of literature concerning creative cities, and we focus on the organisation of a particular cultural event and its impact and assimilation into a medium size Portuguese city. This paper looks at the two editions (2011 and 2012) of one of such events – Noc Noc – organized by a local association in the city of Guimarães, Portugal. Inspired by similar events, Noc Noc is based on creating transient spaces of culture which are explored by artists and audiences, by transforming numerous homes into ephemeral convivial and playful social ‘public’ environments. The event is based on a number of cultural venues/homes scattered around the old and newer city, which allows for an informal urban exploration and an autonomous rambling and getting lost along streets. This strategy not only disrupts the cleavages between public and private space permitting for various transgressions, but it also disorders normative urban experiences and unsettles the dominant role of the city council as the culture patron of the large majority of events. Guimarães, an UNESCO World Heritage City was the European Capital of Culture in 2012, with a public investment of roughly 73 million euro. By interviewing a sample of people who have hosted these transitory art performances and exhibitions, sometimes doubling as artists, the events’ organizers and by experience both editions of the event, this paper illustrates how urban citizens’ engagement and motivations in a low budget cultural event can strengthen community ties. Furthermore, it also questions the advantages of large scale high budget events, and how this event may be seen as unconscious counter movement against a commodification of cultural events and everyday urban experience at large, engaging with the concepts of staging and authenticity.

Perspectives of the Internal Public in a Cultural Event: the Case of Noc Noc, Guimarães - Portugal

Given the significant impact that cultural events may have in local communities and the inherent organization complexity, it is important to understand their specificities. Most of the times cultural events disregard marketing and often marketing is distant from art. Thus an analysis of an inside perspective might bring significant returns to the organization of such an event. This paper considers the three editions (2011, 2012 and 2013) of a cultural event – Noc Noc – organized by a local association in the city of Guimarães, Portugal. Its format is based in analogous events, as Noc Noc intends to convert everyday spaces (homes, commercial outlets and a number of other buildings) into cultural spaces, processed and transformed by artists, hosts and audiences. By interviewing a sample of people (20) who have hosted this cultural event, sometimes doubling as artists, and by experiencing the three editions of the event, this paper illustrates how the internal public understands this particular cultural event, analyzing specifically their motivations, ways of acting and participating, as well as their relationship with the public, with the organization of the event and with art in general. Results support that artists and hosts motivations must be identified in a timely and appropriate moment, as well as their views of this particular cultural event, in order to keep them participating, since low budget cultural events such as this one may have a key role in small scale cities.

Levels and risks of particulate-bound PAHs in indoor air influenced by tobacco smoke: a field measurement

Considering tobacco smoke as one of the most health-relevant indoor sources, the aim of this work was to further understand its negative impacts on human health. The specific objectives of this work were to evaluate the levels of particulate-bound PAHs in smoking and non-smoking homes and to assess the risks associated with inhalation exposure to these compounds. The developed work concerned the application of the toxicity equivalency factors approach (including the estimation of the lifetime lung cancer risks, WHO) and the methodology established by USEPA (considering three different age categories) to 18 PAHs detected in inhalable (PM10) and fine (PM2.5) particles at two homes. The total concentrations of 18 PAHs (ΣPAHs) was 17.1 and 16.6 ng m−3 in PM10 and PM2.5 at smoking home and 7.60 and 7.16 ng m−3 in PM10 and PM2.5 at non-smoking one. Compounds with five and six rings composed the majority of the particulate PAHs content (i.e., 73 and 78 % of ΣPAHs at the smoking and non-smoking home, respectively). Target carcinogenic risks exceeded USEPA health-based guideline at smoking home for 2 different age categories. Estimated values of lifetime lung cancer risks largely exceeded (68–200 times) the health-based guideline levels at both homes thus demonstrating that long-term exposure to PAHs at the respective levels would eventually cause risk of developing cancer. The high determined values of cancer risks in the absence of smoking were probably caused by contribution of PAHs from outdoor sources.

Radioactivity levels of 238U and 232Th decay series and related dose rates in the surroundings of a coal power plant using high resolution g-spectrometry

Gamma radiations measurements were carried out in the vicinity of a coal-fired power plant located in the southwest coastline of Portugal. Two different gamma detectors were used to assess the environmental radiation within a circular area of 20 km centred in the coal plant: a scintillometer (SPP2 NF, Saphymo) and a high purity germanium detector (HPGe, Canberra). Fifty urban and suburban measurements locations were established within the defined area and two measurements campaigns were carried out. The results of the total gamma radiation ranged from 20.83 to 98.33 counts per second (c.p.s.) for both measurement campaigns and outdoor doses rates ranged from 77.65 to 366.51 Gy/h. Natural emitting nuclides from the U-238 and Th-232 decay series were identified as well as the natural emitting nuclide K-40. The radionuclide concentration from the uranium and thorium series determined by gamma spectrometry ranged from 0.93 to 73.68 Bq/kg, while for K-40 the concentration ranged from 84.14 to 904.38 Bq/kg. The obtained results were used primarily to define the variability in measured environmental radiation and to determine the coal plant’s influence in the measured radiation levels. The highest values were measured at two locations near the power plant and at locations between the distance of 6 and 20 km away from the stacks, mainly in the prevailing wind direction. The results showed an increase or at least an influence from the coal-fired plant operations, both qualitatively and quantitatively.

Estudo do impacte da institucionalização em lares na satisfação das necessidades humanas fundamentais : perspectiva dos idosos residentes

RESUMO O envelhecimento populacional, nos países ditos “desenvolvidos”, tem sido largamente discutido a nível internacional pelas suas implicações económicas, sociais e de saúde. Uma das prioridades de intervenção face a este fenómeno é promover o aumento de pessoas idosas autónomas inseridas no seu contexto social e familiar habitual. No entanto, nem sempre esse objectivo é atingido e a muitas pessoas idosas restam os lares, ou preferem-nos, como opção de alojamento e de satisfação das necessidades humanas fundamentais. O principal objectivo deste estudo foi procurar saber se a institucionalização no lar teve impacte na satisfação habitual das necessidades humanas fundamentais das pessoas idosas. Como objectivos secundários pretendeu-se complementar esta informação com alguns aspectos relacionados com o processo de institucionalização e perceber se existem diferenças significativas no que respeita ao sexo, grupo etário ou tempo de internamento. Foram incluídas no estudo 125 pessoas com 65 ou mais anos, residentes em 15 lares com alvará de iniciativa privada, pertencentes à Região de Lisboa e Vale do Tejo, no distrito de Setúbal. Os dados foram obtidos através de um questionário construído para o efeito pela autora. As principais conclusões do estudo apontaram para um impacte negativo da institucionalização na satisfação habitual de algumas necessidades que se enquadram no plano social, nomeadamente ocupar-se para se sentir útil, recrear-se e comunicar com os semelhantes. Nas diferentes necessidades, de uma forma geral, a institucionalização teve um impacte negativo no que respeita às dimensões relacionadas com privacidade e preferência individual. Por outro lado, a institucionalização parece ter tido um impacte positivo nas dimensões relacionadas com a segurança e a acessibilidade. Não foram encontradas diferenças significativas no que respeita ao número médio de respostas favoráveis ao lar ou à casa entre os grupos etários ou quanto ao tempo de internamento. Apesar disso, encontraram-se diferenças no que respeita ao grau de satisfação em residir num lar, sendo que o nível de satisfação com a institucionalização foi maior nas pessoas que residiam no lar há mais de um ano, comparativamente às que residiam no lar há um ano ou menos.-------------------------------------------- ABSTRACT: The ageing of the population of the more developed countries has been largely discussed internationally because of its economic, social and health implications. One of the priorities of intervention facing the ageing phenomenon is to promote the increase of autonomous elderly, within their usual social and familiar environment. Not always this goal is achieved and many elderly have nursing homes as option, or voluntary choose them, for lodgement and fundamental human needs satisfaction. The main goal of this study was to search whether the nursing home institutionalization had impact in the satisfaction of fundamental human needs. As secondary goals it was established to complement this information with some aspects of the institutionalization process, as well as to analyse if there were significant differences as far as sex, age groups or institutionalization time. The study sample included 125 individuals aged 65 years or more, living in 15 private nursing homes with approved legal certification, belonging to the Lisboa and Tagus Valley Region, in the district of Setúbal. Data were collected through a questionnaire designed for this study by the author. The main conclusions of this study pointed at a negative impact of institutionalization on the usual satisfaction of some human needs included at the social field, namely occupation, recreation and communication. At another level of needs, in a general way, institutionalization had negative impact concerning privacy and individual preferences dimensions. On the other hand, institutionalization appeared to have a positive impact in safety and accessibility dimensions. It was not found significant differences between age groups or institutionalization time as far as the average positive answers in favour to nursing home or house. Notwithstanding, there were differences relating to satisfaction in living at the nursing home being the satisfaction higher in residents who lived at the nursing home for more than a year, comparatively to those that lived at the nursing home for a year or less.

Identification of factors and groups at risk of infection with Schistosoma mansoni: a strategy for the implementation of control measures?

A fourteen year schistosomiasis control program in Peri-Peri (Capim Branco, MG) reduced prevalence from 43.5 to 4.4%; incidence from 19.0 to 2.9%, the geometric mean of the number of eggs from 281 to 87 and the level of the hepatoesplenic form cases from 5.9 to 0.0%. In 1991, three years after the interruption of the program, the prevalence had risen to 19.6%. The district consists of Barbosa (a rural area) and Peri-Peri itself (an urban area). In 1991, the prevalence in the two areas was 28.4% and 16.0% respectively. A multivariate analysis of risk factors for schistosomiasis indicated the domestic agricultural activity with population attributive risk (PAR) of 29.82%, the distance (< 10 m) from home to water source (PAR = 25.93%) and weekly fishing (PAR = 17.21%) as being responsible for infections in the rural area. The recommended control measures for this area are non-manual irrigation and removal of homes to more than ten meters from irrigation ditches. In the urban area, it was observed that swimming at weekly intervals (PAR = 20.71%), daily domestic agricultural activity (PAR = 4.07%) and the absence of drinking water in the home (PAR=4.29%) were responsible for infections. Thus, in the urban area the recommended control measures are the substitution of manual irrigation with an irrigation method that avoids contact with water, the creation of leisure options of the population and the provision of a domestic water supply. The authors call attention to the need for the efficacy of multivariate analysis of risk factors to be evaluated for schistosomiasis prior to its large scale use as a indicator of the control measures to be implemented.

Plataforma de gestão de guias de programação de TV digital

Com o consumismo de mais variedade e qualidade de informação, assim como, produtos interativos, surgiu a necessidade de apresentar mais conteúdos, para além da programação de televisão comum. Com os avanços tecnológicos ligados à indústria da televisão e sua distribuição nos lares portugueses pelos operadores de TV, a quantidade de oferta de canais deixou de ser um foco, passando a ser prioritário a melhoria da experiência do cliente. Com a introdução de novas funcionalidades nas caixas recetoras de sinais de transmissão de canais, como por exemplo, a capacidade de apresentar informações adicionais sobre os programas, desde da sua apresentação em modo trailer até ao elenco detalhado que o compõe, os clientes podem ter uma nova experiência de interação com os serviços de TV. A funcionalidade de gravação agendada de programas levou ao próximo ponto de melhoria de experiência do cliente. As gravações que resultavam em programas indevidamente cortados, quer no seu início quer no seu fim, foi um dos motivos que levou os operadores de TV a procurarem um melhor serviço de gestão de guias de programação digitais. A InfoPortugal, entidade detentora do seguinte projeto e EPG Provider de algumas operadoras de TV nacionais, viu-se obrigada a atualizar os seu sistemas de distribuição de conteúdos, para responder à evolução dos requisitos dos seus clientes.

SCADA House Intelligent Management for Energy Efficiency Analysis in Domestic Consumers

The implementation of smart homes allows the domestic consumer to be an active player in the context of the Smart Grid (SG). This paper presents an intelligent house management system that is being developed by the authors to manage, in real time, the power consumption, the micro generation system, the charge and discharge of the electric or plug-in hybrid vehicles, and the participation in Demand Response (DR) programs. The paper proposes a method for the energy efficiency analysis of a domestic consumer using the SCADA House Intelligent Management (SHIM) system. The main goal of the present paper is to demonstrate the economic benefits of the implemented method. The case study considers the consumption data of some real cases of Portuguese house consumption over 30 days of June of 2012, the Portuguese real energy price, the implementation of the power limits at different times of the day and the economic benefits analysis.