Effectiveness of artemether-lumefantrine provided by community health workers in under-five children with uncomplicated malaria in rural Tanzania : an open label prospective study

Background: Home-management of malaria (HMM) strategy improves early access of anti-malarial medicines to high-risk groups in remote areas of sub-Saharan Africa. However, limited data are available on the effectiveness of using artemisinin-based combination therapy (ACT) within the HMM strategy. The aim of this study was to assess the effectiveness of artemether-lumefantrine (AL), presently the most favoured ACT in Africa, in under-five children with uncomplicated Plasmodium falciparum malaria in Tanzania, when provided by community health workers (CHWs) and administered unsupervised by parents or guardians at home. Methods: An open label, single arm prospective study was conducted in two rural villages with high malaria transmission in Kibaha District, Tanzania. Children presenting to CHWs with uncomplicated fever and a positive rapid malaria diagnostic test (RDT) were provisionally enrolled and provided AL for unsupervised treatment at home. Patients with microscopy confirmed P. falciparum parasitaemia were definitely enrolled and reviewed weekly by the CHWs during 42 days. Primary outcome measure was PCR corrected parasitological cure rate by day 42, as estimated by Kaplan-Meier survival analysis. This trial is registered with ClinicalTrials.gov, number NCT00454961. Results: A total of 244 febrile children were enrolled between March-August 2007. Two patients were lost to follow up on day 14, and one patient withdrew consent on day 21. Some 141/241 (58.5%) patients had recurrent infection during follow-up, of whom 14 had recrudescence. The PCR corrected cure rate by day 42 was 93.0% (95% CI 88.3%-95.9%). The median lumefantrine concentration was statistically significantly lower in patients with recrudescence (97 ng/mL [IQR 0-234]; n = 10) compared with reinfections (205 ng/mL [114-390]; n = 92), or no parasite reappearance (217 [121-374] ng/mL; n = 70; p <= 0.046). Conclusions: Provision of AL by CHWs for unsupervised malaria treatment at home was highly effective, which provides evidence base for scaling-up implementation of HMM with AL in Tanzania.

Must teachers be social workers, as well …? : Reflections on the current teacher role in the Swedish upper secondary school and how it affects teacher training

The Swedish upper secondary school has made a transition from a school for the elite to be a school for everybody. When almost every youth nowadays chooses to continue studying, for some of them this is not what they want to do most of all. However, as there in practice is no choice, there come up problems and many upper secondary school teachers experience a growing frustration. We will here discuss some aspects of the following questions: -  How do upper secondary schoolteachers handle their working-conditions in a new situation? - What possible consequences do this have on teacher education?

Turismo social e terceira idade:desafios emergentes

Este estudo tem por objetivo realçar e discutir dois temas de relevância atual: o turismo social e a terceira idade. O turismo social consiste em um esforço conjunto da Sociedade e do Estado em promover a universalização e a humanização da prática turística incorporando nesta atividade grupos socialmente e/ou economicamente desfavorecidos tais como os trabalhadores, os deficientes, os jovens e os idosos. Estes últimos, face ao processo de envelhecimento da população mundial ora em curso, têm assim justificada a necessidade de inclusão de suas demandas, entre as quais o direito ao lazer, no rol das políticas sociais formulado quer no âmbito estatal, quer no conjunto de ações que venha a ser adotado a nível da sociedade civil organizada. A questão da terceira idade é analisada a partir de uma pesquisa histórica que descreve a evolução do tratamento dispensado aos idosos pelas diversas sociedades, ao longo do tempo. Esta trajetória investigativa culmina com a explanação da situação atual do velho no mundo e mais especificamente no Brasil. O turismo social é abordado através da formulação de conceitos, da sua confrontação com os valores que norteiam o chamado turismo tradicional e da apresentação de experiências já postas em prática. É destacado o papel precípuo do Bureau Intemational du Tourisme Social - BITS na divulgação e no fomento desta atividade pelo mundo. Na última parte do trabalho, é feita a correlação entre os dois temas, quando então é demonstrada a importante contribuição que o lazer e o turismo social em particular têm a oferecer à população idosa como exercício completo de participação, com resultados positivos no desenvolvimento físico e mental de um estrato etário ao mesmo tempo carente e ansioso por possibilidades de integração social.

From public to private : the performance of former public workers in the Brazilian labor market

This paper analyzes the placement in the private sector of a subset of Brazilian public-sector employees. This group left public employment in the mid-1990’s through a voluntary severance program. This paper contrasts their earnings before and after quitting the public sector, and compares both sets of wages to public and private sector earnings for similar workers. We find that participants in this voluntary severance program suffered a significant reduction in average earnings wage and an increase in earnings dispersion. We test whether the reduction in average earnings and the increase in earnings dispersion is the expected outcome once one controls for observed characteristics, by means of counterfactual simulations. Several methods of controlling for observed characteristics (parametric and non-parametrically) are used for robustness. The results indicate that this group of workers was paid at levels below what would be expected given their embodied observable characteristics.

The influence of lifestyle and gender on sickness absence in brazilian workers

Background: Despite an increasing body of knowledge concerning gender and lifestyle factors as determinants of sickness absence in well-developed countries, the relationship between these variables has not been elucidated in emerging economic power countries, where the burden of non-communicable diseases is particularly high. This study aimed to analyze the relationships among lifestyle-related factors and sick leave and to examine whether gender differences in sickness absence can be explained by differences in socio-demographic, work and lifestyle-related factors among Brazilian workers. Methods: In this longitudinal study with a one year follow-up among 2.150 employees of a Brazilian airline company, sick leave was the primary outcome of interest. Independent variables collected by interview at enrolment in the study were gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity and smoking). In addition, the risk for coronary heart disease was determined based on measurement of blood pressure, total cholesterol and glucose levels. The total number of days on sick leave during 12 months follow-up was available from the company register. Logistic regression analysis was used to determine the influence of socio-demographic, type of work and lifestyle-related factors on sick leave. Results: Younger employees, those with lower educational level, those who worked as air crew members and those with higher levels of stress were more likely to have sick leave. Body mass index and level of physical activity were not associated with sick leave. After adjustment by socio-demographic variables, increased odds for 10 or more days of sick leave were found in smokers (OR = 1.51, CI = 1.05-2.17), and ex-smokers (OR = 1.45, CI = 1.01-2.10). Women were more likely to have 10 or more days of sick leave. Gender differences were reduced mainly when adjusted for type of work (15%) and educational level (7%). Conclusions: The higher occurrence of sick leave among women than among men was partly explained by type of work and educational level. Our results suggest that type of work, a stressful life, and smoking are important targets for health promotion in this study population

Preliminary studies on the effects of d-limonene to workers of the leaf-cutting ant Atta sexdens rubropilosa and its implications for control

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Seroprevalence of Antibodies to Chlamydophila psittaci in Zoo Workers in Brazil

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

Behavioural responses of workers towards worker-produced male larvae and queen-produced worker larvae in Acromyrmex subterraneus brunneus Forel, 1911 (Hym., Formicidae)

Leaf-cutting ant workers care for larvae with an elaborate behavioural repertoire to satisfy the needs of the offspring. In order to investigate worker discrimination ability in the leaf-cutting ant Acromyrmex subterraneus brunneus, we compared the behavioural responses of workers towards worker-produced male larvae and queen-produced worker larvae, including the following behavioural acts: licking the larval body, transporting larvae, feeding larvae with hyphae, scraping larval mouth parts, ingesting faecal fluid excreted by the larva, and inserting hyphae of the symbiontic fungus on the larval body. We verified that workers behaved differently depending on larval origin, i.e. licking the larval body, transporting larvae and inserting hyphae of the symbiontic fungus on the larval body. Observed differences denote the ability of workers in discriminating among larvae, probably because of their different individual needs.

The influence of the scout upon the decision-making process of recruited workers in three Acromyrmex species (Formicidae : Attini)

We examined how the information communicated by a scout worker influences the plant species transported by recruited workers in Acromymex balzani, Acromyrmex rugosus, and Acromyrmex crassispinus, three species of leaf-cutting ant that have different substrate and habitat preferences. We verified that certain plant species were more likely to be transported than others and that recruitment occurs. We found that recruited workers were more likely to transport non-preferred plant species when they were recruited to these by scout workers. The results suggest that the scout worker can communicate information about plant identity to recruited workers, but that recruited workers integrate the information communicated with their own experience during the decision-making process. (C) 2004 Published by Elsevier B.V.

Selectivity of Workers of the Grass-Cutting Ants Atta bisphaerica and Atta capiguara (Hymenoptera: Formicidae) to Vegetable Oils

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

Sleep complaints and polysomnographic findings: A study of nuclear power plant shift workers

The literature widely recognizes that shift workers have more health complaints than the general population. The objective of this study was to describe the prevalence of sleep complaints and verify the polysomnographic (PSG) variables of shift workers in two Brazilian nuclear power plants. We carried out a subjective evaluation with a sleep questionnaire. Based on these results, the interviewees that reported sleep-related complaints were referred for polysomnographic evaluation. of the 327 volunteers initially evaluated by the sleep questionnaire, 113 (35%) reported sleep complaints; they were significantly older, had higher body mass index (BMI), and worked more years on shifts than those without sleep complaints. of these 113, 90 met criteria for various sleep disorders: 30 (9%) showed obstructive sleep apnea (OSA), 18 (5.5%) showed limb movement, and 42 (13%) evidenced both sleep problems and had a significantly higher proportion of sleep stage 1 and arousals compared with the 23 shift workers that had no indices of sleep problems. The present study found that 90 (27.5%) of the evaluated participants met the PSG criteria of some type of clinical sleep disorder. This high proportion should be investigated for associations with other aspects of work, such as working hours, working schedule, years performing shift work, and access to health services. Due to the strong association between sleep disorders and the incidence of fatigue and sleepiness, the evaluation of the sleep patterns and complaints of shift workers is essential and should be considered to be one of the basic strategies of industry to prevent accidents.

Urinary Mutagenicity in Chemical Laboratory Workers Exposed to Solvents

Solvents represent an important group of environmental pollutants to which people are exposed daily in the workplace. The physico chemical properties of solvents may result in disturbances to cellular structures, including damage to DNA. However, the effects of mixtures of solvents are not well known. Mutations caused by environmental agents are related to cancer development and other degenerative diseases. The work in a research laboratory that uses several types of solvents is equally predisposed to these hazards. In this study, we evaluated the mutagenicity of urine from 29 subjects exposed occupationally to solvents in a chemistry research laboratory and 29 subjects without occupational exposure (controls). Urine samples were collected in polyethylene containers at the end of the work shift. For the concentration and extraction of urine samples the XAD-2 resin was used with acetone as an eluting agent. Several strains of Salmonella typhimurium (TA100, TA98, TA97a, TA1535, YG1024) should be used to assess mutagenic susceptibilities among workers exposed to organic solvents. Different doses of extract (1.5; 3.0; 6.0 and 12.0 m/ equivalents of urine per plate) were tested on S. typhimurium strains TA100 and YG 1024, with and without metabolic activation. The mutagenic activity, measured in Salmonella typhimurium YGI1024 with S9 mix, was significantly greater in urine from workers than from controls (p <= 0.05). These results indicate the relevance of using biomarkers to assess the risk of occupational exposure to organic solvents.

As pessoas com deficiência no mercado de trabalho: expressão das desigualdades sociais

This work was developed in the extent of the Post Graduation Program in Social Service of the Federal University of Rio Grande do Norte. It talks about the process of inclusion of the disabled people in the Job market in Mossoró-RN, bringing for the academic debate relevant thematic for the Brazilian society, for the profession of Social Service and similar areas and for the people with deficiency. It has the objective to apprehend the determiners that make possible the process of the disabled people's inclusion in the Job market in Mossoró, having as parameter the National Politics for the Integration of People Bearers of Deficiency. The critical theoretical perspective is backed in Marx's ideas for the understanding concerning the work, as well as in Pochamann, concerning the job market, regarding the exclusion/inclusion category is based in Martins, Yasbek and Sposati and on deficiency in the National Politics for the Integration of the Disabled People. The research is of qualitative nature and it took as subjects 26 (twenty-six) people, being 09 (nine) people with deficiency, inserted in the formal job and regulated market, and 17 (seventeen) managers of private companies and public institutions of the city of Mossoró-RN. For the collection of data we used techniques of nonsystemic observation, semi-structured interview and documental analysis. The results of the research mark that any modality of the human workforce used in the current context, they are functional to the capitalism and they move forward towards exploration, alienation and subordination of the work to the capital; the National Politics for the Integration of the People with Deficiency expresses and reproduces the contradictory dynamics of the class society, it reflects the neo liberal shades through the selectivity and of the articulation among the federated beings and organizations of the civil society for its operational system; there is a misproportion between the percentages of the quotas and the amount of people with deficiency inserted in the job market, just corresponding to a tiny numeric magnitude; the developed activities are of low social status and it is expressive the amount of workers that receives between one and two minimum wages. These data drive us to infer that the mentioned politics make possible, partly, the inclusion of the disabled people in the job market, though, such inclusion is executed in the selective or focused dimensions, marginal, precarious and unstable

Knowledge and attitudes of health care workers from intensive care units regarding nosocomial transmission of influenza: a study on the immediate pre-pandemic period

The transmission of influenza in health care settings is a major threat to patients, especially those with severe diseases. The attitude of health care workers (HCWs) may influence the transmission of countless infections. The current study aimed to quantify knowledge and identify attitudes of HCWs involved in intensive care units (ICUs) regarding the risk of nosocomial influenza transmission. A questionnaire was applied through interviews to HCWs who worked in one of the five ICUs from a teaching hospital. Questions about influenza were deliberately dispersed among others that assessed several infectious agents. Forty-two HCWs were interviewed: nine physicians, ten nurses and 23 nursing technicians or auxiliaries. Among the 42 HCWs, 98% were aware of the potential transmission of influenza virus in the ICUs, but only 31% would indicate droplet precautions for patients with suspected infection. Moreover, only 31% of them had been vaccinated against influenza in the last campaign (2008). Nursing technicians or auxiliaries were more likely to have been vaccinated, both by univariate and multivariable analysis. When asked about absenteeism, only 10% of the study subjects stated that they would not go to work if they had an influenza-like illness. Those findings suggest that, in non-pandemic periods, influenza control in hospitals requires strategies that combine continuous education with changes in organizational culture.

Predictors of adherence to influenza vaccination for healthcare workers from a teaching hospital: a study in the prepandemic era

Introduction: Even before the 2009 pandemics, influenza in healthcare workers (HCW) was a known threat to patient safety, while Influenza vaccine coverage in the same group was generally low. Identification of predictors for HCW adherence to Influenza vaccination has challenged infection control committees. Methods: Our group conducted a cross-sectional survey in December 2007, interviewing 125 HCWs from a teaching hospital to identify adherence predictors for Influenza vaccination. The outcomes of interest were: A - adherence to the 2007 vaccination campaign; B - adherence to at least three yearly campaigns in the past five years. Demographic and professional data were assessed through univariate and multivariate analysis. Results: of the HCWs interviewed, 43.2% were vaccinated against Influenza in 2007. However, only 34.3% of HCWs working in healthcare for more than five years had adhered to at least three of the last five vaccination campaigns. Multivariate analysis showed that working in a pediatric unit (OR = 7.35, 95% I = 1.90-28.44, p = 0.004) and number of years in the job (OR = 1.32, 95%CI = 1.00-1.74, p = 0.049) were significant predictors of adherence to the 2007 campaign. Physicians returned the worst outcome performances in A (OR = 0.40, 95%CI = 0.16-0.97, p = 0.04) and B (OR = 0.17, 95%CI = 0.05-0.60, p = 0.006). Conclusions: Strategies to improve adherence to Influenza vaccination should focus on physicians and newly-recruited HCWs. New studies are required to assess the impact of the recent Influenza A pandemics on HCW-directed immunization policies.