Histoplasmosis in immunocompetent individuals living in an endemic area in the Brazilian Southeast

Introduction The distribution of infection by Histoplasma capsulatum in Brazil is heterogeneous, and the number of cases affecting immunocompetent individuals is relatively small. This study reports the epidemiological and clinical data regarding histoplasmosis in non-immunosuppressed individuals. Methods The study included only the immunocompetent patients with histoplasmosis who were diagnosed between 1970 and 2012 at a university hospital located in Ribeirão Preto, State of São Paulo, Brazil. Clinical and epidemiological data were collected retrospectively from the patient records. Results Of the 123 patients analyzed, 95 had an active disease that manifested in the different clinical forms of histoplasmosis. Men were the predominant gender, and most patients resided in the Northeast of the State of São Paulo and in the nearby municipalities of the State of Minas Gerais. The risk factors for acquiring histoplasmosis and prolonged contact in a rural environment were recorded in 43.9% and 82.9% of cases, respectively. Smoking, alcoholism, and comorbidity rates were high among the patients with the chronic pulmonary and subacute/chronic disseminated forms of histoplasmosis. Many patients achieved clinical cure spontaneously, but 58.9% required antifungals; the disease lethality rate was 5.3%. Conclusions Immunocompetent individuals manifested the diverse clinical forms of histoplasmosis over a period of 4 decades, revealing an additional endemic area of this fungal disease in the Brazilian Southeast.

Detection of arboviruses of public health interest in free-living New World primates (Sapajus spp.; Alouatta caraya) captured in Mato Grosso do Sul, Brazil

Introduction A sero-epidemiological survey was undertaken to detect the circulation of arboviruses in free-living non-human primates. Methods Blood samples were obtained from 16 non-human primates (13 Sapajus spp. and three Alouatta caraya) that were captured using terrestrial traps and anesthetic darts in woodland regions in the municipalities of Campo Grande, Aquidauana, Jardim, Miranda and Corumbá in the State of Mato Grosso do Sul, Brazil. The samples were sent to the Instituto Evandro Chagas (IEC) in Ananindeua, Pará, Brazil, to detect antibodies against 19 species of arboviruses using a hemagglutination inhibition test (HI). Results Of the 16 primates investigated in the present study, five (31.2%) were serologically positive for an arbovirus. Of these five, two (12.5%) exhibited antibodies to the Flavivirus genus, one (6.2%) exhibited a monotypic reaction to Cacipacoré virus, one (6.2%) was associated with Mayaro virus, and one (6.2%) was positive for Oropouche virus. Conclusions Based on the positive serology observed in the present study, it was possible to conclude that arboviruses circulate among free-living primates. The viruses in the areas studied might have been introduced by infected humans or by primates from endemic or enzootic areas. Studies of this nature, as well as efficient and continuous surveillance programs, are needed to monitor viral activities in endemic and enzootic regions.

Impact of mobile app user acquisition on managerial decisions: Evidence from empirical experiment

In this research we conducted a mixed research, using qualitative and quantitative analysis to study the relationship and impact between mobile advertisement and mobile app user acquisition and the conclusions companies can derive from it. Data was gathered from management of mobile advertisement campaigns of a portfolio of three different mobile apps. We found that a number of implications can be extracted from this intersection, namely to product development, internationalisation and management of marketing budget. We propose further research on alternative app users sources, impact of revenue on apps and exploitation of product segments: wearable technology and Internet of Things.

Cliente mobile para consumo e disponibilização de serviços georreferenciados

Actualmente as aplicações móveis são indispensáveis para o utilizador. De acordo com estudos recentes, as receitas geradas pela sua utilização resultaram em aproximadamente 20 biliões de dólares só em 2013. Com estes valores estima-se que no futuro estes números aumentem, daí tornar-se imperativo abordar num estudo científico sobre este mercado em expansão. A somar às inúmeras aplicações referentes ao sistema móvel Android, surgem as aplicações de serviços georreferenciados que vão aqui ser abordadas em maior profundidade, nomeadamente o consumo e disponibilização destes serviços em clientes mobile. Ponderadas diversas soluções é possível com alguns melhoramentos atingir benefícios específicos para um maior número de utilizadores tendo em conta as suas características a priori. Uma das questões principais passa pela capacidade de publicação de diversas fontes de informação (vários publishers) com o uso de uma Application Programing Interface (API) documentada e aberta para que qualquer entidade possa publicar os seus conteúdos georreferenciados. O consumo por parte dos utilizadores (subscriber) é feita numa plataforma móvel Android onde os possam vários publishers possam publicar os seus conteúdos a partir da posição do utilizador. Esta publicação será facilitada criando bases de dados para o armazenamento de todas as informações relevantes tanto da parte dos publishers como dos subscribers. A validação deste trabalho consistiu em testar vários tipos de publicações, nomeadamente texto, imagem e gráficos na sua pesquisa e consumo numa plataforma móvel Android. Numa segunda fase, foi testada a publicação de gráficos em tempo real na plataforma.

A description of the Australian early psychosis intervention model and a proposal to establish a Pilot Early Intervention Program in Santa Cruz de la Sierra, Bolívia

RESUMO: Em 2011, a Associação Psiquiátrica Mundial lançou um programa de bolsas de investigação para psiquiatras em início de carreira a partir de países de renda baixa ou média-baixa, no âmbito deste programa, o autor foi selecionado para uma bolsa de pesquisa no Centre for Youth Mental Health/Orygen Youth Health Research Centre da Universidade de Melbourne. Orygen, é a principal organização de pesquisa e tradução do conhecimento do mundo com foco em problemas de saúde mental em pessoas jovens. O estágio foi baseado em Prevenção e Intervenção Precoce Psychosis Centre (EPPIC), que faz parte do Orygen. EPPIC fornece programa de tratamento abrangente e integrada, baseada na comunidade para o primeiro episódio de psicose. Esta dissertação descreve o modelo EPPIC, e seus componentes essenciais e fatores que são necessários para uma implementação de serviço direito. Além disso, uma proposta de criação de um programa-piloto de intervenção psicose precoce é discutido. Este programa inclui um programa de extensão inovadora que combina princípios comerciais sólidos, com metas sociais, a fim de combater especificamente a maior barreira para o tratamento da psicose precoce na Bolívia: o estigma da doença mental. Ao utilizar uma equipe de tratamento móvel, multidisciplinar, que enfatiza os papéis dos gerentes do caso treinados focada em fornecer indivíduo intensiva e apoio familiar no lar, este programa irá prestar cuidados culturalmente apropriados que irá alavancar contribuições de um suprimento limitado de psiquiatras e mudar longe da dependência um sistema médico fragmentado. ---------------------------- ABSTRACT: In 2011, the World Psychiatric Association launched a programme of research fellowships for early-career psychiatrists from low- or lower-middle income countries, within this programme, the author was selected to a research fellowship at the Centre for Youth Mental Health/Orygen Youth Health Research Centre at University of Melbourne. Orygen, is the world’s leading research and knowledge translation organization focusing on mental ill-health in young people. The traineeship was based on Early Psychosis Prevention and Intervention Centre (EPPIC), which is part of Orygen. EPPIC provides comprehensive, integrated, community-based treatment program for first-episode psychosis. This dissertation describes the EPPIC model, and its core components and factors which are necessary to a right service implementation. Additionally, a proposal to establish a pilot early psychosis intervention programme is discussed. This programme includes an innovative outreach programme that combines sound business principals with social goals in order to specifically target the largest barrier to early psychosis treatment in Bolivia: the stigma of mental illness. By utilizing a mobile, multidisciplinary treatment team that emphasizes the roles of trained case managers focused on providing intensive individual and family support in the home, this programme will provide culturally appropriate care that will leverage contributions from a limited supply of psychiatrists and shift dependence away from a fragmented medical system.

O impacto do diagnóstico de demência no casal

RESUMO: A experiência de viver com demência ocorre, frequentemente, num contexto de uma relação conjugal duradoura. A qualidade da relação e o sentido de coerência (conjunto de características pessoais que permite compreender, gerir e integrar os factores de stress de forma construtiva) apresentam-se como factores promotores e protectores da saúde, no contexto de experiências adversas, nomeadamente de doença. Provavelmente, o mesmo poderá acontecer nos quadros demenciais. O presente estudo teve como objectivo principal analisar o impacto do diagnóstico, no contexto das fases iniciais de demência, em casais de pessoas idosas, explorando o papel da qualidade da relação conjugal e do sentido de coerência na confrontação com o diagnóstico e na experiência de viver com a doença. Realizámos um estudo observacional de seis casais de pessoas idosas (pessoas com demência e respectivos cônjuges prestadores de cuidados), com recurso a entrevistas individuais e conjuntas como suplemento metodológico central, suportado pela utilização dos instrumentos: Orientation to Life Questionnaire - SOC (Antonovsky, 1987) e Quality of Carer-Patient Relationships – QCPR (Spruytte et al. 2000). Os resultados sugerem que a qualidade da relação e um sentido de coerência mais elevado podem facilitar uma adaptação bem-sucedida aos desafios, promover a adopção de estratégias para reforçar os aspectos positivos da experiência de cuidar e atenuar os negativos (sobrecarga e sofrimento psíquico do cuidador), encorajar padrões positivos no acesso e na utilização dos cuidados formais e adiar a institucionalização precoce da pessoa com demência.----------------------- ABSTRACT: In couples, caregiving experiences in dementia usually occur within long-standing relationships preceding the onset of the illness and evolving as it progresses. The quality of relationship (QR) and Antonovsky’s salutogenic construct of sense of coherence (SOC) are assumed to promote and protect health in stressful situations, such as dementia. SOC refers to the extent to which a person considers his/her life as comprehensible, manageable and meaningful. We aim to uncover the role of QR and SOC as moderator or mediator in the ability of patients and their partners to cope with the impact of dementia We studied six couples in which one spouse had been diagnosed with dementia. We used a qualitative research approach (combining in-depth individual and joint interviews), triangulated with the measures Orientation to Life Questionnaire - SOC scale (Antonovsky, 1987) and the Quality of Carer-Patient Relationships – QCPR (Spruytte et al. 2000). The method was informed by a literature review on the role of RQ and SOC within dementia. Results highlight the importance of listening to both spouses, in a dyadic perspective, while acknowledging the voice of PwD themselves despite methodological challenges. Aspects of prior relationship impact on caregiving dynamics and on how the care-giver and care-recipient roles are experienced. At the same time, the experience of living with dementia impacts on the relationship, often causing change or loss which is difficult to accept or adjust to. Diagnosis played an important role on the SOC’s comprehensibility component (life makes sense). Good pre-caregiving and current relationship was associated with carers’ ability to cope, namely on SOC’s manageability (problems will be bearable) and meaningfulness (life is viewed as a challenge). Our findings suggest that an understanding of QR and SOC prior to diagnosis may encourage positive patterns of care, foster successful adaptation to changing needs, and support in-home arrangements as long as possible.

Association between the degree of physical impairment from leprosy and dependence in activities of daily living among the elderly in a health unit in the State of Minas Gerais

Introduction In addition to the common alterations and diseases inherent in the aging process, elderly persons with a history of leprosy are particularly vulnerable to dependence because of disease-related impairments. Objective determine whether physical impairment from leprosy is associated with dependence among the elderly. Methods An analytical cross-sectional study of elderly individuals with a history of leprosy and no signs of cognitive impairment was conducted using a database from a former leprosy colony-hospital. The patients were evaluated for dependence in the basic activities of daily living (BADL) and instrumental activities of daily living (IADL), respectively) and subjected to standard leprosy physical disability grading. Subsequently, descriptive and univariate analyses were conducted, the latter using Pearson's chi-squared test. Results A total of 186 elderly persons were included in the study. Of these individuals, 53.8% were women, 49.5% were older than 75 years of age, 93% had four or less years of formal education, 24.2% lived in an institution for the long-term care of the elderly (ILTC), and 18.3% had lower limb amputations. Among those evaluated, 79.8% had visible physical impairments from leprosy (grade 2), 83.3% were independent in BADL, and 10.2% were independent in IADL. There was a higher impairment grade among those patients who were IADL dependent (p=0.038). Conclusion s: The leprosy physical impairment grade is associated with dependence for IADL, creating the need for greater social support and systematic monitoring by a multidisciplinary team. The results highlight the importance of early diagnosis and treatment of leprosy to prevent physical impairment and dependence in later years.

A business plan for a new mobile application to the consumer foodservice industry

The Portuguese consumer foodservice industry is experiencing a boost in technology adoption, driven by significant changes in consumer behavior and business dynamics, due to mobile increasing penetration. Accordingly, the present work project consists on developing a business plan for meeting an identified opportunity in the technological foodservice landscape. Therefore, this report is divided into three sections, each of which addressing different objectives: (A) External Environment, providing key external insights that support the opportunity; (B) Strategy Formulation, establishing a strategic direction; and (C) Action Plan, determining an implementation plan for starting the business

Value creation in the nursing home real estate investment market - A case study

The underlying thesis examines the value drivers of direct investments in nursing home real estate in Germany. A survey among investors and operators is conducted in order to identify significant value drivers. Moreover, based on survey results, a framework for assessing German nursing home real estate is developed. This is applied in a case-study about the set-up of a nursing home value-add fund which will demonstrate the value creation process of redeveloping an existing nursing home real estate portfolio. Through a concluding analysis the sources of value creation, sensitivities and future prospects of direct investing into German nursing home real estate are concluded.

Measuring poverty in Portugal: An absolute approach

The aim of this article is to measure poverty in Portugal from an absolute perspective. We estimated several absolute poverty lines and defined maximum and minimum thresholds. We applied aggregation measures to these thresholds and constructed probit models to assess the effect of some variables on poverty. The intervals obtained contain the poverty lines constructed by other approaches. We got evidence that poverty is positively correlated with the number of people in the household, with living alone; negatively correlated with the number of workers in the household, the share on non-food expenditure and the existence of a heating device at home.

Using mobile technology to conduct epidemiological investigations

INTRODUCTION : The aim of this study was to report the experience of an epidemiological field survey for which data were collected and analyzed using tablets. METHODS : The devices used Epi Info 7 (Android version), which has been modeled a database with variables of the traditional form. RESULTS : Twenty-one households were randomly selected in the study area; 75 residents were registered and completed household interviews with socioeconomic and environmental risk variables. CONCLUSIONS : This new technology is a valuable tool for collecting and analyzing data from the field, with advantageous benefits to epidemiological surveys.

Evaluation of arboviruses of public health interest in free-living non-human primates (Alouatta spp., Callithrix spp., Sapajus spp.) in Brazil

INTRODUCTION: The aim of the present study was to evaluate the presence of arboviruses from the Flavivirus genus in asymptomatic free-living non-human primates (NHPs) living in close contact with humans and vectors in the States of Paraná and Mato Grosso do Sul, Brazil. METHODS: NHP sera samples (total n = 80, Alouatta spp. n = 07, Callithrix spp. n = 29 and Sapajus spp. n = 44) were screened for the presence of viral genomes using reverse transcription polymerase chain reaction and 10% polyacrylamide gel electrophoresis techniques. RESULTS: All of the samples were negative for the Flavivirus genome following the 10% polyacrylamide gel electrophoresis analysis. CONCLUSIONS: These negative results indicate that the analyzed animals were not infected with arboviruses from the Flavivirus genus and did not represent a risk for viral transmission through vectors during the period in which the samples were collected.

Socio-demographic correlates of physical activity of European adults: A cross-sectional study from the European Social Survey

ABSTRACT - Background: From a public health perspective, the study of socio-demographic factors related to physical activity is important in order to identify subgroups for intervention programs. Purpose: This study also aimed to identify the prevalence and the socio-demographic correlates related with the achievement of recommended physical activity levels. Methods: Using data from the European Social Survey round 6, physical activity and socio-demographic characteristics were collected from 39278 European adults (18271 men, 21006 women), aged 18-64 years, from 28 countries in 2012. Meeting physical activity guidelines was assessed using World Health Organization criteria. Results: 64.50% (63.36% men, 66.49% women) attained physical activity recommended levels. The likelihood of attaining physical activity recommendations was higher in age group of 55-64 years (men: OR=1.22, p<0.05; women: OR=1.66, p<0.001), among those who had completed high school (men: OR=1.28, p<0.01; women: OR=1.26, p<0.05), among those who lived in rural areas (men: OR=1.20, p<0.001; women: OR=1.10, p<0.05), and among those who had 3 or more people living at home (men: OR=1.40, p<0.001; women: OR=1.43, p<0.001). On the other hand, attaining physical activity recommendations was negatively associated with being unemployed (men: OR=0.70, p<0.001; women: OR=0.87, p<0.05), being a student (men: OR=0.56, p<0.001; women: OR=0.64, p<0.01), being a retired person (men: OR=0.86, p<0.05) and with having a higher household income (OR=0.80, p<0.001; women: OR=0.81, p<0.01). Conclusion: This research helped clarify that, as the promotion of physical activity is critical to sustain health and prevent disease, socio-demographic factors are important to consider when planning the increase of physical activity.

A importância dos média e da língua de acolhimento na integração de imigrantes. Estudos de caso : a comunidade nepalesa de Portugal e a comunidade portuguesa em Macau

Esta pesquisa foca-se na comunidade imigrante portuguesa em Macau e na comunidade imigrante nepalesa em Portugal. Analisa os usos dos média – étnicos, mainstream e transnacionais - por imigrantes durante o processo de integração: na manutenção de laços com o país de origem e na adaptação à sociedade de acolhimento, em que a língua de acolhimento assume um papel crucial. A investigação enquadra-se nos estudos de audiências e baseia-se na teoria dos Usos e Gratificações dos Média (Katz, Blumler, & Gurevitch, 1974). No que respeita à integração assenta no modelo de estratégias de aculturação de Berry & Sam (2001, 2006). Quanto à língua, assenta na teoria do poder e da prática de Bourdieu (1991), especificamente na parte relativa ao poder simbólico da língua. Quanto à metodologia, foram realizadas oito entrevistas em profundidade na comunidade nepalesa e 29 entrevistas na comunidade portuguesa. A amostra foi de conveniência e teoricamente sustentada. A seguir às entrevistas, foi feita uma análise de conteúdo individual e transversal. Esta tese pretende contribuir para o enriquecimento de linhas de investigação sobre audiências activas dos média. Poderá servir de fonte de informação para políticas relacionadas com a integração de imigrantes, nomeadamente, para reformulação de políticas relacionadas com os média e com a língua de acolhimento. No caso de empresas de comunicação, a informação obtida poderá ser útil para adaptarem melhor os seus conteúdos a este público específico.

Dynamic group formation in mobile computer supported collaborative learning environment

Forming suitable learning groups is one of the factors that determine the efficiency of collaborative learning activities. However, only a few studies were carried out to address this problem in the mobile learning environments. In this paper, we propose a new approach for an automatic, customized, and dynamic group formation in Mobile Computer Supported Collaborative Learning (MCSCL) contexts. The proposed solution is based on the combination of three types of grouping criteria: learner’s personal characteristics, learner’s behaviours, and context information. The instructors can freely select the type, the number, and the weight of grouping criteria, together with other settings such as the number, the size, and the type of learning groups (homogeneous or heterogeneous). Apart from a grouping mechanism, the proposed approach represents a flexible tool to control each learner, and to manage the learning processes from the beginning to the end of collaborative learning activities. In order to evaluate the quality of the implemented group formation algorithm, we compare its Average Intra-cluster Distance (AID) with the one of a random group formation method. The results show a higher effectiveness of the proposed algorithm in forming homogenous and heterogeneous groups compared to the random method.