Opportunistic screening actions for breast cancer performed by nurses working in primary health care

Abstract OBJECTIVE To identify opportunistic screening actions for breast cancer performed by nurses working in primary health care units in Ribeirão Preto, São Paulo. METHOD Cross-sectional study with 60 nurses from 28 units, who had been working for at least one year in the public municipal health care network. Data were collected between December 2013 and March 2014, by means of a questionnaire, using descriptive analysis and the software IBM SPSS version 20 and Microsoft Excel 2010. RESULTS The results showed that 71.7% of the participants questioned their female patients as for risk factors for breast cancer, mainly during nursing consultation; 70.0% oriented users about the age to perform clinical breast exam, whereas 30.0% did not due to lack of knowledge and time; 60.0% explained about the age to perform mammogram; 73.3% did not refer patients with suspicious breast exam results to the referral department, citing scheduling as the main obstacle to referral. Educational activities were not performed by 78.3% of participants. CONCLUSION Investment is needed in professional training and management of breast cancer screening.

Prensa escrita y poder político en Argentina (2007-2013) : estudio de caso sobre Papel Prensa S.A.

Papel Prensa es l’ única empresa argentina fabricant de paper per a consum dels diaris. Els grups Clarín i La Nación han estat els seus accionistes majoritaris des del 1976, desprès del cop d’ Estat cívic militar. El Govern va aconseguir aprovar el mes de desembre del 2011 una llei que declarava “d’interès públic” la producció, comercialització i distribució de paper per a diaris. El conflicte desfermat pel control de l’empresa paperera enfronta al poder executiu amb el poder dels grups de comunicació tradicionals amb una més gran influència social i també política. L’ anàlisi de les informacions i opinions publicades mostren la progressiva polarització del país

Chirurgie bariatrique en 2013: principes, avantages et inconvénients des interventions a disposition [Bariatric surgery in 2013: principles, advantages and disadvantages of the available procedures].

For severe obesity (BMI > 35 kg/m2), bariatric surgery is not only the best, but often the only means of obtaining sufficient and durable weight loss. This article aims to review the available bariatric procedures. Gastric bypass remains the reference when it comes to the risk/benefit ratio. Gastric banding is declining rapidly due to the high prevalence of long-term complications. Primary malabsorptive procedures remain largely unpopular because of their potential nutritional complications. Sleeve gastrectomy, although it is not reversible as it includes a significant gastric resection, increases currently in popularity because of its apparent simplicity and the fact that early results regarding weight loss mimic those obtained with gastric bypass.

Metodologia de Calculo de custo de capital da CVTelecom 2011 2013

Apresenta a consulta publica sobre a revisão do calculo do WACC visando fixar uma Metodologia de Cálculo do Custo de Capital e Determinar o valor da taxa do custo de capital da CVTelecom para o triénio de 2011 a 2013 aplicado na definição das tarifas do serviço de telefonia fixa.

Signal search analysis server.

Signal search analysis is a general method to discover and characterize sequence motifs that are positionally correlated with a functional site (e.g. a transcription or translation start site). The method has played an instrumental role in the analysis of eukaryotic promoter elements. The signal search analysis server provides access to four different computer programs as well as to a large number of precompiled functional site collections. The programs offered allow: (i) the identification of non-random sequence regions under evolutionary constraint; (ii) the detection of consensus sequence-based motifs that are over- or under-represented at a particular distance from a functional site; (iii) the analysis of the positional distribution of a consensus sequence- or weight matrix-based sequence motif around a functional site; and (iv) the optimization of a weight matrix description of a locally over-represented sequence motif. These programs can be accessed at: http://www.isrec.isb-sib.ch/ssa/.

Parallel scheduling of multiclass M/M/m queues: Approximate and heavy-traffic optimization of achievable performance

We address the problem of scheduling a multiclass $M/M/m$ queue with Bernoulli feedback on $m$ parallel servers to minimize time-average linear holding costs. We analyze the performance of a heuristic priority-index rule, which extends Klimov's optimal solution to the single-server case: servers select preemptively customers with larger Klimov indices. We present closed-form suboptimality bounds (approximate optimality) for Klimov's rule, which imply that its suboptimality gap is uniformly bounded above with respect to (i) external arrival rates, as long as they stay within system capacity;and (ii) the number of servers. It follows that its relativesuboptimality gap vanishes in a heavy-traffic limit, as external arrival rates approach system capacity (heavy-traffic optimality). We obtain simpler expressions for the special no-feedback case, where the heuristic reduces to the classical $c \mu$ rule. Our analysis is based on comparing the expected cost of Klimov's ruleto the value of a strong linear programming (LP) relaxation of the system's region of achievable performance of mean queue lengths. In order to obtain this relaxation, we derive and exploit a new set ofwork decomposition laws for the parallel-server system. We further report on the results of a computational study on the quality of the $c \mu$ rule for parallel scheduling.

Trends in prevalence, awareness, treatment and control of hypertension in the Republic of Seychelles (African region) between 1989 and 2013 [Poster]

Background: Few data exist on secular trends of high blood pressure (HBP) detection and control in low and middle income countries, particularly in the African region. This study examines trends of HBP over 25 years based on 4 independent population surveys. In the Seychelles, heath care is free to all inhabitants within a national health system, inclusive all HBP medications. Previous studies have shown a transition from traditional to cardiometabolic cardiovascular risk factors in Seychelles. Age adjusted cardiovascular disease mortality rates is high but decreasing over the last two decades.

Relatório de Estimativa da Produção Agro - Pecuário - 2013

Este relatório apresenta a estimativa da produção agropecuária relativamente ao ano 2013. São apresentadas as estimativas de produção de (i) Hortícolas; (ii) Raízes e Tubérculos; (iii) Frutas; (iv) Culturas de Renda; (v) Culturas de Sequeiro; (vi) Produtos Pecuários; e (vii) Produtos Silvícolas. Tem havido grande aumento na produção de hortícolas ao longo dos últimos anos graças às tecnologias mais produtivas, introduzidas na horticultura, nomeadamente: a adopção massiva de novas tecnologias de rega, a ampla utilização de sementes híbridas, o aumento do número de estufas e sistemas hidropónicos instalados, entre outras. Estas tecnologias, conjuntamente com o aumento na disponibilidade de água, têm contribuído para o aumento da produção e para o abastecimento do mercado de forma mais regular, com produtos mais diversificados e de maior qualidade. As estimativas de produção referentes aos últimos 5 anos apontam para uma média à volta de 47.000 toneladas de hortícolas produzidas anualmente, sendo a produção de 2013 estimada em 51.265 toneladas, correspondendo a um aumento de 5% relativamente à produção estimada para 2012. A produção de raízes e tubérculos tem também aumentado consideravelmente. A produção de 2013 é estimada em 27.163 toneladas, equivalente a um aumento de cerca de 25% relativamente ao ano anterior. Refira-se que a importação de raízes e tubérculos nos últimos 5 anos, que se restringe quase que exclusivamente à batata comum, tem registado uma tendência decrescente. Segundo os dados divulgados pelo INE, de 2009 a 2013 a importação de batata comum (fresca) desceu de 9.032 toneladas, em 2009, para 5.238 toneladas, em 2013, ou seja uma diminuição de 42%. Outro dado digno de destaque é a descida contínua no preço médio anual tanto da mandioca como da batata-doce, no mercado nacional, nos últimos 5 anos, embora este último tenha aumentado ligeiramente em 2013.A produção de frutas em 2013 foi estimada à volta de 17.000 toneladas, correspondendo a um aumento de cerca de 4% em relação ao ano precedente. A introdução das culturas de banana “in vitro” a partir de 2009, a introdução de novas tecnologias de rega, novas variedades de papaia e manga bem como o aumento da área cultivada destas frutas em pomar, e o número de plantas fixadas de outras espécies fruteiras, apontam para um acréscimo significativo da produção frutícola nos últimos anos. As intervenções levadas a cabo neste subsector ao longo dos anos têm sido refletidas claramente nas quantidades disponíveis no mercado bem como na baixa dos preços que se tem verificado, principalmente no que diz respeito à banana e à papaia, embora esta última tenha registado uma ligeira subida no preço médio em 2013 (1,27%). Não se faz importação de banana desde 2009, inclusive; a importação de papaia, embora apresentando algumas oscilações, baixou consideravelmente no período 2009 a 2011, voltando porém a subir em 2012 e novamente em 2013, de forma acentuada; a importação de manga também apresenta flutuações, tendo aumentado em 2012 e em 2013. Contudo, as quantidades importadas de papaia e manga são muito reduzidas (48 toneladas e 44 toneladas, respetivamente, em 2013), representando apenas uma ínfima percentagem da oferta total destas frutas ao nível nacional (apenas 1,4% e 2%, respectivamente). Dos contactos que a DSEGI fez as empresas importadoras de manga e papaia obtivemos informação que as mesmas, estão localizadas nas ilhas do Sal e da Boa Vista e, que a quantidade importada se justifica pelo facto, de não existir uma rede de transportes permanente, capaz de dar resposta as necessidades das ilhas turísticas, no que respeita ao escoamento dos produtos, das ilhas de maior produção para as de fraca produção. Entretanto, graças às melhorias registadas na produção hortofrutícola, tem-se verificado que a produção nacional vem conquistando paulatinamente o mercado turístico, tendo as vendas aos hotéis aumentado cerca de dez vezes mais, no período de 2010 a 2013, passando de 57 toneladas para 608 toneladas. Outros produtos como ovos e queijos vêm igualmente conquistando esse mercado, não obstante os problemas de transporte inter-ilhas que continuam constituindo um entrave no escoamento dos produtos agrícolas entre as ilhas. No que toca às culturas de renda, as estimativas da produção anual de uvas apontam para sucessivos aumentos, tendo atingido 346 toneladas em 2013, na maioria destinada à produção de vinhos. A produção de café sofreu uma diminuição em 2013, à volta de 30%, relacionada com a problemática da safra/contrassafra. A produção estimada de cana-de-açúcar manteve-se estável em 28.375 toneladas. Os produtos tradicionais de sequeiro, milho e feijões, dependentes da aleatoriedade das chuvas, sofreram um ligeiro decréscimo em 3013, respetivamente 3,6% e 0,1%. Os produtos pecuários cujas estimativas de produção baseiam-se em dados que carecem de atualização (dados sobre o número de efectivos que remontam ao RGA 2004, e coeficientes zootécnicos provenientes do Plano Director da Pecuária), apresentam ligeiros aumentos na produção estimada para 2013, com excepção da produção de ovos em que os dados fornecidos pelos produtores indicam uma ligeira diminuição à volta de 3% (alguns produtores justificam a diminuição da produção pela falta de transportes inter-ilhas). A seguir se apresenta um resumo dos resultados da estimativa de produção 2013.

2009-2013 Iowa Transportation Improvement Program

The Iowa Transportation Improvement Program (Program) is published to inform Iowans of planned investments in our state's transportation system. The Iowa Transportation Commission (Commission) and Iowa Department of Transportation (Iowa DOT) are committed to programming those investments in a fiscally responsible manner. Iowa's transportation system is multi-modal; therefore, the Program encompasses investments in aviation, transit, railroads, trails, and highways. A major component of the Program is the highway section. The FY2009-2013 highway section is financially balanced and was developed to achieve several objectives. The Commission's primary highway investment objective is the safety, maintenance and preservation of Iowa's existing highway system. The Commission has allocated an annual average of $321 million to achieve this objective. This includes $185 million in 2009 and $170 million annually in years 2010-2013 for preserving the interstate system. It includes $114 million in 2009, $100 million in 2010 and $90 million annually in years 2011-2013 for non-interstate pavement preservation. It includes $38 million annually in 2009 and 2010, and $35 million annually in years 2011-2013 for non-interstate bridges. In addition, $15 million annually is allocated for safety projects. However, due to increasing construction costs, flattened revenues and overall highway systems needs, the Commission acknowledges that insufficient funds are being invested in the maintenance and preservation of the existing highway system. Another objective involves investing in projects that have received funding from the federal transportation act and/or subsequent federal transportation appropriation acts. In particular, funding is being used where it will complete a project, corridor or useable segment of a larger project. As an investment goal, the Commission also wishes to advance highway projects that address the state's highway capacity and economic development needs. Projects that address these needs and were included for completion in the previous program have been advanced into this year's Program to maintain their scheduled completion. This program also includes a small number of other projects that generally either represent a final phase of a partially programmed project or an additional segment of a partially completed corridor. The TIME-21 bill, Senate File 2420, signed by Governor Chet Culver on April 22, provides additional funding to cities, counties and the Iowa DOT for road improvements. This will result in additional revenue to the Primary Road Fund beginning in the second half of FY2009 and gradually increase over time. The additional funding will be included in future highway programming objectives and proposals and is not reflected in this highway program. The Iowa DOT and Commission appreciate the public's involvement in the state's transportation planning process. Comments received personally, by letter, or through participation in the Commission's regular meetings or public input meetings held around the state each year are invaluable in providing guidance for the future of Iowa's transportation system. It should be noted that this document is a planning guide. It does not represent a binding commitment or obligation of the Commission or Iowa DOT, and is subject to change. You are invited to visit the Iowa DOT's Web site at iowadot.gov for additional and regular updates about the department's programs and activities.

Cape Verde - Diagnostic Trade Inttegration study Update - 2013

This Report is an update of the Cape Verde Diagnostic Trade Integration Study, titled Cape Verde’s Insertion into the Global Economy, produced and validated by the Government of Cape Verde in December 2008. Like the previous 2008 study, this Cape Verde Diagnostic Trade Integration Study Update provides a critical examination of the major institutional and production constraints that hinder Cape Verde’s ability to capitalize fully on the growth and welfare gains from its integration into the world economy. As a policy report, this study offers a set of priority policies and measures that can be implemented by both the public and private sectors to mitigate and surmount these supply side and institutional constraints. These recommendations are summarized in an Action Matrix. The Report is fruit of the generous support of the multi-donor program the Enhanced Integrated Framework (EIF). In every crisis there is an opportunity. Four years after the validation of the country’s first Diagnostic Trade Integration Study in 2008, Cape Verde finds itself in a drastically altered external environment. Cape Verde faces a worsened external environment than four years ago, when it was also traversing years of crisis as global food and energy prices escalated. Just as the country was validating its first trade study in late 2008, and celebrating its graduation from the list of Least Developed Countries, the onset of the deepest global recession in recent memory triggered an even worse external situation as the country’s principal source of markets, investments, remittances and aid, the Eurozone, unraveled economically and politically. As the Eurozone crisis spread, it was Cape Verde’s misfortune that the crisis contaminated precisely its biggest Eurozone partners and donors, such as Portugal, Spain and Italy. For such a highly dependent and exposed economy like that of Cape Verde, the deteriorating external sector has had a substantial negative impact on its macroeconomic performance. At the time of the validation workshop and graduation in 2008, no one could have foreseen or predicted the severity of the global crisis that followed. Despite traversing these years of adversity and external shocks, and suffering palpable setbacks, Cape Verde’s economy had proven surprisingly resilient, especially its principal sector, tourism. To its great credit, the country’s economic fundamentals are solid, and have been carefully and prudently managed over the years. For this reason alone, the country has thus far weathered the global and Eurozone crisis. Yet the near and medium term future remains uncertain. The country’s margin for maneuver has narrowed, its options far more limited, and hard choices lie ahead. Thus, there is no better time than now to analyze Cape Verde’s position in the global economy, and to examine the many challenges and opportunities it faces. The first diagnostic trade study outlined an ambitious agenda and set of policy strategies to enhance Cape Verde’s participation in the global economy. Written prior to the global crisis, the study did not, and could not, anticipate the scope and depth of the subsequent global and Eurozone crises. A few short months before the validation of the first DTIS Cape Verde joined the World Trade Organization (WTO). It has spent these four years adjusting to this status and implementing its commitments. At the same time, the country seeks greater economic integration with the European Union. Since 2008 the government has been investing heavily in the country’s economic infrastructure, focusing especially on fostering transformation in key sectors like agriculture, fisheries, tourism and creative industries. For these and many other reasons, it is both timely and urgent to review the road traveled since 2008. It is an opportune moment to reassess the country’s options, to rethink strategies, and to chart a new way forward that it is practical, implementable, and that builds on the country’s competitive advantages and current successes.

Location of multiple server common service centers or public facilities for minimizing general congestion and travel cost functions

We propose a model and solution methods, for locating a fixed number ofmultiple-server, congestible common service centers or congestible publicfacilities. Locations are chosen so to minimize consumers congestion (orqueuing) and travel costs, considering that all the demand must be served.Customers choose the facilities to which they travel in order to receiveservice at minimum travel and congestion cost. As a proxy for thiscriterion, total travel and waiting costs are minimized. The travel costis a general function of the origin and destination of the demand, whilethe congestion cost is a general function of the number of customers inqueue at the facilities.

L'occitan, una lenga a la fin'amors

Treball de recerca realitzat per alumnes d’ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l’any 2010. El treball pretén explicar la situació de la llengua occitana en el segle XIII i reivindicar avui dia la rica herència cultural d' aquesta llengua sense Estat, el seu paper fonamental en els orígens de la lírica trobadoresca i el tractament discriminatori que pateix a França. El treball, síntesi d'un projecte més ambiciós, es divideix en tres blocs: l'estudi de la civilització occitana del XII- XIII, de la seva lírica i l'anàlisi pràctic de la poesia de sis autors/es. La metodologia passa per llegir diversos llibres, sintetitzar el tema i contrastar les fonts; acudir a un curs intensiu de Llengua Occitana al CAOC; transcriure en vers la traducció en prosa dels poemes que donava Martí de Riquer i analitzar-los; atesa la seva escassetat, crear mapes a partir del Google Earth i Microsoft Office Visio; concertar entrevistes; intentar contactar amb l'Acadèmia Francesa. Com a resultat el treball toca diverses branques: història, societat, llengua i literatura, emmarcades en la societat feudal. Ajuda a la comprensió de la fin amors, base de tota la poesia amorosa de l'època. S'ha intentat menystenir la lacre del masclisme en el llenguatge i en l'elecció d'autors, tot i que fins i tot s'ha vist reflectit en els repertoris de poesies, més extensos en els trobadors que en les trobadores. Serveix per mostrar el veritable drama que viu l'Occità, que, des d'un lloc literàriament privilegiat, ara es troba en una situació molt pitjor que la que viu el Català.

Accions transversals del CME contra l'odi i la discriminació (2008-2013)

1.El Pla de govern 2004-2007, va incloure per primera vegada polítiques específiques per a les persones LGTB. Es va crear el Pla interdepartamental per a la no discriminació de las persones LGTB 2006-2014, que crea el Consell Nacional para persones LGTB del Departament d’Acció Social i Ciutadania i detalla “accions de govern” que afecten al Departament d’Interior. A nivell municipal: creació de diferents consells LGTB.Creació el 2007 de la figura del Fiscal interlocutor en delictes amb component de discriminació per orientació sexual. Coincidència durant 2008 de diferents esdevenimentsLGTB: Conferencia internacional de policies gais-les en Barcelona, Eurogames, Creuers internacionals, mostra internacional de cinema, Gaycircus, Loveball, Circuit-festival, etc.