RACE, RESOURCES, AND POLITICAL PARTICIPATION IN A BRAZILIAN CITY

Does race influence political behavior in Brazil? Using data from Belo Horizonte, Brazil, we explore whether an individual`s propensity to take part in a political association is affected by race, independent of socioeconomic position and of the availability of resources derived from this position. We found that white individuals participate more in political associations than do black individuals; however, after taking into account the differences in all types of resources, we found no difference in participation by racial groups. Nevertheless, by interacting race, skills, and income, it turns out that different racial groups use the same resources differently. A white individual`s propensity to participate politically is significantly more affected by income than a similar black individual`s propensity. Therefore, we argue that race mediates the effect of resources on political participation, which means that either different groups may use different resources or different groups can differ in how intensively they use resources.

Evaluate of the efficacy and safety of tacrolimus ointment 0,03% to treat atopic dermatitis in pediatric patients

BACKGROUND: Tacrolimus ointment has been shown to be effective in treatment of atopic dermatitis. OBJECTIVES: To evaluate the efficacy and safety of 0.03% tacrolimus ointment (Protopic(R)) in pediatric patients with mild, moderate and severe atopic dermatitis. METHODS.. Open, non-comparative, multicentric study carried out in Brazil. 174 patients (ages from two to 10) with mild to severe atopic dermatitis were included. Patients were instructed to apply Protopic(R) twice a day for six weeks. Primary efficacy criterion was clinical improvement >= 90% assessed by the pbysician (Clinical Response Global Evaluation Scale). Other efficacy criteria included reduction of the Eczema Area Severity Index (EASI), decrease of the affected body surface area (%BSA) and evaluation of the itching by the patients or their guardians (visual analogical scale). Safety was evaluated by adverse events reported by patients and/or guardians or by investigators. RESULTS: Thirty-three percent of patients showed clinical improvement 90%. 45.5% of patients (1st week) decreased EASI and 61.8% (6th week) (p<0,001). %BSA decreased 30.4% and 55.5% in the first and sixth week. improvement was also significant when measured by itching (p<0, 001). Most frequent adverse effects were: burning and itching. CONCLUSION: 0.03% tacrolimus ointment is a safe and effective therapy for mild to severe atopic dermatitis in pediatric patients.

Models of alcohol use by young adults: An examination of various attitude-behavior theories

Objective: The aim of this study was to test the effectiveness of various attitude-behavior theories in explaining alcohol use among young adults. The theory of reasoned action (TRA), the theory of planned behavior and an extension of the TRA that incorporates past behavior were compared by the method of maximum-likelihood estimation, as implemented in LISREL for Windows 8.12. Method: Respondents consisted of 122 university students (82 female) who were questioned about their attitudes, subjective norms, perceived behavioral control, past behavior and intentions relating to drinking behavior. Students received course credit for their participation in the research. Results: Overall, the results suggest that the extension of the theory of reasoned action which incorporates past behavior provides the best fit to the data. For these young adults, their intentions to drink alcohol were predicted by their past behavior as well as their perceptions of what important others think they should do (subjective norm). Conclusions: The main conclusions drawn from the research concern the importance of focusing on normative influences and past behavior in explaining young adult alcohol use. Issues regarding the relative merit of various alternative models and the need for greater clarity in the measure of attitudes are also discussed.

An ergonomic approach to reorganize parking inspection agents` work productivity, health and safety in Sao Paulo, Brazil

Objective: The Traffic Engineering Company of the City of Sao Paulo (Brazil) observed a decrease in productivity, and an increase in sick leave, accidents and psychological distress among their parking inspection agents. To document this situation, qualitative research was undertaken to obtain an in-depth comprehension of work activity. Participants: Workers, managers and health and safety professionals contributed to the documentation of the problem and to the proposal of possible solutions. Methods: Ergonomic work analysis focusing on real work activity, as well as interviews with individual or groups of stakeholders, were conducted. Results: This research revealed that political-economic factors gradually contributed to: 1) an increasing work load; 2) growing fatigue throughout the day, increasing the workers` vulnerability to incidents and accidents and their tendency to react inappropriately to violence experienced on the street; and 3) excessive individual responsibility to manage dangerous situations. Conclusions: Recommendations to ameliorate the situation are proposed. These suggestions are discussed in terms of feasibility given the impact of macro social factors upon micro work activity, and the associated potential expansion of the ergonomist`s role.

International study of temperature, heat and urban mortality: the `ISOTHURM` project

Background This study describes heat- and cold-related mortality in 12 urban populations in low- and middle-income countries, thereby extending knowledge of how diverse populations, in non-OECD countries, respond to temperature extremes. Methods The cities were: Delhi, Monterrey, Mexico City, Chiang Mai, Bangkok, Salvador, So Paulo, Santiago, Cape Town, Ljubljana, Bucharest and Sofia. For each city, daily mortality was examined in relation to ambient temperature using autoregressive Poisson models (2- to 5-year series) adjusted for season, relative humidity, air pollution, day of week and public holidays. Results Most cities showed a U-shaped temperature-mortality relationship, with clear evidence of increasing death rates at colder temperatures in all cities except Ljubljana, Salvador and Delhi and with increasing heat in all cities except Chiang Mai and Cape Town. Estimates of the temperature threshold below which cold-related mortality began to increase ranged from 15 degrees C to 29 degrees C; the threshold for heat-related deaths ranged from 16 degrees C to 31C. Heat thresholds were generally higher in cities with warmer climates, while cold thresholds were unrelated to climate. Conclusions Urban populations, in diverse geographic settings, experience increases in mortality due to both high and low temperatures. The effects of heat and cold vary depending on climate and non-climate factors such as the population disease profile and age structure. Although such populations will undergo some adaptation to increasing temperatures, many are likely to have substantial vulnerability to climate change. Additional research is needed to elucidate vulnerability within populations.

Conceptualizing impulsivity and risk taking in bipolar disorder: importance of history of alcohol abuse

Elevated levels of impulsivity and increased risk taking are thought to be core features of both bipolar disorder (BD) and addictive disorders. Given the high rates of comorbid alcohol abuse in BD, alcohol addiction may exacerbate impulsive behavior and risk-taking propensity in BD. Here we examine multiple dimensions of impulsivity and risk taking, using cognitive tasks and self-report measures, in BD patients with and without a history of alcohol abuse. Thirty-one BD subjects with a prior history of alcohol abuse or dependence (BD-A), 24 BD subjects with no history of alcohol abuse/dependence (BD-N), and 25 healthy control subjects (HC) were assessed with the Barratt Impulsiveness Scale (BIS) and the computerized Balloon Analogue Risk Task (BART). Both BD groups scored significantly higher than controls on the BIS. In contrast, only the BD-A group showed impaired performance on the BART. BD-A subjects popped significantly more balloons than the BD-N and HC groups. In addition, subjects in the BD-A group failed to adjust their performance after popping balloons. Severity of mood symptomatology was not associated with performance on either task. The current study supports a primary role of prior alcohol abuse in risk-taking propensity among patients with bipolar disorder. In addition, findings suggest that impulsivity and risky behavior, as operationalized by self-report and experimental cognitive probes, respectively, are separable constructs that tap distinct aspects of the bipolar phenotype.

Study of the Extent of the Information of Cardiologists from Sao Paulo City, Brazil, Regarding a Low-Prevalence Entity: Brugada Syndrome

Objective: To determine the degree of knowledge that cardiologists from Sao Paulo, Brazil, have regarding a low-prevalent entity associated with a high rate of sudden death-Brugada syndrome. Methods: Two hundred forty-four cardiologists were interviewed by an instrument divided in two parts: in the first, we recorded gender, age, and data related to academic profile. The second-answered only by the professionals that manifested having some degree of knowledge on the syndrome-had 28 questions that evaluated their knowledge. The answers were spontaneous and they did not have a chance to consult. We used uni- and multivariate analysis on the average percentage of right and wrong answers, and the influence of the academic profile. Results: The predominant gender was the male gender (61.1%), the average age was 44.32 +/- 10.83 years, 40% with more than 20 years after obtaining their degree, 44% were educated in public institutions, 69% had a residency in cardiology, 20% had overseas practice, 12% had postdegree, 41% were linked to an educational institution, 24% with publication(s) in an indexed journal, 17.2% were authors of chapters in books, 2.5% had edited books, and 10% were linked to the Brazilian Society of Cardiac Arrhythmias. The average percentage of right answers was 45.7%. Conclusion: The sample studied revealed a little knowledge on the entity. A residency in cardiology was the factor of greater significance in the percentage of right answers. Other significant factors were the link of the interviewed person to an educational institution, or the Brazilian Society of Cardiac Arrhythmias, and having a specialist degree.

Percutaneous ultrasound-guided renal biopsy in children - safety, efficacy, indications and renal pathology findings: 14-year Brazilian university hospital

Introduction: Pediatric percutaneous renal biopsy (Bx) is a routine procedure in pediatric nephrology to obtain renal tissues for histological study. We evaluated the safety, efficacy, indications and renal findings of this procedure at a tertiary care pediatric university hospital and compared our findings with the literature. Methods: Retrospective study based on medical records from January 1993 to June 2006. Results: In the study period, 305 Bx were performed in 262 patients, 127 (48.5%) male, aged 9.8 +/- 4.2 years. A 16-gauge needle was utilized in 56/305 Bx, an 18-gauge needle in 252/305 Bx (82.6%). 56.1% Bx were performed under sedation plus local anesthesia, 43.9% under general anesthesia. The number of punctures per Bx was 3.1 +/- 1.3. Minor complications occurred in 8.6% procedures. The 16-gauge needle caused a higher frequency of renal hematomas (p = 0.05). The number of glomeruli per puncture was >= 5 in 96.7% and >= 7 in 92%. Glomeruli number per puncture and frequency of complications were not different according to the type of anesthesia used. A renal pathology diagnosis was achieved in 93.1% Bx. The main indications of Bx were nephrotic syndrome (NS), lupus nephritis (LN) and hematuria (HE). The diagnosis of minimal change disease (MCD) (61.3%), class V (35.6%) and IgA nephropathy (26.3%) predominated in NS, LN and HE patients, respectively. Conclusion: Pediatric real-time ultrasound-guided percutaneous renal biopsy was safe and effective. The main clinical indications for Bx were NS and LN, the predominant renal pathology diagnoses were MCD and class V LN.

A pilot study to evaluate the safety, tolerance, and efficacy of a novel stationary antral balloon (SAB) for obesity

Background: A 150 cm(3) pear-shaped gastric balloon with a 30 cm-long duodenal stem and a 7 g metallic weight at its distal end was designed and developed to facilitate weight loss by (a) delaying gastric emptying thus enhancing interprandial satiety, and (b) stimulating antral and duodenal receptors of satiation. Methods: Twenty-six patients (body mass index of 29 to 40 kg/m(2)) who failed to lose weight despite dietary intervention underwent endoscopic implantation of the balloon device. Patients were monitored for tolerance to the balloon, complications, weight loss, and compliance with a restricted caloric intake. Results: Six men and 20 women with a median body weight of 93.0kg (range, 73.5 to 119.9), median body mass index 34.3 kg/m(2) (range, 28.8 to 39.5) underwent balloon implantation for a median period of 4.0 months (range, 0.75 to 6.0). Twenty-two patients successfully complied with a 1250 to 1500 kcal daily diet restriction during the study period. Median weight reduction was 6.5 kg (range, 3.7 to 19.9). Patients with initial body weight of > 90 kg tended to loose more weight (8.1 kg) than patients weighing < 90 kg (4.5 kg) (P = 0.14). Nine patients with dwell times of 6 months lost 11.5 +/- 4.6 kg. The balloon malfunctioned in 4 patients (in I patient, the balloon leaked spontaneously but remained in the stomach and in 3 patients, the balloon migrated distally). Conclusions: Our novel balloon device may be effective in inducing weight loss by promoting compliance with a restricted caloric intake and is well tolerated due to its small size. Complications resulted from balloon rupture, which can be easily prevented by enhancements in design and use of alternative materials.

Access to tuberculosis diagnosis in Itaborai City, Rio de Janeiro, Brazil: the patient`s point of view

SETTING: Itaborai Municipality in Rio de Janeiro, Brazil. OBJECTIVE: To evaluate access to tuberculosis (TB) diagnosis for users of the Family Health Program (FHP) and Reference Ambulatory Units (RAUs). DESIGN : A cross-sectional study was conducted in Itaborai City, Rio de Janeiro, Brazil. Between July and October 2007, a sample of 100 TB patients registered consecutively with the TB Control Program was interviewed using the primary care assessment tool. The two highest scores, describing `almost always` and `always`, or `good` and `very good`, were used as a cut-off point to define high quality access to diagnosis. RESULTS: FHP patients were older and had less education than RAU interviewees. Sex and overcrowding did not differ in the two groups. Patient groups did not differ with regard to the number of times care was sought at a unit, transport problems, cost of attending units and availability of consultation within 24 h. Adequate access to diagnosis was identified by 62% of the FHP patients and 53% of the RAU patients (P = 0.01). CONCLUSION: In Itaborai, Rio de Janeiro, TB patients believe that the FHP units provide greater access to TB diagnosis than RAUs. These findings will be used by the Department of Health to improve access to diagnosis in Itaborai.

A Survey of Diseases in Passeriform Birds Obtained From Illegal Wildlife Trade in Sao Paulo City, Brazil

The order Passeriformes comprises the largest number of families and species of birds of any avian order. Brazil is rich in passerine birds, which are a common victim of wildlife trafficking in Brazil. Annually, many birds die as a consequence of illegal trade. To investigate the occurrence of the principle diseases and to identify the main causes of death in smuggled passerine birds, the cause of death was evaluated in 360 passerine birds confiscated within the city of Sao Paulo, Brazil. Causes of death were determined by anatomopathologic and microbiologic studies. Infectious diseases were the cause of death of most birds, which corresponded to 78.6% of cases. The most common infectious diseases were poxvirus infection, aspergillosis, and coccidiosis. Although the etiologic agents of these diseases can coexist asymptomatically within hosts, once the host`s immunity is compromised, the pathogen multiplies quickly and causes disease. The results of this study may help to improve the care of passerine birds in captivity and increase the survival rate of confiscated birds. Results may also be useful for in situ conservation programs that investigate the reintroduction of confiscated species or captive birds.

An evaluation of a suburban railway pedestrian crossing safety programme

This study evaluated a programme of educational and environmental (access prevention) interventions designed to reduce the incidence of illegal and unsafe crossing of the rail corridor at a suburban station in Auckland, New Zealand. Immediately after the programme of interventions, the proportion of those crossing the rail corridor by walking across the tracks directly rather than using the nearby overbridge had decreased substantially. Three months later, the decrease was even greater. However, the educational and environmental interventions were introduced simultaneously so that the effects of each could not be separated, nor could other unmeasured factors be ruled out. Anonymous surveys administered immediately before and 3 months after the interventions indicated that while awareness of the illegality of walking across the tracks had increased slightly, perception of risk had not changed. This suggests that the educational interventions may have had less effect than the access prevention measures. (C) 2001 Elsevier Science Ltd. All rights reserved.

Recent dioxin contamination from Agent Orange in residents of a southern Vietnam city

Marked elevation of dioxin associated with the herbicide Agent Orange was recently found in 19 of 20 blood samples from persons living in Bien Hoa, a large city in southern Vietnam. This city is located near an air base that was used for Agent Orange spray missions between 1962 and 1970. A spill of Agent Orange occurred at this air base more than 30 years before blood samples were collected in 1999. Samples were collected, frozen, and sent to a World Health Organization-certified dioxin laboratory fm congener-specific analysis as part of a Vietnam Red Cross project. Previous analyses of more than 2200 pooled blood samples collected in the 1990s identified Bien Hoa as one of several southern Vietnam areas with persons having elevated blood dioxin levels from exposure to Agent Orange. In sharp contrast to this study, our previous research showed decreasing tissue dioxin levels over time since 1970. Only the dioxin that contaminated Agent Orange, 2,3, 7, 8-tetrachlmodibenzo-p-dioxin (TCDD), was elevated in the blood of 19 of 20 persons sampled from Bien Hoa. A comparison pooled sample from 100 residents of Hanoi, where Agent Orange was not used, measured blood TCDD levels of 2 parts per trillion (ppt). TCDD levels of up to 271 ppt, a 135-fold increase, were found in Bien Hoa residents. TCDD contamination was also found in some nearby soil and sediment samples. Persons new to this region and children born after Agent Orange spraying ended also had elevated TCDD levels. This TCDD uptake was recent and occurred decades after spraying ended. We hypothesize that a major route of current and past exposures is from the movement of dioxin from soil into river sediment, then into fish, and from fish consumption into people.

An action research report on the Korean national digital library

This paper presents the results of my action research. I was involved in establishing and running a digital library that was founded by the government of South Korea. The process involved understanding the relationship between the national IT infrastructure and the success factors of the digital library. In building, the national IT infrastructure, a digital library system was implemented; it combines all existing digitized university libraries and can provide overseas information, such as foreign journal articles, instantly and freely to every Korean researcher. An empirical survey was made as a part of the action research; the survey determined user satisfaction in the newly established national digital library. After obtaining the survey results, I suggested that the current way of running the nationwide government-owned digital library should be retained. (C) 2002 Elsevier Science B.V. All rights reserved.

A practical framework for the generation and selection of strategic plans of action, The relevance of timeframe considerations and a systems thinking approach

The paper proposes a methodology especially focused on the generation of strategic plans of action, emphasizing the relevance of having a structured timeframe classification for the actions. The methodology explicitly recognizes the relevance of long-term goals as strategic drivers, which must insure that the complex system is capable to effectively respond to changes in the environment. In addition, the methodology employs engineering systems techniques in order to understand the inner working of the system and to build up alternative plans of action. Due to these different aspects, the proposed approach features higher flexibility compared to traditional methods. The validity and effectiveness of the methodology has been demonstrated by analyzing an airline company composed by 5 subsystems with the aim of defining a plan of action for the next 5 years, which can either: improve efficiency, redefine mission or increase revenues.