Hospitalization rates for pneumococcal disease in Brazil, 2004 - 2006

OBJECTIVE: To estimate hospitalization rates for pneumococcal disease based on the Brazilian Hospital Information System (SIH). METHODS: Descriptive study based on the Hospital Information System of Brazilian National Health System data from January 2004 to December 2006: number of hospitalizations and deaths for pneumococcal meningitis, pneumococcal sepsis, pneumococcal pneumonia and Streptococcus pneumoniae as the cause of diseases reported in Brazil. Data from the 2003 Brazilian National Household Survey were used to estimate events in the private sector. Pneumococcal meningitis cases and deaths reported to the Notifiable Diseases Information System during the study period were also analyzed. RESULTS: Pneumococcal disease accounted for 34,217 hospitalizations in the Brazilian National Health System (0.1% of all hospitalizations in the public sector). Pneumococcal pneumonia accounted for 64.8% of these hospitalizations. The age distribution of the estimated hospitalization rates for pneumococcal disease showed a "U"-shape curve with the highest rates seen in children under one (110 to 136.9 per 100,000 children annually). The highest hospital case-fatality rates were seen among the elderly, and for sepsis and meningitis. CONCLUSIONS: PD is a major public health problem in Brazil. The analysis based on the SIH can provide an important input to pneumococcal disease surveillance and the impact assessment of immunization programs.

Molinate quantification in environmental water by a glutathione-S-transferase based biosensor

A glutathione-S-transferase (GST)based biosensor was developed to quantify the thiocarbamate herbicide molinate in environmental water.The biosensor construction was based on GST immobilization onto a glassy carbon electrode via aminosilane–glutaraldehyde covalent attachment. The principle supporting the use of this biosensor consists of the GST inhibition process promoted by molinate. Differential pulse voltammetry was used to obtain a calibration curve for molinate concentration, ranging from 0.19 to 7.9 mgL -1 and presenting a detection limit of 0.064 mgL- 1. The developed biosensor is stable,and reusable during 15 days.The GST-based biosensor was successfully applied to quantify molinate in rice paddy field floodwater samples. The results achieved with the developed biosensor were in accordance with those obtained by high performance liquid chromatography. The proposed device is suitable for screening environmental water analysis and, since no sample preparation is required, it can be used in situ and in real-time measurements.

Short Assessment of Health Literacy for Portuguese-speaking Adults

OBJECTIVE: To develop and validate a short health literacy assessment tool for Portuguese-speaking adults. METHODS: The Short Assessment of Health Literacy for Portuguese-speaking Adults is an assessment tool which consists of 50 items that assess an individual's ability to correctly pronounce and understand common medical terms. We evaluated the instrument's psychometric properties in a convenience sample of 226 Brazilian older adults. Construct validity was assessed by correlating the tool scores with years of schooling, self-reported literacy, and global cognitive functioning. Discrimination validity was assessed by testing the tool's accuracy in detecting inadequate health literacy, defined as failure to fully understand standard medical prescriptions. RESULTS: Moderate to high correlations were found in the assessment of construct validity (Spearman's coefficients ranging from 0.63 to 0.76). The instrument showed adequate internal consistency (Cronbach's alpha=0.93) and adequate test-retest reliability (intraclass correlation coefficient=0.95). The area under the receiver operating characteristic curve for detection of inadequate health literacy was 0.82. A version consisting of 18 items was tested and showed similar psychometric properties. CONCLUSIONS: The instrument developed showed good validity and reliability in a sample of Brazilian older adults. It can be used in research and clinical settings for screening inadequate health literacy.

Adaptacao e validacao do WHODAS 2.0 em utentes com dor musculoesqueletica

OBJETIVO Validar a versão em português do World Health Organization Disability Assessment Schedule (WHODAS 2.0). M01;TODOS A versão original de 36 itens do WHODAS 2.0, administrada por entrevista, foi traduzida para o português de acordo com orientações internacionais e testada em nove participantes da população em geral. A versão em português foi administrada em 204 pacientes com patologia musculoesquelética. Foram coletados os dados sociodemográficos e de sa0;de dos pacientes, assim como o n0;mero de locais onde apresentavam dor e sua intensidade. O WHODAS 2.0 foi novamente administrado por um segundo entrevistador, um a três dias após a primeira entrevista, para avaliar a confiabilidade interavaliadores. A validade de constructo foi avaliada quanto a: capacidade do WHODAS 2.0 para diferenciar participantes com diferentes locais com dor e associação entre o WHODAS 2.0 e a intensidade da dor. A consistência interna também foi avaliada. RESULTADOS A versão portuguesa do WHODAS 2.0 teve fácil compreensão, apresentou boa consistência interna (α = 0,84) e confiabilidade interavaliadores (CCI = 0,95). Mostrou ser capaz de detectar diferenças estatisticamente significativas entre indivíduos com diferente n0;mero de locais com dor (p < 0,01) e indicar que maior incapacidade está associada à maior intensidade da dor (r = 0,44, p < 0,01), indicando validade de constructo. CONCLUSÕES A versão portuguesa do WHODAS 2.0 mostrou-se confiável e válida quando utilizada em pacientes com dor associada à patologia musculoesquelética.

Geopor na Web 2.0

Actas do Encontro sobre Web 2.0. Braga: CIEd

HIV/AIDS knowledge among men who have sex with men: applying the item response theory

OBJECTIVE To evaluate the level of HIV/AIDS knowledge among men who have sex with men in Brazil using the latent trait model estimated by Item Response Theory. METHODS Multicenter, cross-sectional study, carried out in ten Brazilian cities between 2008 and 2009. Adult men who have sex with men were recruited (n = 3,746) through Respondent Driven Sampling. HIV/AIDS knowledge was ascertained through ten statements by face-to-face interview and latent scores were obtained through two-parameter logistic modeling (difficulty and discrimination) using Item Response Theory. Differential item functioning was used to examine each item characteristic curve by age and schooling. RESULTS Overall, the HIV/AIDS knowledge scores using Item Response Theory did not exceed 6.0 (scale 0-10), with mean and median values of 5.0 (SD = 0.9) and 5.3, respectively, with 40.7% of the sample with knowledge levels below the average. Some beliefs still exist in this population regarding the transmission of the virus by insect bites, by using public restrooms, and by sharing utensils during meals. With regard to the difficulty and discrimination parameters, eight items were located below the mean of the scale and were considered very easy, and four items presented very low discrimination parameter (< 0.34). The absence of difficult items contributed to the inaccuracy of the measurement of knowledge among those with median level and above. CONCLUSIONS Item Response Theory analysis, which focuses on the individual properties of each item, allows measures to be obtained that do not vary or depend on the questionnaire, which provides better ascertainment and accuracy of knowledge scores. Valid and reliable scales are essential for monitoring HIV/AIDS knowledge among the men who have sex with men population over time and in different geographic regions, and this psychometric model brings this advantage.

An IEEE 802.15.4 protocol implementation (in nesC/TinyOS): reference guide v1.0

This technical report is to provide a reference guide to the implementation of the IEEE 802.15.4 protocol in nesC/TinyOS for the MICAz motes. The implementation is provided as a tool that can be used to implement, test and evaluate the current functionalities defined in the protocol standard as well as to enable the development of functionalities not yet implemented and new add-ons to the protocol.

Prevalence of anemia and associated factors in older adults: evidence from the SABE Study

OBJECTIVE To assess the prevalence of anemia and associated factors in older adults. METHODS The prevalence and factors associated with anemia in older adults were studied on the basis of the results of the Sa0;de, Bem-Estar e Envelhecimento (SABE – Health, Welfare and Aging) study. A group of 1,256 individuals were interviewed during the third wave of the SABE study performed in Sao Paulo, SP, in 2010. The study included 60.4% females; the mean age of the participants was 70.4 years, and their average education was 5.3 years. The dependent variable was the presence of anemia (hemoglobin levels: 12 g/dL in women and 13 g/dL in men). Descriptive analysis and hierarchical logistic regression were performed. The independent variables were as follows: a) demographics: gender, age, and education and b) clinical characteristics: self-reported chronic diseases, presence of cognitive decline and depression symptoms, and body mass index. RESULTS The prevalence of anemia was 7.7% and was found to be higher in oldest adults. There was no difference between genders, although the hemoglobin distribution curve in women showed a displacement toward lower values in comparison with the distribution curve in men. Advanced age (OR = 1.07; 95%CI 0.57;1.64; p < 0.001), presence of diabetes (OR = 2.30; 95%CI 1.33;4.00; p = 0.003), cancer (OR = 2.72; 95%CI 1.2;6.11; p = 0.016), and presence of depression symptoms (OR = 1.75; 95%CI 1.06;2.88; p = 0.028) remained significant even after multiple analyses. CONCLUSIONS The prevalence of anemia in older adults was 7.7% and was mainly associated with advanced age and presence of chronic diseases. Thus, anemia can be an important marker in the investigation of health in older adults because it can be easily diagnosed and markedly affects the quality of life of older adults.

Prescription, dispensation and marketing patterns of methylphenidate

OBJECTIVE To analyze the patterns and legal requirements of methylphenidate consumption. METHODS We conducted a cross-sectional study of the data from prescription notification forms and balance lists of drugs sales – psychoactive and others – subject to special control in the fifth largest city of Brazil, in 2006. We determined the defined and prescribed daily doses, the average prescription and dispensation periods, and the regional sales distribution in the municipality. In addition, we estimated the costs of drug acquisition and analyzed the individual drug consumption profile using the Lorenz curve. RESULTS The balance lists data covered all notified sales of the drug while data from prescription notification forms covered 50.6% of the pharmacies that sold it, including those with the highest sales volumes. Total methylphenidate consumption was 0.37 DDD/1,000 inhabitants/day. Sales were concentrated in more developed areas, and regular-release tablets were the most commonly prescribed pharmaceutical formulation. In some regions of the city, approximately 20.0% of the prescriptions and dispensation exceeded 30 mg/day and 30 days of treatment. CONCLUSIONS Methylphenidate was widely consumed in the municipality and mainly in the most developed areas. Of note, the consumption of formulations with the higher abuse risk was the most predominant. Both its prescription and dispensation contrasted with current pharmacotherapeutic recommendations and legal requirements. Therefore, the commercialization of methylphenidate should be monitored more closely, and its use in the treatment of behavioral changes of psychological disorders needs to be discussed in detail, in line with the concepts of the quality use of medicines.

ERICA: prevalences of hypertension and obesity in Brazilian adolescents

ABSTRACT OBJECTIVE To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents. METHODS Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population. RESULTS We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%. CONCLUSIONS ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5.

Peers' evaluation of a reconfigurable IEEE1451.0-compliant and FPGA-based weblab

It is already more than 10 years that weblabs are seen as important resources to provide the experimental work required in engineering education. Several weblabs have been applied in engineering courses, but there are still unsolved problems related to the development of their infrastructures. For solving some of those problems, it was implemented a weblab with a reconfigurable infrastructure compliant with the IEEE1451.0 Std. and supported by Field Programmable Gate Array (FPGA) technology. This paper presents the referred weblab, and provides and analyses a set of researchers' opinions about the implemented infrastructure, and the adopted methodology for the conduction of real experiments.

Integração Intranet – Pro/Engineer Wildfire 3.0 Via Pro/Web.Link

Mestrado em Engenharia Informática, Área de Especialização em Arquiteturas, Sistemas e Redes

Work-in-progress on a thin IEEE1451.0 - architecture to implement reconfigurable Weblab infrastructures

Institutions have been creating their own specific weblab infrastructures. Usually, they use distinct software and hardware architectures comprehending instruments and modules (I&M) able to be parameterized but difficult to be shared. These aspects are impairing their widespread in education, since collaboration between institutions, in developing and sharing resources, is still low. To handle both aspects, this paper proposes the adoption of the IEEE1451.0 Std. with FPGA technology for creating reconfigurable weblab infrastructures. It is suggested the adoption of an IEEE1451.0 infrastructure with compatible instruments, described in Hardware Description Languages (HDL), to be reconfigured in FPGA-based boards. Besides an overview of the IEEE1451.0 Std., this paper presents a solution currently under development which seeks to enable the reconfiguration and the remote control of weblab infrastructures using a set of IEEE1451.0 HTTP commands.

Towards e-learning 2.0: case study of an e-learning environment

In these days the learning experience is no longer confined within the four walls of a classroom. Computers and primarily the internet have broadened this horizon by creating a way of delivering education that is known as e-learning. In the meantime, the internet, or more precisely, the Web is heading towards a new paradigm where the user is no longer just a consumer of information and becomes an active part in the communication. This two-way channel where the user takes the role of the producer of content triggered the appearance of new types of services such as Social Networks, Blogs and Wikis. To seize this second generation of communities and services, educational vendors are willing to develop e-learning systems focused on the new and emergent users needs. This paper describes the analysis and specification of an e-learning environment at our School (ESEIG) towards this new Web generation, called PEACE – Project for ESEIG Academic Environment. This new model relies on the integration of several services controlled by teachers and students such as social networks, repositories libraries, e-portfolios and e-conference sytems, intelligent tutors, recommendation systems, automatic evaluators, virtual classrooms and 3D avatars.

Interoperability on e-learning 2.0: the PEACE case study

The confluence of education with the evolution of technology boosted the paradigm shift of the face-to-face learning to distance learning. In this scenario e-Learning plays an essential role as a facilitator of the teaching/learning process. However new demands associated with the new Web paradigm require that existent e-Learning environments characterized mostly by monolithic systems begin interacting with new specialized services. In this decentralized scenario the definition of a strategy of interoperability is the cornerstone to ensure the standardization communication among systems. This paper presents a definition of an interoperability strategy for an e-Learning environment at our School (ESEIG) called PEACE – Project for ESEIG Academic Content Environment. This new interoperability model relies on the application of several coordination and integration standards on several services, controlled by teachers and students, and included in the PEACE environment such as social networks, repositories, libraries, e-portfolios, intelligent tutors, recommendation systems and virtual classrooms.