Determinants of Portuguese bank’s provisioning policies: Discretionary behaviour of generic and specific allowances

In this paper we test for the impact of the regulatory environment on a bank’s discretionary provisioning practices. We develop a model that structures the dynamics of the provision policy for the two classes of provisions: generic provisions and specific provisions. The model is tested using a comprehensive database of all financial institutions operating in Portugal for 1990-2000. This unique dataset comprises banks subject to the Portuguese rules as well as bank subsidiaries subject to their home-country regulation and we were able to identify distinct behaviours between them. Our results show the importance of handling he two types of provisions separately. They support the hypothesis that banks have a discretionary behaviour in setting up their provisions, and find evidence of income smoothing and capital management. We also find that the regulatory regime impacts on discretionary provisioning policies because banks when forced to increase one type of provision react by reducing the iscretionary component of the other, a finding we designated as a substitution effect.

Estigma e percepções dos médicos de Clínica Geral sobre a doença mental e o suicídio

RESUMO: INTRODUÇÃO: A OMS (2001) revela que cerca de 450 milhões de pessoas sofrem de perturbações mentais ou comportamentais em todo o mundo, mas apenas uma pequena minoria tem tratamento, ainda que elementar. Transformam-se em vítimas por causa da sua doença e convertem-se em alvos de estigma e discriminação. O suicídio é considerado como um grande problema de saúde pública em todo o mundo, é uma das principais causas de morte de jovens adultos e situa-se entre as três maiores causas de morte na população entre 15-34 anos (OMS, 2001). As perturbações mentais aumentam o risco de suicídio. A depressão, esquizofrenia, e a utilização de substâncias incrementam o risco de suicídio. Estudos (Sartorius, 2002; Magliano et al., 2012) mostram que os profissionais de saúde, tal como o público em geral, podem ter atitudes negativas e estigma em relação às pessoas com perturbações mentais, podendo agir em conformidade, uma vez feito e conhecido o diagnóstico psiquiátrico. Os clínicos gerais são os receptores das perturbações mentais e tentativas de suicídio nas principais portas de entrada no acesso a cuidados de saúde. As crenças, conhecimentos e contacto com a doença mental e o suicídio, podem influenciar a atenção clínica. OBJECTIVOS: Avaliar o estigma e as percepções dos médicos de clínica geral em relação às tentativas de suicídio, o suicídio e perturbações mentais bem como os possíveis factores associados a estes fenómenos. MATERIAIS E MÉTODOS: Estudo do tipo transversal, combinando métodos quantitativos e qualitativos. A amostra é constituída por 125 sujeitos, médicos de clínica geral. Utilizaram-se as versões adaptadas dos seguintes instrumentos: Questionário sobre Percepções e Estigma em Relação à Saúde Mental e ao Suicídio (Liz Macmin e SOQ, Domino, 2005) e a Escala de Atitudes sobre a Doença Mental (Amanha Hahn, 2002). Para o tratamento estatístico dos dados usou-se a estatística 1) descritiva e 2) Análise estatística das hipóteses formuladas (Qui Quadrado - 2) a correlação entre variáveis (Spearman: ρ, rho). Os dados conectados foram limpos de inconsistências com base no pacote informático e estatístico SPSS versão 20. Para a aferição da consistência interna foi usado o teste de Alfa de Cronbach. RESULTADOS: Uma boa parte da amostra (46.4%) refere que não teve formação formal ou informal em saúde mental e (69.35%) rejeitam a ideia de que “grupos profissionais como médicos, dentistas e psicólogos são mais susceptíveis a cometer o suicídio”. Já (28.0%) têm uma perspectiva pessimista quanto a possibilidade de recuperação total dos sujeitos com perturbação mental. Sessenta e oito(54.4%) associa sujeitos com perturbação mental, a comportamentos estranhos e imprevisíveis, 115 (92.0%) a um baixo QI e 35 (26.7%) a poderem ser violentas e e perigosas. Os dados mostram uma associação estatisticamente significativa (p0.001) entre as variáveis: tempo de serviço no SNS, recear estar perto de sujeitos com doença mental e achar que os sujeitos com doença mental são mais perigosos que outros. Em termos estatísticos, existe uma associação estatitisticamente significativa entre as duas variáveis(X2=9,522; p0.05): percepção de que “é vergonhoso ter uma doença mental” e os conhecimentos em relação à doença mental. Existe uma correlação positiva, fraca e estatisticamente significativa entre os conhecimentos dos clínicos gerais(beneficiar-se de formação em saúde mental) e a percepção sobre os factores de risco (0,187; P0,039). DISCUSSÃO E CONCLUSÕES: A falta de conhecimento sobre as causas e factores de risco para os comportamentos suicidários, opções de intervenção e tratamento, particularmente no âmbito da doença mental, podem limitar a procura de ajuda individual ou dos próximos. Percepções negativas como o facto de não merecerem prioridade nos serviços, mitos (frágeis e cobarde, sempre impulsivo, chamadas de atenção, problemas espirituais) podem constituir-se como um indicador de que os clínicos gerais podem sofrer do mesmo sistema de estigma e crenças, de que sofre o público em geral, podendo agir em conformidade (atitudes de afastamento ereceio). As atitudes são influenciadas por factores como a formação, cultura e sistema de crenças. Sujeitos com boa formação na área da saúde mental têm uma percepção positiva e optimista sobre os factores de risco e uma atitude positiva em relação aos sujeitos com doença mental e comportamentos suicidários.-------------ABSTRACT: INTRODUCTION: The WHO (2001) reveals that about 450 million people suffer from mental or behavioral disorders worldwide, but only a small minority have access to treatment, though elementary. They become victims because of their disease and they become the targets of stigma and discrimination. Suicide is seen as a major public health problem worldwide, is a leading cause of death for young adults and is included among the three major causes of death in the population aged 15-34 years (WHO, 2001). Mental disorders increase the risk of suicide. Depression, schizophrenia, and the substances misuse increase the risk of suicide. Studies (Sartorius, 2002; Magliano et al, 2012) show that health professionals, such as the general public, may have negative attitudes and stigma towards people with mental disorders, and can act accordingly after psychiatric diagnosis is known. General practitioners are the main entry points of mental disorders and suicide attempts in the health sistem. Beliefs, knowledge and contact with mental illness and suicide, may influence clinical care. OBJECTIVES: To assess stigma and perceptions of general practitioners in relation to suicide attempts, suicide and mental disorders as well as possible factors associated with these phenomena. MATERIAL AND METHODS: This was a descriptive cross-sectional study, combining quantitative and qualitative methods. The sample consisted of 125 subjects, general practitioners. We used adapted versions of the following instruments: Questionnaire of Perceptions and Stigma in Relation to Mental Health and Suicide (Liz Macmin and SOQ, Domino, 2005) and the Scale of Attitudes on Mental Illness (Tomorrow Hahn, 2002). For the statistical treatment of the data we used: 1) descriptive (Data distribution by absolute and relative frequencies for each of the variables under study (including mean and standard deviation measures of central tendency and deviation), 2) statistical analysis of hypotheses using (Chi Square - 2, a hypothesis test that is intended to find a value of dispersion for two nominal variables, evaluating the association between qualitative variables) and the correlation between variables (Spearman ρ, rho), a measure of non-parametric correlation, which evaluates an arbitrary monotonic function can be the description of the relationship between two variables, without making any assumptions about the frequency distribution of the variables). For statistical analysis of the correlations were eliminated subjects who did not respond to questions. The collected data were cleaned for inconsistencies based on computer and statistical package SPSS version 20. To measure the internal consistency was used the Cronbach's alpha test. RESULTS: A significant part of the sample 64 (46.4%) reported no formal or informal training in mental health and 86 (69.35%) reject the idea that "professional groups such as doctors, dentists and psychologists are more likely to commit suicide." On the other hand, 42 (28.0%) have a pessimistic view of the possibility of full recovery of individuals with mental disorder. Sixty-eight ( 54.4 % ) of them associates subjects with mental disorder to strange and unpredictable behavior, 115 ( 92.0 % ), to low IQ, 35 ( 26.7 % ) and even to violent and dangerous behavior, 78 ( 62.4 % ) The data show a statistically significant (p = 0.001) relationship between the following variables: length of service in the NHS, fear of being close to individuals with mental illness and considering individuals with mental illness more dangerous than others. In statistical terms, there is a dependency between the two variables (X2 = 9.522, p> 0.05): the perception that "it is shameful to have a mental illness" and knowledge regarding mental illness. There is a positive and statistically significant weak correlation between knowledge of general practitioners (benefit from mental health training) and the perception of the risk factors (0,187; P0,039). DISCUSSION AND CONCLUSIONS: The lack of knowledge about the causes and risk factors for suicidal behavior, intervention and treatment, particularly in the context of mental illness options, may decreaseseeking for help by individual and their relatives. Negative perceptions such as considering that they dont deserve priority in services, myths (weak and cowards, always impulsive, seeking for attentions, spirituals problems) may indicate that general practitioners, may suffer the same stigma and beliefs systems as the general public, and can act accordingly (withdrawal and fear attitudes). Attitudes are influenced by factors such as education, culture and belief system. Subjects with good training in mental health have a positive and optimistic perception of the risk factors and a positiveattitude towards individuals with mental illness and suicidal behaviour.

Knowledge management framework based on brain models and human physiology

The life of humans and most living beings depend on sensation and perception for the best assessment of the surrounding world. Sensorial organs acquire a variety of stimuli that are interpreted and integrated in our brain for immediate use or stored in memory for later recall. Among the reasoning aspects, a person has to decide what to do with available information. Emotions are classifiers of collected information, assigning a personal meaning to objects, events and individuals, making part of our own identity. Emotions play a decisive role in cognitive processes as reasoning, decision and memory by assigning relevance to collected information. The access to pervasive computing devices, empowered by the ability to sense and perceive the world, provides new forms of acquiring and integrating information. But prior to data assessment on its usefulness, systems must capture and ensure that data is properly managed for diverse possible goals. Portable and wearable devices are now able to gather and store information, from the environment and from our body, using cloud based services and Internet connections. Systems limitations in handling sensorial data, compared with our sensorial capabilities constitute an identified problem. Another problem is the lack of interoperability between humans and devices, as they do not properly understand human’s emotional states and human needs. Addressing those problems is a motivation for the present research work. The mission hereby assumed is to include sensorial and physiological data into a Framework that will be able to manage collected data towards human cognitive functions, supported by a new data model. By learning from selected human functional and behavioural models and reasoning over collected data, the Framework aims at providing evaluation on a person’s emotional state, for empowering human centric applications, along with the capability of storing episodic information on a person’s life with physiologic indicators on emotional states to be used by new generation applications.

Seroprevalence of hantavirus and Yersinia pestis antibodies in professionals from the Plague Control Program

Introduction Professionals who handle rodents in the field and in the laboratory are at risk of infection by the microorganisms harbored by these animals. Methods Serum samples from professionals involved in rodent and Yersinia pestis handling in field or laboratory work were analyzed to determine hantavirus and plague seroprevalence and to establish a relationship between these activities and reports of illnesses. Results Two individuals had antibodies against hantavirus, and two harbored antibodies against the plague; none of the individuals had experienced an illness related to their duties. Conclusions These results confirm the risks of hantavirus- and plague-related field and laboratory activities and the importance of protective measures for such work.

The impact of job insecurity on adaptive performance via burnout

Difficult and unpredictable times, due to economic instability, lead employees to feel high job insecurity. Organizations’ only way to subsistence is to search innovative ways of solving problems and find creative solutions. This study focuses on the impact that job insecurity has on adaptive performance, a recent measure integrating the response of creativity, reactivity in the face of emergencies, interpersonal adaptability, training effort, and handling work stress, and, mediated by burnout. From the responses of two questionnaires (????????1=252; ????????2=145), we conclude that job insecurity leads to exhaustion, but not to disengagement. In turn, it is the latter that demonstrates to have negative relations with some measures of adaptive performance. Thus, it is crucial to understand how organizations can minimize the inherent process.

Characterization of an OPCPA laser amplifier based on the nonlinear crystal YCOB

The work described in this thesis was performed at the Laboratory for Intense Lasers (L2I) of Instituto Superior Técnico, University of Lisbon (IST-UL). Its main contribution consists in the feasibility study of the broadband dispersive stages for an optical parametric chirped pulse amplifier based on the nonlinear crystal yttrium calcium oxi-borate (YCOB). In particular, the main goal of this work consisted in the characterization and implementation of the several optical devices involved in pulse expansion and compression of the amplified pulses to durations of the order of a few optical cycles (20 fs). This type of laser systems find application in fields such as medicine, telecommunications and machining, which require high energy, ultrashort (sub-100 fs) pulses. The main challenges consisted in the preliminary study of the performance of the broadband amplifier, which is essential for successfully handling pulses with bandwidths exceeding 100 nm when amplified from the μJ to 20 mJ per pulse. In general, the control, manipulation and characterization of optical phenomena on the scale of a few tens of fs and powers that can reach the PW level are extremely difficult and challenging due to the complexity of the phenomena of radiation-matter interaction and their nonlinearities, observed at this time scale and power level. For this purpose the main dispersive components were characterized in detail, specifically addressing the demonstration of pulse expansion and compression. The tested bandwidths are narrower than the final ones, in order to confirm the parameters of these elements and predict the performance for the broadband pulses. The work performed led to additional tasks such as a detailed characterization of laser oscillator seeding the laser chain and the detection and cancelling of additional sources of dispersion.

Evaluation of antihypertensive drugs in patients with obstructive sleep apnea and in rats submitted to chronic intermittent hypoxia

RESUMO: A hipertensão arterial (HA) é uma patologia altamente prevalente, embora claramente subdiagnosticada, em doentes com síndrome de apneia obstrutiva do sono (SAOS). Estas duas patologias apresentam uma estreita relação e a monitorização ambulatória da pressão arterial (MAPA), por um período de 24 horas, parece ser o método mais preciso para o diagnóstico de hipertensão em doentes com SAOS. No entanto, esta ferramenta de diagnóstico para além de ser dispendiosa e envolver um número acrescido de meios técnicos e humanos, é mais morosa e, por conseguinte, não é utilizada por rotina no contexto do diagnóstico da SAOS. Por outro lado, apesar da aplicação de pressão positiva contínua nas vias aéreas (CPAP – Continous Positive Airway Pressure) ser considerada a terapêutica de eleição para os doentes com SAOS, o seu efeito no abaixamento da pressão arterial (PA) parece ser modesto, exigindo, por conseguinte, a implementação concomitante de terapêutica anti-hipertensora. Acontece que são escassos os dados relativos aos regimes de fármacos anti-hipertensores utilizados em doentes com SAOS e, acresce ainda que, as guidelines terapêuticas para o tratamento farmacológico da HA, neste grupo particular de doentes, permanecem, até ao momento, inexistentes. A utilização de modelos animais de hipóxia crónica intermitente (CIH), que mimetizam a HA observada em doentes com SAOS, revela-se extremamente importante, uma vez que se torna imperativo identificar fármacos que promovam um controle adequado da PA neste grupo de doentes. No entanto, estudos concebidos com o intuito de investigar o efeito anti-hipertensor dos fármacos neste modelo animal revelam-se insuficientes e, por outro lado, os escassos estudos que testaram fármacos anti-hipertensores neste modelo não foram desenhados para responder a questões de natureza farmacológica. Acresce ainda que se torna imprescindível garantir a escolha de um método para administração destes fármacos que seja não invasivo e que minimize o stress do animal. Embora a gavagem seja uma técnica indiscutivelmente eficaz e amplamente utilizada para a administração diária de fármacos a animais de laboratório, ela compreende uma sequência de procedimentos geradores de stress para os animais e, que podem por conseguinte, constituir um viés na interpretação dos resultados obtidos. O objectivo global da presente investigação translacional foi contribuir para a identificação de fármacos anti-hipertensores mais efectivos para o tratamento da HT nos indivíduos com SAOS e investigar mecanismos subjacentes aos efeitos sistémicos associadas à SAOS bem como a sua modulação por fármacos anti-hipertensores. Os objectivos específicos foram: em primeiro lugar,encontrar novos critérios, baseados nas medidas antropométricas, que permitam a identificação de doentes com suspeita de SAOS, que erroneamente se auto-classifiquem como nãohipertensos, e desta forma promover um uso mais criterioso do MAPA; em segundo lugar, investigar a existência de uma hipotética associação entre os esquemas de fármacos antihipertensores e o controle da PA (antes e após a adaptação de CPAP) em doentes com SAOS em terceiro lugar, avaliar a eficácia do carvedilol (CVD), um fármaco bloqueador β-adrenérgico não selectivo com actividade antagonista α1 intrínseca e propriedades anti-oxidantes num modelo animal de hipertensão induzida pela CIH; em quarto lugar, explorar os efeitos da CIH sobre o perfil farmacocinético do CVD; e, em quinto lugar, investigar um método alternativo à gavagem para a administração crónica de fármacos anti-hipertensores a animais de laboratório. Com este intuito, na primeira fase deste projecto, fizemos uso de uma amostra com um número apreciável de doentes com SAOS (n=369), que acorreram, pela primeira vez, à consulta de Patologia do Sono do CHLN e que foram submetidos a um estudo polissonográfico do sono, à MAPA e que preencheram um questionário que contemplava a obtenção de informação relativa ao perfil da medicação anti-hipertensora em curso. Numa segunda fase, utilizámos um modelo experimental de HT no rato induzida por um paradigma de CIH. Do nosso trabalho resultaram os seguintes resultados principais: em primeiro lugar, o índice de massa corporal (IMC) e o perímetro do pescoço (PP) foram identificados como preditores independentes de “auto-classificação errónea” da HA em doentes com suspeita de SAOS; em segundo lugar, não encontramos qualquer associação com significado estatístico entre os vários esquemas de fármacos anti-hipertensores bem como o número de fármacos incluídos nesse esquemas, e o controle da PA (antes e depois da adaptação do CPAP); em terceiro lugar, apesar das doses de 10, 30 e 50 mg/kg de carvedilol terem promovido uma redução significativa da frequência cardíaca, não foi observado qualquer decréscimo na PA no nosso modelo animal; em quarto lugar, as razões S/(R+S) dos enantiómeros do CVD nos animais expostos à CIH e a condições de normóxia revelaram-se diferentes; e, em quinto lugar, a administração oral voluntária mostrou ser um método eficaz para a administração diária controlada de fármacos anti-hipertensores e que é independente da manipulação e contenção do animal. Em conclusão, os resultados obtidos através do estudo clínico revelaram que o controle da PA, antes e após a adaptação do CPAP, em doentes com SAOS é independente, quer do esquema de fármacos anti-hipertensores, quer do número de fármacos incluídos num determinado esquema. Os nossos resultados salientam ainda a falta de validade da chamada self-reported hypertension e sugerem que em todos os doentes com suspeita de SAOS, com HA não diagnosticada e com um IMC e um PP acima de 27 kg/m2 e 39 cm, respectivamente, a confirmação do diagnóstico de HA deverá ser realizada através da MAPA, ao invés de outros métodos que com maior frequência são utilizados com este propósito. Os resultados obtidos no modelo animal de HA induzida pela CIH sugerem que o bloqueio do sistema nervoso simpático, juntamente com os supostos efeitos pleiotrópicos do CVD, não parece ser a estratégia mais adequada para reverter este tipo particular de hipertensão e indicam que as alterações farmacocinéticas induzidas pela CIH no ratio S/(R+S) não justificam a falta de eficácia anti-hipertensora do CVD observada neste modelo animal. Por último, os resultados do presente trabalho suportam ainda a viabilidade da utilização da administração oral voluntária, em alternativa à gavagem, para a administração crónica de uma dose fixa de fármacos anti-hipertensores.---------------------------- ABSTRACT: Hypertension (HT) is a highly prevalent condition, although under diagnosed, in patients with obstructive sleep apnea (OSA). These conditions are closely related and 24-hour ambulatory blood pressure monitoring (ABPM) seems to be the most accurate measurement for diagnosing hypertension in OSA. However, this diagnostic tool is expensive and time-consuming and, therefore, not routinely used. On the other hand, although continuous positive airway pressure (CPAP) is considered the gold standard treatment for symptomatic OSA, its lowering effect on blood pressure (BP) seems to be modest and, therefore, concomitant antihypertensive therapy is still required. Data on antihypertensive drug regimens in patients with OSA are scarce and specific therapeutic guidelines for the pharmacological treatment of hypertension in these patients remain absent. The use of animal models of CIH, which mimic the HT observed in patients with OSA, is extremely important since it is imperative to identify preferred compounds for an adequate BP control in this group of patients. However, studies aimed at investigating the antihypertensive effect of antihypertensive drugs in this animal model are insufficient, and most reports on CIH animal models in which drugs have been tested were not designed to respond to pharmacological issues. Moreover, when testing antihypertensive drugs (AHDs) it becomes crucial to ensure the selection of a non-invasive and stress-free method for drug delivery. Although gavage is effective and a widely performed technique for daily dosing in laboratory rodents, it comprises a sequence of potentially stressful procedures for laboratory animals that may constitute bias for the experimental results. The overall goal of the present translational research was to contribute to identify more effective AHDs for the treatment of hypertension in patients with OSA and investigate underlying mechanisms of systemic effects associated with OSA, as well as its modulation by AHDs. The specific aims were: first, to find new predictors based on anthropometric measures to identify patients that misclassify themselves as non-hypertensive, and thereby promote the selective use of ABPM; second, to investigate a hypothetical association between ongoing antihypertensive regimens and BP control rates in patients with OSA, before and after CPAP adaptation; third, to determine, in a rat model of CIH-induced hypertension, the efficacy of carvedilol (CVD), a nonselective beta-blocker with intrinsic anti-α1-adrenergic activity and antioxidant properties; fourth, to explore the effects of CIH on the pharmacokinetics profile of CVD and fifth, to investigate an alternative method to gavage, for chronic administration of AHDs to laboratory rats. For that, in the first phase of this project, we used a sizeable sample of patients with OSA (n=369), that attended a first visit at Centro Hospitalar Lisboa Norte, EPE Sleep Unit, and underwent overnight polysomnography, 24-h ABPM and filled a questionnaire that included ongoing antihypertensive medication profile registration. In the second phase, a rat experimental model of HT induced by a paradigm of CIH that simulates OSA was used. The main findings of this work were: first, body mass index (BMI) and neck circumference (NC) were identified as independent predictors of hypertension misclassification in patients suspected of OSA; second, in patients with OSA, BP control is independent of both the antihypertensive regimen and the number of antihypertensive drugs, either before or after CPAP adaptation; third, although the doses of 10, 30 and 50 mg/Kg of CVD promoted a significant reduction in heart rate, no decrease in mean arterial pressure was observed; fourth, the S/(R+S) ratios of CVD enantiomers, between rats exposed to CIH and normoxic conditions, were different and fifth, voluntary ingestion proved to be an effective method for a controlled daily dose administration, with a define timetable, that is independent of handling and restraint procedures. In conclusion, the clinical study showed that BP control in OSA patients is independent of both the antihypertensive regimen and the number of antihypertensive drugs. Additionally, our results highlight the lack of validity of self-reported hypertension and suggest that all patients suspected of OSA with undiagnosed hypertension and with a BMI and NC above 27 Kg/m2 and 39 cm should be screened for hypertension, through ABPM. The results attained in the rat model of HT related to CIH suggest that the blockade of the sympathetic nervous system together with the putative pleiotropic effects of carvedilol is not able to revert hypertension induced by CIH and point out that the pharmacokinetic changes induced by CIH on S/(R+S) ratio are not apparently responsible for the lack of efficacy of carvedilol in reversing this particular type of hypertension. Finally, the results here presented support the use of voluntary oral administration as a viable alternative to gavage for chronic administration of a fixed dose of AHDs.

Detection of intestinal parasites on field-grown strawberries in the Federal District of Brazil

Introduction This study evaluated the presence of pathogenic human parasites on field-grown strawberries in the Federal District of Brazil. Methods A total of 48 samples of strawberries and 48 soil samples from 16 properties were analyzed. Results Contaminated strawberries were detected in 56% of the properties. Schistosoma mansoni, Ascaris lumbricoides or Ascaris suum, Balantidium coli, Endolimax nana, and Entamoeba spp. were detected. Soil was contaminated with Entamoeba spp., Entamoeba coli, Strongyloides spp., Ancylostomatidae, and Hymenolepis nana. Conclusions Producers should be instructed on the safe handling of strawberries in order to reduce the incidence of strawberries that are contaminated with enteroparasites.

Toxoplasma gondii seropositivity and risk factors in pregnant women followed up by the Family Health Strategy

INTRODUCTION : Toxoplasmosis is a zoonotic infection caused by Toxoplasma gondii. It is transmitted by the ingestion of contaminated water and foods, by soil contaminated with cat feces, especially while handling it, and congenitally via the placenta. The diagnosis of maternal infection is made by serological detection of either IgM or IgG antibodies. This study assessed the seropositivity in pregnant women followed up by the Family Health Strategy (FHS) in Lages, Santa Catarina, Brazil. METHODS: The study was performed in 19 FHS units and included 148 childbearing women. The outcomes evaluated were IgM and IgG seropositivity and behavioral variables. RESULTS: IgG yielded positive results in 16% of the pregnant women, whereas IgM was positive in only 1%. CONCLUSIONS: The 1% IgM positivity rate for T. gondii indicates congenital toxoplasmosis is not common in Lages.

Risk factors for Toxoplasma gondii infection among pregnant women from the State of Tocantins, Northern Brazil

ABSTRACT INTRODUCTION: The prevalence of infection by Toxoplasma gondii and associated risk factors in pregnant women in Tocantins, Northern Brazil were assessed. METHODS: Serological analysis was performed in 338 serum samples and an oral questionnaire was utilized to identify potential risk factors. RESULTS: Anti-IgG antibodies against T. gondii were detected in 71% (240/338) of the pregnant women. Prior contact with cats and meat handling were found to be associated with T. gondii infection. CONCLUSIONS: A considerable percentage (29%) of women living in the Tocantins area remain susceptible to infection by the T. gondii protozoon, representing a serious public health risk.

Cost of drugs manufactured by the University Hospital - role of the Central Pharmacy

The hospital pharmacy in large and advanced institutions has evolved from a simple storage and distribution unit into a highly specialized manipulation and dispensation center, responsible for the handling of hundreds of clinical requests, many of them unique and not obtainable from commercial companies. It was therefore quite natural that in many environments, a manufacturing service was gradually established, to cater to both conventional and extraordinary demands of the medical staff. That was the case of Hospital das Clinicas, where multiple categories of drugs are routinely produced inside the pharmacy. However, cost-containment imperatives dictate that such activities be reassessed in the light of their efficiency and essentiality. METHODS: In a prospective study, the output of the Manufacturing Service of the Central Pharmacy during a 12-month period was documented and classified into three types. Group I comprised drugs similar to commercially distributed products, Group II included exclusive formulations for routine consumption, and Group III dealt with special demands related to clinical investigations. RESULTS: Findings for the three categories indicated that these groups represented 34.4%, 45.3%, and 20.3% of total manufacture orders, respectively. Costs of production were assessed and compared with market prices for Group 1 preparations, indicating savings of 63.5%. When applied to the other groups, for which direct equivalent in market value did not exist, these results would suggest total yearly savings of over 5 100 000 US dollars. Even considering that these calculations leave out many components of cost, notably those concerning marketing and distribution, it might still be concluded that at least part of the savings achieved were real. CONCLUSIONS: The observed savings, allied with the convenience and reliability with which the Central Pharmacy performed its obligations, support the contention that internal manufacture of pharmaceutical formulations was a cost-effective alternative in the described setting.

Blue rubber bleb nevus syndrome: case report

The case of a patient with blue rubber bleb nevus syndrome who is infected by acquired immunodeficiency syndrome virus due to multiple blood transfusions is presented. This case shows that although it is a rare systemic disorder, blue rubber bleb nevus syndrome has to be considered in the differential diagnosis of chronic anemia or gastrointestinal bleeding. Patients should be investigated by endoscopy, which is the most reliable method for detecting these lesions. The patient underwent gastroscopy and enteroscopy via enterotomy with identification of all lesions. Minimal resection of the larger lesions and string-purse suture of the smaller ones involving all the layers of the intestine were performed. The string-purse suture of the lesions detected by enteroscopy proved to be an effective technique for handling these lesions, avoiding extensive intestinal resection and stopping the bleeding. Effective management of these patients demands aggressive treatment and should be initiated as soon as possible to avoid risks involved in blood transfusions, as occurred in this case.

Livros de artista: gestão da coleção da Biblioteca de Arte da Fundação Calouste Gulbenkian

Os Livros de Artista são obras de arte contemporâneas cujo nascimento se situa no século XX. As coleções deste tipo de documentos encontram‐se em museus e em bibliotecas. Nas bibliotecas os riscos do manuseamento estão mais presentes porque os Livros de Artista são tocados para serem lidos. As particularidades deste tipo de coleções, onde os livros têm tamanhos diversos, formas variadas e materiais díspares, levou‐nos à reflexão sobre o impacto do seu manuseamento nas bibliotecas. A reflexão baseou‐se no estudo das práticas em uso na Biblioteca de Arte da Fundação Calouste Gulbenkian. A observação da gestão do risco do manuseamento em Livros de Artista na instituição e a revisão da literatura permitiram a elaboração de um conjunto de regras. As regras devem ser seguidas pelas instituições que têm à sua guarda coleções de Livros de Artista. Acreditamos que a sua adoção, progressiva e continuada, contribui para a minimização dos efeitos do manuseamento e constitui um auxílio na disponibilização e acessibilidade ao longo do tempo dos Livros de Artista. Não anula, de forma total e absoluta, os efeitos do uso de uma coleção de Livros de Artista. Os Livros de Artista para serem lidos são tocados e, por isso, existirá sempre um dano – o desgaste.

Contributos para um Plano de Preservação no Arquivo Intermédio da Câmara Municipal de Sintra

Os aquivos municipais preservam a documentação definida legalmente como de conservação permanente, a memória e a experiência da Administração Local e, como tal, são agentes imprescindíveis à preservação dos direitos municipais. A preocupação com a preservação da documentação deve constituir um dos pilares principais do arquivo desde o início da sua criação. E não somente quando a documentação é transferida para o Arquivo Histórico, deve estar presente durante todo o ciclo de vida da documentação. Com a criação do PARAM (Programa de Apoio à Rede de Arquivos Municipais), os arquivos municipais ganham um novo incremento, não só a nível técnico como a nível financeiro, sendo-lhe reconhecido o seu devido valor e importância, na sua dupla dimensão, administrativa e cultural. Uma das funções do arquivo é disponibilizar a documentação que têm à sua guarda e que se encontra armazenada nos depósitos. Para tal é fundamental criar condições a curto, a médio e a longo prazo, implementando toda uma política integrada de preservação, envolvendo os demais serviços da instituição, fazendo-se o controlo do estado de conservação da documentação, aplicando uma metodologia da manipulação de documentos para disponibilizá-los tanto aos clientes internos como externos. O Arquivo Intermédio da Câmara Municipal de Sintra não possui plano de preservação documental, nem ações de preservação extensíveis aos objetos digitais, daí que a presente tese de mestrado pretenda ser um proposta de um contributo de um plano de preservação, que tenha em consideração os demais aspetos desde a localização e construção ou manutenção do edifício onde se encontra o arquivo, questões de segurança, de controlo ambiental, de luz/fotodegradação, o controlo integrado de pragas, danos causados por água, os desastres naturais, a poluição, a limpeza e vigilância na zona de depósitos e armazenamento e manuseamento dos documentos.

Safest level of tricaine methanesulfonate (ms-222) to induce anesthesia in juveniles of Matrinxã, Brycon cephalus

The use of MS-222 as an anesthetic for matrinxã juveniles was investigated. At dosage of 100 mg/L or lower fish did not achieve a complete anesthesia state. At 150 mg/L, MS-222 induced anesthesia within 36 seconds and recovered from a 10 minutes period of anesthesia within 5.2 min. Higher concentrations (200, 250 and 300 mg/L) anesthetized fish in lesser times, with the offset of mortality (16.7 and 33.3%) at the 200 and 300 mg/L MS-222 doses, respectively. The only significant differences observed in the hematological parameters, was for the glucose values in fish anesthetized with 250 and 300 mg/L. From the results, the recommended dose of MS-222 for handling matrinxã juveniles is 150 mg/L.