Distribution of hospital admissions in a middle-income country of the African region

Introduction: Few studies have reported the distribution of all hospital admissions at the entire country level in low and middle-income countries (LMICs). We examined this question in Seychelles, a rapidly developing small island state in the Africa region, in which access to health care is provided free of charge to all inhabitants through a national health system and all hospital admissions are routinely registered. Methods: Based on all admissions to all hospitals in Seychelles in 2005-2008, we calculated the distribution of hospital admissions, age at admission, length of stay and bed occupancy (i.e. cumulated number of patients * number of days spent in all hospitals) according to both hospital departments and broad causes of diseases (using codes of the ICD-10 classification of diseases). Results: Bed occupancy was largest in the surgical wards (36.7% of all days spent in all hospitals), followed by the medical wards (24.3%), gynecology/obstetrics wards (18.4%), pediatric wards (11.2%), and psychiatric wards (7.2%). According to broad causes of diseases/conditions, bed occupancy was highest for obstetrics/gynecology conditions (19.9% of all days spent at hospital), mental diseases (8.6%), cardiovascular diseases (8.1%), upper aerodigestive/pulmonary diseases (8%), infectious/parasitic diseases (8%), gastrointestinal diseases (7.2%), and urogenital diseases (6.7%). Adjusted to 100'000 population, 153 hospital beds are needed every day, including 31 for obstetrics/gynecologic conditions, 13 for mental diseases, 12 for cardiovascular diseases, 12 for upper aerodigestive diseases, 12 for infectious/parasitic diseases, and 11 for gastrointestinal diseases. Conclusion: Our findings give a good indication of the overall distribution of admissions according to both hospital departments and broad causes of diseases in a middle-income country. These findings provide important information for health care planning at the national level

Hospital admissions due to ambulatory care sensitive conditions among children by age group and health region

OBJECTIVE to describe hospital admissions for ambulatory care sensitive conditions in children under five years of age in the State of Paraná, Brazil by condition type, age group and health region. METHOD a temporal ecological study was conducted using data from the Unified Health System Hospital Information System for the period 2000 to 2011. Conditions were grouped in accordance with the list of ambulatory care sensitive conditions in Brazil. RESULTS there was an increase in the rate of admissions for ambulatory care sensitive conditions in all age groups in 50% of the health regions, with a marked increase in children under the age of one. Pneumonia, gastroenteritis and asthma were the main causes of admissions. There was an increase in the proportion of overall admissions accounted for by pneumonia and gastroenteritis. CONCLUSION the increase in admissions reveals the need for actions to improve access to primary healthcare and provide effective treatment of the main ambulatory care sensitive conditions in order to prevent hospital admissions among children.

Respiratory effects of an exposure to grain dust among grain workers in the Vaud region (Switzerland)

Introduction: Bioaerosols such as grain dust (GD) elicit direct immunological reactions within the human respiratory system. Workplace-dependent exposure to GD may induce asthma, chronic bronchitis, and hypersensitivity pneumonitis. Aims: To assess the clinical impact of occupational exposure to GD and to determine quantitative biological markers of bioaerosol exposure in grain workers. Methods: This longitudinal study has been conducted from summer 2012 to summer 2013, comprising 6 groups of 30 active workers with different GD exposure patterns (4 groups of grain workers, 2 control groups). Two evaluations at high- and low-exposing seasons take place, during which an occupational and a medical history are questionnaire-assessed, lung function is evaluated by spirometry, airway inflammation is measured by exhaled nitric oxide (eNO) and specific blood IgG and IgE are titrated. Results: The preliminary results are those of 2 of the 4 exposed groups, (harvesters and mill workers), compared to the control groups, at first assessment (n=100). Mean age is 38.4 [years]; 98% are male. Exposed groups differ from controls (p<0.05) in daily contact with animals (57% vs. 40%) and active smoking (39% vs. 11%). Grain workers have more respiratory (50%), nasal (57%), ocular (45%) and dermatologic (36%) occupational symptoms than controls (6.4%, 19%, 16%, 6.4% respectively, p<0.05). Lower mean peak-expiratory-flow (PEF) values (96.1 ± 18.9 vs. 108.2 ± 17.4 [% of predicted], p<0.05) and eNO values (13.9 ± 9.6 vs. 20.5 ± 14.7 [ppm], p<0.05) are observed in the exposed groups. Conclusion: Preliminary results show a higher prevalence of clinical symptoms and a lower mean PEF value in the groups exposed to GD.

Variation of the Chlorophyll a Related to Sea Surface Temperature, Wind and Geostrophic Currents in the Cape Verde Region Using Satellite Data

We present a comparative analysis of satellite derived climatologies in the Cape Verde region (CV). In order to establish chlorophyll a variability, in relation to other oceanographic phenomena, a set of, relatively long (from five to eight years), time series of chlorophyll a, sea surface temperature, wind and geostrophic currents, were ensembled for the Eastern Central Atlantic (ECA). We studied seasonal and inter-annual variability of phytoplankton concentration, in relation to the rest of the variables, with a special focus in CV. We compared the situation within the archipelago with those of the surrounding marine environments, such as the North West African Upwelling (NWAU), North Atlantic Subtropical Gyre (NASTG), North Equatorial Counter Current (NECC) and Guinea Dome (GD). At the seasonal scale, CV region behaves partly as the surrounding areas, nevertheless, some autochthonous features were also found. The maximum peak of the pigment having a positive correlation with temperature is found at the end of the year for all the points in the archipelago; a less remarkable rise with negative correlation is also detected in February for points CV2 and CV4. This is behavior that none of the surrounding environments have shown. This enrichment was found to be preceded by a drastic drop in wind intensity (SW Monsoon) during summer months. The inter-annual analysis shows a tendency for decreasing of the chlorophyll a concentration.

Variation of the Chlorophyll a Related to Sea Surface Temperature, Wind and Geostrophic Currents in the Cape Verde Region Using Satellite Data

We present a comparative analysis of satellite derived climatologies in the Cape Verde region (CV). In order to establish chlorophyll a variability, in relation to other oceanographic phenomena, a set of, relatively long (from five to eight years), time series of chlorophyll a, sea surface temperature, wind and geostrophic currents, were ensembled for the Eastern Central Atlantic (ECA). We studied seasonal and inter-annual variability of phytoplankton concentration, in relation to the rest of the variables, with a special focus in CV. We compared the situation within the archipelago with those of the surrounding marine environments, such as the North West African Upwelling (NWAU), North Atlantic Subtropical Gyre (NASTG), North Equatorial Counter Current (NECC) and Guinea Dome (GD). At the seasonal scale, CV region behaves partly as the surrounding areas, nevertheless, some autochthonous features were also found. The maximum peak of the pigment having a positive correlation with temperature is found at the end of the year for all the points in the archipelago; a less remarkable rise with negative correlation is also detected in February for points CV2 and CV4. This is behavior that none of the surrounding environments have shown. This enrichment was found to be preceded by a drastic drop in wind intensity (SW Monsoon) during summer months. The inter-annual analysis shows a tendency for decreasing of the chlorophyll a concentration.

Managers' perspective on continuous health education in a region of São Paulo State

OBJECTIVEAnalysing the concepts of Continuous Health Education - CHE (EPS - in Portuguese), operated by municipal managers and translated into official documents.METHODQualitative research with the use of official documents and semi-structured interviews with the Municipal Health Secretaries or Coordinators of Primary Health Care in the Northeast Region of São Paulo State, and thematic analysis of empirical material.RESULTSResults indicate difficulties in the municipalities problematizing their management practices, services and health care; EPS tools presented are insufficient and unsatisfactory for amending the array of problems raised and are still far from the routine of Primary Care services.CONCLUSIONDespite efforts to implement EPS actions for the strengthening of primary care, the process appears to be incipient.

The achievable region approach to the optimal control of stochastic systems

The achievable region approach seeks solutions to stochastic optimisation problems by: (i) characterising the space of all possible performances(the achievable region) of the system of interest, and (ii) optimisingthe overall system-wide performance objective over this space. This isradically different from conventional formulations based on dynamicprogramming. The approach is explained with reference to a simpletwo-class queueing system. Powerful new methodologies due to the authorsand co-workers are deployed to analyse a general multiclass queueingsystem with parallel servers and then to develop an approach to optimalload distribution across a network of interconnected stations. Finally,the approach is used for the first time to analyse a class of intensitycontrol problems.

Tornabenea ribeirensis (Apiaceaeb a new species from São Nicolau, Cape Verde Islands (West Africa)

Many species of Apiaceae are found in the Macaronesien Region. Several have been introduccd by human activities, but a number of taxa is endemic to the different archipelagos or even rrstrictcd to a single island. The following enumeration is based mainly on HANSEN & SUNDING ( 1993). In the Arores 28 different taxa of Apiaceae occur; among them four endemic species [AUIMI; hrrrrii WATSON, A. trifoliatum (WATSON) TKEL., Clrtrc~,y~l~~ll~r~~~ cl:oricrm TREL.. SOErich trwrictr GUTIINICK ex SEUB.]. In Madeira the Apiaceae are very diverse and consist ol’ 29 species and subspecies. From the archipelago two monotypic genera, rC/c/trtio. velitru~rr t/ccipicvr.s (SCHRAD. & J. C. WENDL.) Ho~+hl. md kJorli:ia edu[is LOWE and ~hrcc cndcmic species [Oemmrlre diwricore (R. BR.) MABB.. I/nperrr/orio lotvei COSS. and Burrirr~r hre~$~lirrnr LOWE] are described. The Canary Islands have the highest numbcr of plant-species and a high level of endemism. 5-l taxa of Apiaceae are recorded including three endemic genera (Rtrrheopsis A. HANSEX & KUNKEL, Todm-oa PARL. and Tiqyrmm PARL.) and further I5 endemic taxa. The Apiaceae are represented in the Cape Verde Islands by I2 species. Most of the taxa have been introduced by human activities (LOBIN & ZIZKA 1957) like Amvhm grm’eo- 1efr.s L., Apirm grmvolerrs L, Foerricrrhrr urlgore MILL.. Corimrtlru~t~ srrtirvrrrr L. or Petrosilerrm crisprrm (FRILL.) A.W.HILL. These species are cultivated and some of them later became \\esdy. Other species like Ciclosper- UWL /e/~fo/~/l~ll~rrtr (PER%) SPRAGUE (= Apimr leproplr~llrr~rr) are weeds of cultivated grounds or wasted lands. All these species are today widespread in temperate. subtropical or tropical regions all over the world. The only native species are to be found in the endemic genus To~wI~~I~~~ PARL.

A new spermophagous species of Heilipus Germar from the Amazonian Region (Coleoptera, Curculionidae, Molytinae)

Heilipus odoratus sp. nov. (type locality: Brazil, Amazonas, Manaus) is described based on adults reared from seeds of Aniba rosaeodora Ducke (Lauraceae), popularly called "pau-rosa". The species is spermophagous and develops from egg to adult inside the seeds. The new taxon is compared with the similar Heilipus draco (Fabricius, 1801). Illustrations of larva, pupa, adult and of important structures for species identification are given, including the male and female genitalia, figured for the first time for a species of Heilipus.

A new species of Calloconophora Dietrich (Hemiptera, Membracidae) from the semi-arid region of northeastern Brazil

A new species of treehopper, Calloconophora gaudencia sp. nov., from Araruna, Paraíba State, is described and illustrated.

The serine-rich N-terminal region of Arabidopsis phytochrome A is required for protein stability.

Deletion or substitution of the serine-rich N-terminal stretch of grass phytochrome A (phyA) has repeatedly been shown to yield a hyperactive photoreceptor when expressed under the control of a constitutive promoter in transgenic tobacco or Arabidopsis seedlings retaining their native phyA. These observations have lead to the proposal that the serine-rich region is involved in negative regulation of phyA signaling. To re-evaluate this conclusion in a more physiological context we produced transgenic Arabidopsis seedlings of the phyA-null background expressing Arabidopsis PHYA deleted in the sequence corresponding to amino acids 6-12, under the control of the native PHYA promoter. Compared to the transgenic seedlings expressing wild-type phyA, the seedlings bearing the mutated phyA showed normal responses to pulses of far-red (FR) light and impaired responses to continuous FR light. In yeast two-hybrid experiments, deleted phyA interacted normally with FHY1 and FHL, which are required for phyA accumulation in the nucleus. Immunoblot analysis showed reduced stability of deleted phyA under continuous red or FR light. The reduced physiological activity can therefore be accounted for by the enhanced destruction of the mutated phyA. These findings do not support the involvement of the serine-rich region in negative regulation but they are consistent with a recent report suggesting that phyA turnover is regulated by phosphorylation.

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.