Phlebotomine sandfly fauna and natural Leishmania infection rates in a rural area of Cerrado (tropical savannah) in Nova Mutum, State of Mato Grosso in Brazil

Introduction American cutaneous leishmaniasis (ACL) has been reported in every municipality of the State of Mato Grosso, Brazil, but the transmission epidemiology remains poorly understood. Our study was developed in a rural area of the Nova Mutum municipality where four autochthonous cases of ACL were reported in 2009. Our aims were to describe the local phlebotomine sandfly fauna and to investigate the infection rates and infecting Leishmania species in the captured sandflies. Methods Entomological captures were performed bimonthly at 10 fixed sites close to the edge of a forested area between June 2011 and April 2012. Results A total of 3,743 phlebotomine sandflies belonging to 31 distinct species were captured. Approximately 75% of the specimens were females. The most abundant species (45.4%) was Lutzomyia antunesi, which was consistently captured at every site. Species that are epidemiologically important for ACL, such as L. flaviscutellata, L. whitmani and L. umbratilis, were also captured. L. antunesi and L. ubiquitalis were naturally infected by Leishmania braziliensis or Le. guyanensis, with minimum infection rates of 0.88% and 6.67%, respectively. Surprisingly, L. antunesi was infected by Le. infantum (synonym chagasi). Conclusions The natural infection of L. antunesi and L. ubiquitalis by Leishmania sp. suggests that these species might play a role in the zoonotic cycle of ACL in Nova Mutum. The presence of Le. infantum in L. antunesi suggests that there may be a risk of an outbreak of visceral leishmaniasis (VL) in Nova Mutum.

Social tariffs for water and waste services in mainland Portugal: An impact analysis

This paper proposes to quantify the effect of social tariffs (ST) in the Portuguese water and waste sector (WWS). It calculates the amount of subsidy implicit in ST schemes, characterising the existing tariffs in 2011 and producing a synthetic tariff scene where the regulator’s recommendation is respected. This is the first time such an exercise is undertaken and it is very relevant in a context of deep economic crisis. Results suggest that there are fewer beneficiaries than what income eligibility criteria would imply and that putting the regulator’s recommendation in practice would considerably raise subsidy amounts, potentially leading to a severe increase in non-subsidised user tariffs to allow for break-even.

The exotic palm Roystonea oleracea(Jacq.) O.F. Cook as a rural biotype for Rhodnius neglectus Lent, 1954, in Caçu, State of Goiás

IntroductionRhodnius neglectus is a triatomine that colonizes different palm species. In this study, we aimed to describe the presence of this triatomine bug in the royal palms (Roystonea oleracea) in a rural region of the State of Goiás.MethodsPalm infestation was investigated by dissecting the palms or by using live-bait traps.ResultsTwo palm trees were infested by R. neglectusnegative for Trypanosoma cruzi, the etiological agent for Chagas disease. In the study area, R. neglectus is frequently found in households.ConclusionsThe adaptation of this species to palm trees introduced in Brazil for landscaping purposes poses another challenge for controlling the vectors of Chagas disease.

An atypical Toxoplasma gondii genotype in a rural Brazilian dog co-infected with Leishmania (Viannia) braziliensis

Toxoplasmosis and leishmaniasis are two worldwide zoonoses caused by the protozoan parasites Toxoplasma gondii and Leishmania spp., respectively. This report describes the clinical and laboratorial findings of a co-infection with both parasites in a 4-year-old female dog suspected of ehrlichiosis that presented anemia, thrombocytopenia, hypoalbuminemia, hyperglobulinemia, tachyzoite-like structures to the lung imprints, and polymerase chain reaction (PCR) results positive for T. gondii (kidney, lung, and liver) and Leishmania spp. Co-infection with Toxoplasma gondii and Leishmania braziliensis was confirmed by sequencing; restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) confirmed an atypical T. gondii genotype circulating in dogs that has been reported to cause human congenital toxoplasmosis.

Estimating demand for primary health care services

Primary health services exist with the purpose of providing basic health care to every person at a cost they can afford. But is it fully available to everyone? The objective of this work project is to estimate the demand for primary health care services having into account that in some regions the citizens are not using as much health care as they would like due to supply side constraints. Using the number of consultations as proxy for demand, and applying an econometric tool called switching regression, the demand for primary health care services will be estimated.

Epidemiological study of hepatitis B and C in a municipality with rural characteristics: Cássia dos Coqueiros, State of São Paulo, Brazil

Abstract: INTRODUCTION: Hepatitis B and C viral infections remain an important cause of global morbidity and mortality. Studies have been conducted in population groups of large cities, leaving gaps in the knowledge regarding the situation in small municipalities. We aimed to measure the prevalence of hepatitis B and C markers and presence of infection-associated factors. METHODS: All inhabitants of Cássia dos Coqueiros aged ≥18 years who agreed to participate in the research were included. We collected blood as well as information via a questionnaire between March 2011 and December 2013. Univariate and multivariate analyses were conducted. RESULTS: Among the 1,001 participants, 41 (4.1%) participants had a serological profile of hepatitis B viral exposure, and only one (0.1%) participant was considered a virus carrier. The frequency of isolated antibody to hepatitis B virus surface antigen (anti-HBs) markers was 17.8% for the overall population. In the multivariate analysis, hepatitis B virus (HBV) infection was associated with age, birth outside the State of São Paulo, history of hepatitis, ≥2 sexual partners in the last 6 months, and tattoos. Four (0.4%) participants had a serological profile of hepatitis C viral exposure. However, after confirmation using viral ribonucleic acid (RNA) evaluation, only one (0.1%) individual remained positive. CONCLUSIONS: The positivity rates for hepatitis B and C were low, despite greater sexual freedom and the recent emergence of illicit drugs, as observed by the health personnel working in Cássia dos Coqueiros.

Evaluation of outpatient child-adolescent mental health services (CAMHS) in Attica-Greece

ABSTRACT: Background: Childhood is a critical time for social and emotional development, educational progress and mental health prevention. Mental health for children and adolescents is defined by the achievement of expected developmental, cognitive, social and emotional skills. The development of child-adolescent mental health services (CAMHS) is a necessity for each country, not only as a prevention measure for the wellbeing of people, but also as an investment to the future of countries. Qualitative evaluation of services is the only way to ensure whether services function under quality standards and increase the possibility of better outcomes for their patients. This study examines the greek outpatient CAMHS against the British Standards of National Institute of Excellence for community CAMHS. The Standards assessed refer to the areas of Assessment, Care and Intervention. Objectives: The main objectives of the study are 1) to evaluate Greek outpatient CAMHS in the Attica region 2) to promote the evaluation process for mental health services in Greece. Methods: Due to the fact that Greek services are based on the British model, the tool used was the British self-review questionnaire of Quality Network for Community CAMHS(QNCC).The tool was translated, adapted and posted to services. Twelve out of twenty outpatient CAMHS of Attica (including Athens) responded. Data was collected and performed by the Statistical Package for Social Sciences SPSS. Results: The study resulted that the CAMHS examined, meet moderately the British Standards of 1) Referral and Access, 2) Assessment & Care planning, 3) Care & Intervention. Two out of twelve services examined, meet the standards of "Assessment and Care" in a higher percentage between 75% and 100%. Conclusions: The paper describes a satisfactory function of CAMHS in Attica prefecture taking into consideration the extremely difficult political situation of Greece at the time of the research. Strong and weak domains are identified. Also the translation and adaptation of British tools promote the evaluation process and quality assurance of Greek CAMHS.

Product extension services deployment platform

Due to the progresses made in the branch of embedded technologies, manufacturers are becoming able to pack their shop floor level manufacturing resources with even more complex functionalities. This technological progression is radically changing the way production systems are designed and deployed, as well as, monitored and controlled. The dissemination of smart devices inside production processes confers new visibility on the production system while enabling for a more efficient and effective management of the operations. By turning the current manufacturing resources functionalities into services based on a Service Oriented Architecture (SOA), in order to expose them as a service to the user, the binomial manufacturing resource/service will push the entire manufacturing enterprise visibility to another level while enabling the global optimization of the operations and processes of a production system while, at the same time, supporting its accommodation to the operational spike easily and with reduced impact on production. The present work implements a Cloud Manufacturing infrastructure for achieving the resource/service value-added i.e. to facilitate the creation of services that are the composition of currently available atomic services. In this context, manufacturing resource virtualization (i.e. formalization of resources capabilities into services accessible inside and outside the enterprise) and semantic representation/description are the pillars for achieving resource service composition. In conclusion, the present work aims to act on the manufacturing resource layer where physical resources and shop floor capabilities are going to be provided to the user as a SaaS (Software as a Service) and/or IaaS (Infrastructure as a Service).

New cases of Chagas disease in a rural area of Northeast Brazilian

Abstract: INTRODUCTION: Chagas disease is considered one of the 17 most neglected tropical diseases in the World, with the most common form of vector transmission. METHODS: This structured cross-sectional study was conducted through an epidemiological survey in the Tobias Barreto municipality of Sergipe. RESULTS: Of the 255 participants, 1 (0.4%) participant was positive for human Chagas disease. Approximately 30.2% of the participants found the triatomine bugs in their houses and outbuildings. CONCLUSIONS: The detection of a case indicated transmission, which was also evidenced by the presence of triatomines and poor housing conditions.

Factors associated with non-adherence to the treatment of vivax malaria in a rural community from the Brazilian Amazon Basin

Abstract: INTRODUCTION We investigated the association between demographic and behavioral factors and non-adherence to antimalarial therapy. METHODS A demographic questionnaire and 5-item self-reported questionnaire regarding non-adherence were completed by 135 patients after treatment for Plasmodium vivax. RESULTS Treatment interruption, but not demographic factors, was significantly associated with non-adherence to therapy. The likelihood of non-adherence was 5.16 times higher when the patients felt better than when they felt worse. The relative risk of parasitic resurgence was 3.04 times higher in non-adherent patients. CONCLUSIONS Treatment interruption is significantly associated with treatment adherence.

Serviços públicos em diferentes contextos territoriais: (re)organização das redes e relações com os sistemas urbanos

A presença de serviços públicos nos aglomerados populacionais suscita diferentes arti-culações e rearranjos socioterritoriais e promove a sua dinamização e especialização, fomenta a economia local e contribui, direta e indiretamente, para a coesão, o desen-volvimento, a atratividade, a competitividade e a resiliência dos territórios. Nas últimas décadas, as lógicas da oferta e da procura dos serviços públicos têm evoluído rapida-mente, passando de um modelo de gestão fechado e burocrático, para um modelo mais aberto, diversificado, simplificado e participativo. Com elas, surgiram (novos) de-safios na sua gestão, que vão desde a sua sustentabilidade económica até aos impac-tos sociais e territoriais resultantes da modernização, sem esquecer a maior (e cres-cente) exigência do cidadão. Estas mutações têm repercussões na filosofia da sua or-ganização e no modus operandi, com uma crescente orientação para as necessidades da procura e a satisfação do utente, procurando, em simultâneo, reduzir os custos e aumentar a produtividade e a qualidade dos serviços prestados, com base em políticas de inovação e em parcerias e governação em rede. Na prática, estas alterações condu-zem a processos diferenciados, que têm passado pela fusão, reconversão ou mesmo encerramento de serviços públicos. Num contexto de crise económico-financeira, como o que se vive em Portugal, e aten-dendo às mutações ocorridas na oferta e na procura de serviços públicos de educação, saúde, eventos de vida, defesa e segurança e justiça, importa refletir sobre os concei-tos inerentes a estes serviços e sintetizar as principais dinâmicas nesse período de tempo, tendo como pressupostos que, por um lado, o território é um elemento dife-renciador na prestação e na utilização de serviços e que, por outro lado, estes serviços, pela sua natureza estratégica para a sociedade e para a economia, exigem a definição de políticas e de estratégias territoriais consentâneas e inclusivas. Esta investigação centra a sua análise em dois âmbitos geográficos. Numa primeira fa-se, à escala de Portugal continental, onde se obtém um retrato atual da espacialização dos serviços públicos referidos acima. Em seguida, após a criação de uma metodologia inovadora baseada em análises e modelação de informação geográfica para a tipifica-ção dos diferentes tipos de territórios, são identificados três casos de estudo regionais, com características distintas. Assim, são estudados territórios metropolita-nos/densamente urbanizados (constituídos pelos concelhos de Lisboa, Almada, Seixal, Palmela, Sesimbra e Setúbal), eixo urbano-rural (Évora, Portel, Viana do Alentejo, Vidi-gueira, Cuba e Beja) e territórios profundamente rurais (Barrancos, Moura, Serpa e Mértola), para os quais foi realizado um inquérito à população, com o objetivo de compreender a utilização que fazem dos serviços públicos e quais as suas expetativas em relação aos mesmos. Os resultados obtidos para as análises nacional e regionais são acompanhados por uma reflexão sobre a territorialização das políticas de serviços públicos, as quais incidem em matérias relacionadas com o seu planeamento e, sobre-tudo, com a sua gestão.

Consumer satisfaction with water, wastewater and waste services in Portugal

While the concept of consumer satisfaction is a central topic in modern marketing theory and practice, citizens' satisfaction with public services, and especially water and waste services, is a eld that still remains empirically rather unexplored. The following study aims to contribute to this area by analysing the determinants of user satisfaction in the water, wastewater and waste sector in Portugal, using a unique survey of 1070 consumers undertaken by the Portuguese Water and Waste Regulator ERSAR. I perform an analysis of the relation between overall service satisfaction and attributespeci c service satisfaction with an ordered logit model. I then explore if subjective consumer satisfaction can be re ected by ERSAR's technical performance indicators. The results suggest that overall consumer satisfaction is driven by consumer's satisfaction with speci c service aspects but unrelated to socioeconomic and demographic characteristics. Furthermore, I show that there is no monotonic association between ERSAR's technical performance indicators and consumers' levels of satisfaction.

What do broadband consumers want? Design and execution of a questionnaire on demand for bundled services on the Portuguese telecomunications market

The report addresses the question of what are the preferences of broadband consumers on the Portuguese telecommunication market. A triple play bundle is being investigated. The discrete choice analysis, adopted in the study, base on 110 responses, mainly from NOVA students. The data for the analysis was collected via manually designed on-line survey. The results show that the price attribute is relatively the most important one while the television attribute is being overlooked in the decision making process. Main effects examined in the research are robust. In addition, "extras" components are being tested in terms of users' preferences.