Epidemiology of bacterial meningitis among children in Brazil, 1997-1998

OBJECTIVE: To document the incidence and the descriptive epidemiology of bacterial meningitis among individuals under age 20 in a geographically defined region in Brazil during the two-year period immediately preceding the introduction of Haemophilus influenzae type b (Hib) vaccines into the national immunization program of Brazil. METHODS: Population-based epidemiological study of all cases of bacterial meningitis reported among residents of Campinas, Brazil, under age 20 (n=316,570) during the period of 1997-98, using comprehensive surveillance records compiled by the Campinas Health Department from cases reported among hospital inpatients, outpatients, emergency room visits, death certificates, and autopsy reports. RESULTS: The incidence of bacterial meningitis (n=274) was 334.9, 115 and 43.5 cases/10(5) person-years (pys) for residents of Campinas under age 1, 5 and 20, respectively. All cases were hospitalized, with an average length of stay of 12 days. Documented prior antibiotic use was 4.0%. The case-fatality rate of bacterial meningitis in individuals under age 20 was 9% (24/274) with 75% of deaths occurring in children under the age of five. The incidence of Hib meningitis (n=26) was 62.8 and 17 cases/10(5) pys in children age <1 and <5, respectively. CONCLUSIONS: The incidence of Hib meningitis in children under the age of 5 in Campinas during 1997-98 was similar to that reported in the US, Western Europe, and Israel prior to widespread Hib vaccine use in those regions. This study provides a baseline for later studies to evaluate changes in the etiology and incidence of bacterial meningitis in children after introduction of routine Hib vaccination in Brazil.

Children visual screening protocol: validation by a focus group panel of experts

Screening programs, particularly the inclusion of specific orthoptic tests to detect visual abnormalities, varies among countries. This study aims to: 1) describes expert perception of issues related with children visual screening; 2) identify specific orthoptic tests to detect visual abnormalities in children visual screening.

Positive Solutions of the Dirichlet Problem for the One-dimensional Minkowski-Curvature Equation

We discuss existence and multiplicity of positive solutions of the Dirichlet problem for the quasilinear ordinary differential equation-(u' / root 1 - u'(2))' = f(t, u). Depending on the behaviour of f = f(t, s) near s = 0, we prove the existence of either one, or two, or three, or infinitely many positive solutions. In general, the positivity of f is not required. All results are obtained by reduction to an equivalent non-singular problem to which variational or topological methods apply in a classical fashion.

Detection of anti-Giardia lamblia serum antibody among children of day care centers

OBJETIVES: To detect anti-Giardia lamblia serum antibodies in healthy children attending public day care centers and to assess serological tests as tools for estimating the prevalence of G. lamblia in endemic areas. METHODS: Three separate stool specimens and filter paper blood samples were collected from 147 children ranging from 0 to 6 years old. Each stool sample was processed using spontaneous sedimentation and zinc sulfate flotation methods. Blood samples were tested by indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA) for Giardia IgG. RESULTS AND CONCLUSIONS: Of 147 individuals tested, 93 (63.3%) showed Giardia cysts in their feces. Using IIF and ELISA, serum antibodies were detected in 93 (63.3%) and 100 (68%) samples , respectively. Sensitivity of IIF and ELISA was 82% and 72%, respectively. However, ELISA revealed to be less specific (39%) than IIF (70%). IIF also showed a higher concordance with microscopic examination than ELISA.

Fungal contamination of poultry litter: a public health problem

Although numerous studies have been conducted on microbial contaminants associated with various stages related to poultry and meat products processing, only a few reported on fungal contamination of poultry litter. The goals of this study were to (1) characterize litter fungal contamination and (2) report the incidence of keratinophilic and toxigenic fungi presence. Seven fresh and 14 aged litter samples were collected from 7 poultry farms. In addition, 27 air samples of 25 litters were also collected through impaction method, and after laboratory processing and incubation of collected samples, quantitative colony-forming units (CFU/m3) and qualitative results were obtained. Twelve different fungal species were detected in fresh litter and Penicillium was the most frequent genus found (59.9%), followed by Alternaria (17.8%), Cladosporium (7.1%), and Aspergillus (5.7%). With respect to aged litter, 19 different fungal species were detected, with Penicillium sp. the most frequently isolated (42.3%), followed by Scopulariopsis sp. (38.3%), Trichosporon sp. (8.8%), and Aspergillus sp. (5.5%). A significant positive correlation was found between litter fungal contamination (CFU/g) and air fungal contamination (CFU/m3). Litter fungal quantification and species identification have important implications in the evaluation of potential adverse health risks to exposed workers and animals. Spreading of poultry litter in agricultural fields is a potential public health concern, since keratinophilic (Scopulariopsis and Fusarium genus) as well as toxigenic fungi (Aspergillus, Fusarium, and Penicillium genus) were isolated.

A influência do contexto familiar no aparecimento de dor espinal em crianças do concelho da Maia

A dor espinal em crianças e jovens constitui um problema cujas dimensões e prevalência tem vindo aumentar nas últimas décadas. Esta problemática parece ser tanto mais significativa se for tido em consideração que os episódios de dor espinal na idade escolar se perpetuam e estão relacionados com os que acontecem na idade adulta. Desta forma, os investigadores alertam para a necessidade de identificar potenciais factores de risco para o desenvolvimento de dor espinal em crianças e jovens de idade escolar. Assim, o presente estudo pretende identificar qual a importância assumida pelo contexto familiar na presença de queixas dolorosas espinais nas crianças em idade escolar do concelho da Maia. A amostra é constituída pelos pais de 1017 crianças do 1º ciclo do Ensino Básico do Concelho da Maia que foram avaliadas relativamente à postura, numa fase anterior do estudo. Desta população constituiu amostra 636 pais que concordaram participar no estudo, tendo obtido resposta de 226, obtendo uma percentagem de adesão de 35,5%. Para a obtenção dos dados qualitativos foi utilizado um método de amostragem estratégica de forma a seleccionar dez pais representativos de todas as categorias possíveis (pais com e sem dor e filhos com e sem dor). Esta amostra foi seleccionada tendo em conta os dados obtidos no questionário Parental Pain e Questionário de Bournemouth, sendo, posteriormente aplicado uma entrevista não estruturada. Os principais resultados obtidos permitiram concluir que o contexto tem uma influência determinante na criança com dor. De acordo com os dados extraídos das entrevistas, os comportamentos de manifestação de dor por parte das crianças podem ser um reflexo de comportamentos apreendidos através da observação do comportamento dos adultos e, consequentemente mimetizados, opinião esta igualmente expressa por alguns dos pais. Mas nem sempre os pais apontam a mimetização como causa para a dor referida pelos filhos, referindo igualmente o transporte da mochila, as posturas assumidas no dia-a-dia, o mobiliário escolar e as actividades de lazer realizadas pelas crianças.

Stability of extemporaneously prepared captopril oral liquid formulation for paediatric patients

Captopril, an inhibitor of angiotensin converting enzyme (ACE), is used to treat medical conditions like hypertension and heart failure, and it is usually administered in tablet form for adults. Since this dosage form is not recommended for infants and children up to 6 years, hospital pharmacies have to prepare liquid formulations for oral administration of captopril. Traditionally, concentration of captopril used in the formulations is 1mg/ml. The problem is that captopril is prone to oxidation, and its stability in solution is affected by pH, concentration of captopril, the presence of oxygen or metal ions. The influence of different formulation ingredients on the properties of physical and chemical stability of captopril in liquid preparations has been evaluated. Main of the study: to evaluate the stability of captopril for 30 days when formulated in a 1 mg/ml suspension adjuvanted with citric acid.

Association between child-care and acute diarrhea: a study in Portuguese children

OBJECTIVE: To quantify the influence of the type of child-care on the occurrence of acute diarrhea with special emphasis on the effect of children grouping during care. METHODS: From October 1998 to January 1999 292 children, aged 24 to 36 months, recruited using a previously assembled cohort of newborns, were evaluated. Information on the type of care and occurrence of diarrhea in the previous year was obtained from parents by telephone interview. The X² and Kruskal-Wallis tests were used to compare proportions and quantitative variables, respectively. The risk of diarrhea was estimated through the calculation of incident odds ratios (OR) and their respective 95% confidence intervals (95% CI), crude and adjusted by unconditional logistic regression. RESULTS: Using as reference category children cared individually at home, the adjusted ORs for diarrhea occurrence were 3.18, 95% CI [1.49, 6.77] for children cared in group at home, 2.28, 95% CI [0.92, 5.67] for children cared in group in day-care homes and 2.54, 95% CI [1.21, 5.33] for children cared in day-care centers. Children that changed from any other type of child-care setting to child-care centers in the year preceding the study showed a risk even higher (OR 7.65, 95% CI [3.25, 18.02]). CONCLUSIONS: Group care increases the risk of acute diarrhea whatsoever the specific setting.

A user-centered interface for scheduling problem definition

In this paper we present a user-centered interface for a scheduling system. The purpose of this interface is to provide graphical and interactive ways of defining a scheduling problem. To create such user interface an evaluation-centered user interaction development method was adopted: the star life cycle. The created prototype comprises the Task Module and the Scheduling Problem Module. The first one allows users to define a sequence of operations, i.e., a task. The second one enables a scheduling problem definition, which consists in a set of tasks. Both modules are equipped with a set of real time validations to assure the correct definition of the necessary data input for the scheduling module of the system. The usability evaluation allowed us to measure the ease of interaction and observe the different forms of interaction provided by each participant, namely the reactions to the real time validation mechanism.

Addressing the facilities layout design problem through constraint logic programming

One of the most difficult problems that face researchers experimenting with complex systems in real world applications is the Facility Layout Design Problem. It relies with the design and location of production lines, machinery and equipment, inventory storage and shipping facilities. In this work it is intended to address this problem through the use of Constraint Logic Programming (CLP) technology. The use of Genetic Algorithms (GA) as optimisation technique in CLP environment is also an issue addressed. The approach aims the implementation of genetic algorithm operators following the CLP paradigm.

An optimal scheduling problem in distribution networks considering V2G

This paper addresses the problem of energy resource scheduling. An aggregator will manage all distributed resources connected to its distribution network, including distributed generation based on renewable energy resources, demand response, storage systems, and electrical gridable vehicles. The use of gridable vehicles will have a significant impact on power systems management, especially in distribution networks. Therefore, the inclusion of vehicles in the optimal scheduling problem will be very important in future network management. The proposed particle swarm optimization approach is compared with a reference methodology based on mixed integer non-linear programming, implemented in GAMS, to evaluate the effectiveness of the proposed methodology. The paper includes a case study that consider a 32 bus distribution network with 66 distributed generators, 32 loads and 50 electric vehicles.

Ant colony search algorithm for the optimal power flow problem

To maintain a power system within operation limits, a level ahead planning it is necessary to apply competitive techniques to solve the optimal power flow (OPF). OPF is a non-linear and a large combinatorial problem. The Ant Colony Search (ACS) optimization algorithm is inspired by the organized natural movement of real ants and has been successfully applied to different large combinatorial optimization problems. This paper presents an implementation of Ant Colony optimization to solve the OPF in an economic dispatch context. The proposed methodology has been developed to be used for maintenance and repairing planning with 48 to 24 hours antecipation. The main advantage of this method is its low execution time that allows the use of OPF when a large set of scenarios has to be analyzed. The paper includes a case study using the IEEE 30 bus network. The results are compared with other well-known methodologies presented in the literature.

Role of malnutrition and parasite infections in the spatial variation in children’s anaemia risk in Northern Angola

Anaemia has a significant impact on child development and mortality and is a severe public health problem in most countries in sub-Saharan Africa. Nutritional and infectious causes of anaemia are geographically variable and anaemia maps based on information on the major aetiologies of anaemia are important for identifying communities most in need and the relative contribution of major causes. We investigated the consistency between ecological and individual-level approaches to anaemia mapping, by building spatial anaemia models for children aged ≤15 years using different modeling approaches. We aimed to a) quantify the role of malnutrition, malaria, Schistosoma haematobium and soil-transmitted helminths (STH) for anaemia endemicity in children aged ≤15 years and b) develop a high resolution predictive risk map of anaemia for the municipality of Dande in Northern Angola. We used parasitological survey data on children aged ≤15 years to build Bayesian geostatistical models of malaria (PfPR≤15), S. haematobium, Ascaris lumbricoides and Trichuris trichiura and predict small-scale spatial variation in these infections. The predictions and their associated uncertainty were used as inputs for a model of anemia prevalence to predict small-scale spatial variation of anaemia. Stunting, PfPR≤15, and S. haematobium infections were significantly associated with anaemia risk. An estimated 12.5%, 15.6%, and 9.8%, of anaemia cases could be averted by treating malnutrition, malaria, S. haematobium, respectively. Spatial clusters of high risk of anaemia (>86%) were identified. Using an individual-level approach to anaemia mapping at a small spatial scale, we found that anaemia in children aged ≤15 years is highly heterogeneous and that malnutrition and parasitic infections are important contributors to the spatial variation in anemia risk. The results presented in this study can help inform the integration of the current provincial malaria control program with ancillary micronutrient supplementation and control of neglected tropical diseases, such as urogenital schistosomiasis and STH infection.

Problem-Based Learning e suas implicações: breve revisão teórica

A ESTSP-IPP implementou em 2008-2009 um novo modelo pedagógico, o PBL, em três licenciaturas. Este modelo tem sido considerado capaz de promover a aquisição de conhecimentos mas também o desenvolvimento de competências transversais valorizadas no mercado de trabalho; orienta-se em torno de problemas significativos da realidade profissional, trabalhados segundo a metodologia dos sete passos, destacando-se a aprendizagem através de pesquisa individual e trabalho de grupo; e visa ainda desenvolver processos cognitivos e metacognitivos como levantar hipóteses, comparar, analisar, interpretar e avaliar. Neste artigo, caracterizamos brevemente o modelo e respectivas implicações, justificando o interesse em investigar as repercussões da sua implementação.

Radiographic outcomes and evaluation of developmental dysplasia of the hip in children

The Developmental Dysplasia of the Hip (DDH), also know as Congenital Dislocation of the Hip, is common in infants and children and may persist into adulthood. The radiographic interpretation is highly conditioned by appropriate patient positioning and image quality criteria. The main goal of this study is to demonstrate the value of radiographic evaluation of DDH. Through the retrospective analysis of 65 radiographs of the hips, only 2 (3.1%) female patients with 1-2 years of age presented radiographic findings of DDH. The inappropriate field size and the improper placement and size of the gonadal shields, were the most common errors observed.