Assessment of integration of the leprosy program into primary health care in Aracaju, state of Sergipe, Brazil

INTRODUCTION: The aim of this study was to assess the epidemiological and operational characteristics of the Leprosy Program before and after its integration into the Primary healthcare Services of the municipality of Aracaju-Sergipe, Brazil. METHODS: Data were drawn from the national database. The study periods were divided into preintegration (1996-2000) and postintegration (2001-2007). Annual rates of epidemiological detection were calculated. Frequency data on clinico-epidemiological variables of cases detected and treated for the two periods were compared using the Chi-squared (χ2) test adopting a 5% level of significance. RESULTS: Rates of detection overall, and in subjects younger than 15 years, were greater for the postintegration period and were higher than rates recorded for Brazil as a whole during the same periods. A total of 780 and 1,469 cases were registered during the preintegration and postintegration periods, respectively. Observations for the postintegration period were as follows: I) a higher proportion of cases with disability grade assessed at diagnosis, with increase of 60.9% to 78.8% (p < 0.001), and at end of treatment, from 41.4% to 44.4% (p < 0.023); II) an increase in proportion of cases detected by contact examination, from 2.1% to 4.1% (p < 0.001); and III) a lower level of treatment default with a decrease from 5.64 to 3.35 (p < 0.008). Only 34% of cases registered from 2001 to 2007 were examined. CONCLUSIONS: The shift observed in rates of detection overall, and in subjects younger than 15 years, during the postintegration period indicate an increased level of health care access. The fall in number of patients abandoning treatment indicates greater adherence to treatment. However, previous shortcomings in key actions, pivotal to attaining the outcomes and impact envisaged for the program, persisted in the postintegration period.

Spiritual dimension of children and adolescents with cancer: an integrative review

OBJECTIVE: To review scientific literature relating to the spiritual dimension of children and adolescents with cancer. METHODS: We conducted an integrative literature review in the LILACS, SciELO, PsycINFO and MEDLINE databases in the period between 1990 to 2011. RESULTS: Twenty-one studies were analyzed and grouped into thematic categories: quality of life and elements of spirituality; alternative and complementary therapies: spirituality as a therapeutic resource; spirituality as a coping strategy and spirituality as an attribute of existential transformations. It was found that spirituality is present at different stages of the disease experience and that its forms of expression may vary, according to age and cognitive development. CONCLUSION: There is a scarcity of specific scales for this age range and a need for scientific production relating to the spiritual dimension of children and adolescents with cancer. Descriptors: Neoplasms; Children; Adolescents; Spirituality

Semantic integration of gene expression analysis tools and data sources using software connectors

Abstract Background The study and analysis of gene expression measurements is the primary focus of functional genomics. Once expression data is available, biologists are faced with the task of extracting (new) knowledge associated to the underlying biological phenomenon. Most often, in order to perform this task, biologists execute a number of analysis activities on the available gene expression dataset rather than a single analysis activity. The integration of heteregeneous tools and data sources to create an integrated analysis environment represents a challenging and error-prone task. Semantic integration enables the assignment of unambiguous meanings to data shared among different applications in an integrated environment, allowing the exchange of data in a semantically consistent and meaningful way. This work aims at developing an ontology-based methodology for the semantic integration of gene expression analysis tools and data sources. The proposed methodology relies on software connectors to support not only the access to heterogeneous data sources but also the definition of transformation rules on exchanged data. Results We have studied the different challenges involved in the integration of computer systems and the role software connectors play in this task. We have also studied a number of gene expression technologies, analysis tools and related ontologies in order to devise basic integration scenarios and propose a reference ontology for the gene expression domain. Then, we have defined a number of activities and associated guidelines to prescribe how the development of connectors should be carried out. Finally, we have applied the proposed methodology in the construction of three different integration scenarios involving the use of different tools for the analysis of different types of gene expression data. Conclusions The proposed methodology facilitates the development of connectors capable of semantically integrating different gene expression analysis tools and data sources. The methodology can be used in the development of connectors supporting both simple and nontrivial processing requirements, thus assuring accurate data exchange and information interpretation from exchanged data.

Comparison of child self-reports and parent proxy-reports on quality of life of children with attention deficit hyperactivity disorder

Abstract Background Attention deficit hyperactivity disorder (ADHD) is a neurobiological condition that affects 3%–7% of the pediatric population and significantly compromises the quality of life (QoL) of these individuals. The aim of the current study was to compare child self-reports and parent proxy reports on the QoL of children with ADHD. Methods Forty-five children with ADHD, combined type, aged 8–12 years without comorbidities, were compared with 43 typically developing children. PedsQL™ 4.0 (Pediatric QoL Inventory™) Generic Core Scales (physical, emotional, social, and school functioning) were completed by families and children self-reporting their health-related QoL. Results Children with ADHD reported themselves significantly lowered their PedsQL™ scores on all dimensions in comparison to typically developing children. Statistically significant differences were observed in social functioning (p = 0.010), school functioning (p <0.001), psychosocial health (p <0.001), and total score (p = 0.002). The physical functioning and emotional functioning dimensions did not differ significantly between groups, with p = 0.841 and p = 0.070, respectively. Parents of children with ADHD also reported lower PedsQL™ scores, with statistically significant differences in all dimensions. The relationship between child self-reports and parent proxy reports indicated that there is greater agreement among children with ADHD, except for the school functioning. Conclusions This suggests that children with the disorder and their parents have a perception of the functional limitations the disorder brings. It is therefore important to undertake studies to verify the QoL in children with ADHD that aim to provide and measure the scope of the well-being of these children.

Thomas Phayer y The book of children (1546): estudio (meta)textual del primer tratado pediátrico en lengua inglesa

Programa de doctorado: Estudios interdisciplinares en lengua, literatura, cultura y traducción.

Middleware principles and design for the integration of ubiquitos mobile services

Nowadays, in Ubiquitous computing scenarios users more and more require to exploit online contents and services by means of any device at hand, no matter their physical location, and by personalizing and tailoring content and service access to their own requirements. The coordinated provisioning of content tailored to user context and preferences, and the support for mobile multimodal and multichannel interactions are of paramount importance in providing users with a truly effective Ubiquitous support. However, so far the intrinsic heterogeneity and the lack of an integrated approach led to several either too vertical, or practically unusable proposals, thus resulting in poor and non-versatile support platforms for Ubiquitous computing. This work investigates and promotes design principles to help cope with these ever-changing and inherently dynamic scenarios. By following the outlined principles, we have designed and implemented a middleware support platform to support the provisioning of Ubiquitous mobile services and contents. To prove the viability of our approach, we have realized and stressed on top of our support platform a number of different, extremely complex and heterogeneous content and service provisioning scenarios. The encouraging results obtained are pushing our research work further, in order to provide a dynamic platform that is able to not only dynamically support novel Ubiquitous applicative scenarios by tailoring extremely diverse services and contents to heterogeneous user needs, but is also able to reconfigure and adapt itself in order to provide a truly optimized and tailored support for Ubiquitous service provisioning.

The integration of curriculum and assessment in interpreter education

In dieser interdisziplinären, translationswissenschaftlichen Studie wird die Integration von Curriculum und Evaluierung in der Dolmetscherausbildung theoretisch fundiert und im Rahmen einer Fallstudie empirisch untersucht. Dolmetschkompetenz wird als ein durch zweckgerechte und messgenaue (valid and reliable) Bewertungsmethoden dokumentiertes Ergebnis der Curriculumanwendung betrachtet. Definitionen, Grundlagen, Ansätze, Ausbildungs- und Lernziele werden anhand der Curriculumtheorie und Dolmetschwissenschaft beschrieben. Traditionelle und alternative Evaluierungsmethoden werden hinsichtlich ihrer Anwendbarkeit in der Dolmetscherausbildung erprobt. In der Fallstudie werden die Prüfungsergebnisse zweier Master-Studiengänge-MA Konferenzdolmetschen und MA Dolmetschen und Übersetzen-quantitativ analysiert. Die zur Dokumentation der Prüfungsergebnisse eingesetzte Bewertungsmethodik wird qualitativ untersucht und zur quantitativen Analyse in Bezug gesetzt. Die Fallstudie besteht aus 1) einer chi-square-Analyse der Abschlussprüfungsnoten getrennt nach Sprachkombination und Prüfungskategorie (n=260), 2) einer Umfrage unter den Jurymitgliedern hinsichtlich der Evaluierungsansätze, -verfahren, und -kriterien (n = 45; 62.22% Rücklaufrate); und 3) einer Analyse des ausgangssprachlichen Prüfungsmaterials ebenfalls nach Sprachkombination und Prüfungskategorie. Es wird nachgewiesen, dass Studierende im MA Dolmetschen und Übersetzen tendenziell schlechtere Prüfungsleistungen erbringen als Studierende im MA Konferenzdolmetschen. Die Analyseergebnisse werden jedoch als aussageschwach betrachtet aufgrund mangelnder Evaluierungsvalidität. Schritte zur Curriculum- und Evaluierungsoptimierung sowie ein effizienteres Curriculummodell werden aus den theoretischen Ansätzen abgeleitet. Auf die Rolle der Ethik in der Evaluierungsmethodik wird hingewiesen.

Integration of cognitive and affective processes in perception and decision-making

The relationship between emotion and cognition is a topic that raises great interest in research. Recently, a view of these two processes as interactive and mutually influencing each other has become predominant. This dissertation investigates the reciprocal influences of emotion and cognition, both at behavioral and neural level, in two specific fields, such as attention and decision-making. Experimental evidence on how emotional responses may affect perceptual and attentional processes has been reported. In addition, the impact of three factors, such as personality traits, motivational needs and social context, in modulating the influence that emotion exerts on perception and attention has been investigated. Moreover, the influence of cognition on emotional responses in decision-making has been demonstrated. The current experimental evidence showed that cognitive brain regions such as the dorsolateral prefrontal cortex are causally implicated in regulation of emotional responses and that this has an effect at both pre and post decisional stages. There are two main conclusions of this dissertation: firstly, emotion exerts a strong influence on perceptual and attentional processes but, at the same time, this influence may also be modulated by other factors internal and external to the individuals. Secondly, cognitive processes may modulate emotional prepotent responses, by serving a regulative function critical to driving and shaping human behavior in line with current goals.

Reliability and consistency affect the integration of visual depth cues

Abstract Originalsprache (englisch) Visual perception relies on a two-dimensional projection of the viewed scene on the retinas of both eyes. Thus, visual depth has to be reconstructed from a number of different cues that are subsequently integrated to obtain robust depth percepts. Existing models of sensory integration are mainly based on the reliabilities of individual cues and disregard potential cue interactions. In the current study, an extended Bayesian model is proposed that takes into account both cue reliability and consistency. Four experiments were carried out to test this model's predictions. Observers had to judge visual displays of hemi-cylinders with an elliptical cross section, which were constructed to allow for an orthogonal variation of several competing depth cues. In Experiment 1 and 2, observers estimated the cylinder's depth as defined by shading, texture, and motion gradients. The degree of consistency among these cues was systematically varied. It turned out that the extended Bayesian model provided a better fit to the empirical data compared to the traditional model which disregards covariations among cues. To circumvent the potentially problematic assessment of single-cue reliabilities, Experiment 3 used a multiple-observation task, which allowed for estimating perceptual weights from multiple-cue stimuli. Using the same multiple-observation task, the integration of stereoscopic disparity, shading, and texture gradients was examined in Experiment 4. It turned out that less reliable cues were downweighted in the combined percept. Moreover, a specific influence of cue consistency was revealed. Shading and disparity seemed to be processed interactively while other cue combinations could be well described by additive integration rules. These results suggest that cue combination in visual depth perception is highly flexible and depends on single-cue properties as well as on interrelations among cues. The extension of the traditional cue combination model is defended in terms of the necessity for robust perception in ecologically valid environments and the current findings are discussed in the light of emerging computational theories and neuroscientific approaches.

Integration of MFA and LCA methodologies: the anthropogenic aluminium cycle in Italy

MFA and LCA methodologies were applied to analyse the anthropogenic aluminium cycle in Italy with focus on historical evolution of stocks and flows of the metal, embodied GHG emissions, and potentials from recycling to provide key features to Italy for prioritizing industrial policy toward low-carbon technologies and materials. Historical trend series were collected from 1947 to 2009 and balanced with data from production, manufacturing and waste management of aluminium-containing products, using a ‘top-down’ approach to quantify the contemporary in-use stock of the metal, and helping to identify ‘applications where aluminium is not yet being recycled to its full potential and to identify present and future recycling flows’. The MFA results were used as a basis for the LCA aimed at evaluating the carbon footprint evolution, from primary and electrical energy, the smelting process and the transportation, embodied in the Italian aluminium. A discussion about how the main factors, according to the Kaya Identity equation, they did influence the Italian GHG emissions pattern over time, and which are the levers to mitigate it, it has been also reported. The contemporary anthropogenic reservoirs of aluminium was estimated at about 320 kg per capita, mainly embedded within the transportation and building and construction sectors. Cumulative in-use stock represents approximately 11 years of supply at current usage rates (about 20 Mt versus 1.7 Mt/year), and it would imply a potential of about 160 Mt of CO2eq emissions savings. A discussion of criticality related to aluminium waste recovery from the transportation and the containers and packaging sectors was also included in the study, providing an example for how MFA and LCA may support decision-making at sectorial or regional level. The research constitutes the first attempt of an integrated approach between MFA and LCA applied to the aluminium cycle in Italy.

Membrane properties and synaptic integration of identified neuronal populations in the developing rodent neocortex

In my PhD work I concentrated on three elementary questions that are essential to understand the interactions between the different neuronal cell populations in the developing neocortex. The questions regarded the identity of Cajal-Retzius (CR) cells, the ubiquitous expression of glycine receptors in all major cell populations of the immature neocortex, and the role of taurine in the modulation of immature neocortical network activity.rnTo unravel whether CR cells of different ontogenetic origin have divergent functions I investigated the electrophysiological properties of YFP+ (derived from the septum and borders of the pallium) and YFP− CR cells (derived from other neocortical origins). This study demonstrated that the passive and active electrophysiological properties as well as features of GABAergic PSCs and glutamatergic currents are similar between both CR cell populations. These findings suggest that CR cells of different origins most probably support similar functions within the neuronal networks of the early postnatal cerebral cortex.rnTo elucidate whether glycine receptors are expressed in all major cell populations of the developing neocortex I analyzed the functional expression of glycine receptors on subplate (SP) cells. Activation of glycine receptors by glycine, -alanine and taurine elicited membrane responses that could be blocked by the selective glycinergic antagonist strychnine. Pharmacological experiments suggest that SP cells express functional heteromeric glycine receptors that do not contain 1 subunits. The activation of glycine receptors by glycine and taurine induced a membrane depolarization, which mediated excitatory effects. Considering the key role of SP cells in immature cortical networks and the development of thalamocortical connections, this glycinergic excitation may influence the properties of early cortical networks and the formation of cortical circuits.rnIn the third part of my project I demonstrated that tonic taurine application induced a massive increase in the frequency of PSCs. Based on their reversal potential and their pharmacological properties these taurine-induced PSCs are exclusively transmitted via GABAA receptors to the pyramidal neurons, while both GABAA and glycine receptors were implicated in the generation of the presynaptic activity. Accordingly, whole-cell and cell-attached recordings from genetically labeled interneurons revealed the expression of glycine and GABAA receptors, which mediated an excitatory action on these cells. These findings suggest that low taurine concentrations can tonically activate exclusively GABAergic networks. The activity level maintained by this GABAergic activity in the immature nervous system may contribute to network properties and can facilitate the activity dependent formation of adequate synaptic projections.rnIn summary, the results of my studies complemented the knowledge about neuronal interactions in the immature neocortex and improve our understanding of cellular processes that guide neuronal development and thus shape the brain.rn

Integration of a simulation platform for electrical mobility within the arrowhead interoperability framework

This dissertation document deals with the development of a project, over a span of more than two years, carried out within the scope of the Arrowhead Framework and which bears my personal contribution in several sections. The final part of the project took place during a visiting period at the university of Luleå. The Arrowhead Project is an European project, belonging to the ARTEMIS association, which aims to foster new technologies and unify the access to them into an unique framework. Such technologies include the Internet of Things phe- nomenon, Smart Houses, Electrical Mobility and renewable energy production. An application is considered compliant with such framework when it respects the Service Oriented Architecture paradigm and it is able to interact with a set of defined components called Arrowhead Core Services. My personal contribution to this project is given by the development of several user-friendly API, published in the project's main repository, and the integration of a legacy system within the Arrowhead Framework. The implementation of this legacy system was initiated by me in 2012 and, after many improvements carried out by several developers in UniBO, it has been again significantly modified this year in order to achieve compatibility. The system consists of a simulation of an urban scenario where a certain amount of electrical vehicles are traveling along their specified routes. The vehicles are con-suming their battery and, thus, need to recharge at the charging stations. The electrical vehicles need to use a reservation mechanism to be able to recharge and avoid waiting lines, due to the long recharge process. The integration with the above mentioned framework consists in the publication of the services that the system provides to the end users through the instantiation of several Arrowhead Service Producers, together with a demo Arrowhead- compliant client application able to consume such services.

Integration of Internet of Things and Cloud computing. A case study on vital signs monitoring.

Il progresso scientifico e le innovazioni tecnologiche nei campi dell'elettronica, informatica e telecomunicazioni, stanno aprendo la strada a nuove visioni e concetti. L'obiettivo della tesi è quello d'introdurre il modello del Cloud computing per rendere possibile l'attuale visione di Internet of Thing. Nel primo capitolo si introduce Ubiquitous computing come un nuovo modo di vedere i computer, cercando di fare chiarezza sulla sua definizione, la sua nascita e fornendo un breve quadro storico. Nel secondo capitolo viene presentata la visione di Internet of Thing (Internet delle “cose”) che si avvale di concetti e di problematiche in parte già considerate con Ubiquitous computing. Internet of Thing è una visione in cui la rete Internet viene estesa agli oggetti di tutti i giorni. Tracciare la posizione degli oggetti, monitorare pazienti da remoto, rilevare dati ambientali sono solo alcuni esempi. Per realizzare questo tipo di applicazioni le tecnologie wireless sono da considerare necessarie, sebbene questa visione non assuma nessuna specifica tecnologia di comunicazione. Inoltre, anche schede di sviluppo possono agevolare la prototipazione di tali applicazioni. Nel terzo capitolo si presenta Cloud computing come modello di business per utilizzare su richiesta risorse computazionali. Nel capitolo, vengono inizialmente descritte le caratteristiche principali e i vari tipi di modelli di servizio, poi viene argomentato il ruolo che i servizi di Cloud hanno per Internet of Thing. Questo modello permette di accelerare lo sviluppo e la distribuzione di applicazioni di Internet of Thing, mettendo a disposizione capacità di storage e di calcolo per l'elaborazione distribuita dell'enorme quantità di dati prodotta da sensori e dispositivi vari. Infine, nell'ultimo capitolo viene considerato, come esempio pratico, l'integrazione di tecnologie di Cloud computing in una applicazione IoT. Il caso di studio riguarda il monitoraggio remoto dei parametri vitali, considerando Raspberry Pi e la piattaforma e-Health sviluppata da Cooking Hacks per lo sviluppo di un sistema embedded, e utilizzando PubNub come servizio di Cloud per distribuire i dati ottenuti dai sensori. Il caso di studio metterà in evidenza sia i vantaggi sia le eventuali problematiche che possono scaturire utilizzando servizi di Cloud in applicazioni IoT.