Predictors of adherence to influenza vaccination for healthcare workers from a teaching hospital: a study in the prepandemic era

Introduction: Even before the 2009 pandemics, influenza in healthcare workers (HCW) was a known threat to patient safety, while Influenza vaccine coverage in the same group was generally low. Identification of predictors for HCW adherence to Influenza vaccination has challenged infection control committees. Methods: Our group conducted a cross-sectional survey in December 2007, interviewing 125 HCWs from a teaching hospital to identify adherence predictors for Influenza vaccination. The outcomes of interest were: A - adherence to the 2007 vaccination campaign; B - adherence to at least three yearly campaigns in the past five years. Demographic and professional data were assessed through univariate and multivariate analysis. Results: of the HCWs interviewed, 43.2% were vaccinated against Influenza in 2007. However, only 34.3% of HCWs working in healthcare for more than five years had adhered to at least three of the last five vaccination campaigns. Multivariate analysis showed that working in a pediatric unit (OR = 7.35, 95% I = 1.90-28.44, p = 0.004) and number of years in the job (OR = 1.32, 95%CI = 1.00-1.74, p = 0.049) were significant predictors of adherence to the 2007 campaign. Physicians returned the worst outcome performances in A (OR = 0.40, 95%CI = 0.16-0.97, p = 0.04) and B (OR = 0.17, 95%CI = 0.05-0.60, p = 0.006). Conclusions: Strategies to improve adherence to Influenza vaccination should focus on physicians and newly-recruited HCWs. New studies are required to assess the impact of the recent Influenza A pandemics on HCW-directed immunization policies.

Parâmetros de fonte de microterremotos em Cascavel-CE

In this dissertation it was studied the rupture characteristic of earthquakes of the Town of Cascavel CE, Northeastern Brazil. Located on the border of the Potiguar Basin, the Town of Cascavel is one of the most seismically active intraplate areas in the country. In this town, on November 20th, 1980 a 5,2mb earthquake occurred. This was the largest earthquake ever reported in Northeast Brazil. Studies of this region using instruments were possible after 1989, with several campaigns being done using seismographic networks. From the beginning of the monitoring to April 2008 more than 55,000 events were recorded. With the data collected by a network with six 3-components digital seismographic stations during the campaigns done from September 29th, 1997 to March 5th, 1998, estimates of source parameters were found fitting the displacement spectra in the frequency domain for each event. From the fitting of the displacement spectra it was possible to obtain the corner frequency ( ) c f and long period amplitude ( ) W0 . Source parameters were determined following Brune (1970) and Madariaga (1976) models. Twenty-one seismic events were analyzed (0.7 £ £ 2.1) b m in order to estimate the source dimension (r ), seismic moment ( ) M0 , static stress drop (Ds ), apparent stress ( ) a s , seismic energy ( ) S E and moment magnitude ( ) W M for each of the events. It was observed that the ratio between radiated seismic energy and moment seismic (apparent stress) increases with increasing moment and hence magnitude at the observed range. As suggested by Abercrombie (1995), also in this work there is a breakdown in the scaling for earthquakes with magnitudes smaller than three ( < 3.0) W M , so that the rupture physics is different for larger events. If this assumption is valid, the earthquakes analyzed in this work are not selfsimilar. Thus, larger events tend to radiated more energy per unit area than smaller ones.

Experiências de famílias na imunização de crianças brasileiras menores de dois anos

O objetivo foi descrever as experiências de famílias sobre imunização de crianças menores de dois anos. É estudo de natureza descritiva, com análise qualitativa dos dados, entrevistas não estruturadas com 22 sujeitos. Os resultados foram agrupados em: conhecimentos práticos sobre imunização, responsabilidade e obrigatoriedade na imunização e ampliação da prática de imunização. Foram destacados elementos que fortalecem a imunização: experiência e realização pessoal no papel de ser mãe, temor de adoecimento, reconhecimento como um bom cuidado, acesso, flexibilidade do horário, divulgação, cartão de vacinas, campanhas de vacinação e disponibilidade de vacinas, e elementos da não imunização: inexperiência dos pais, recusa de aplicações simultâneas de vacinas, assistência fragmentada, ausência de diálogo, discriminação, falsas contraindicações e obrigatoriedade. A imunização centrada no cumprimento do calendário vacinal, ou em situações autoritárias, está descolada do cuidado familiar. O vínculo com as famílias precisa ser fortalecido para ampliação da adesão às medidas de proteção e promoção da saúde da criança.

Análise hidrodinâmica e morfodinâmica do complexo estuarino do Rio Piranhas-Açu/RN, Nordeste do Brasil

The aim of this study was the seasonal characterization of the morphology, sedimentology and hydrodynamic of the Açu, Cavalos and Conchas estuaries. These estuaries are inserted in a semi-arid climate area and form the mouth of the hydrographic basin of the Piranhas-Açu river, that represent the discharge of the largest watershed in the state. They are embedded in an environment consisting of a fluvial-marine floodplain, mangrove ecosystem, sandbanks, fields of dunes, spits and sandy beaches. Adjacent to the natural units are the main local socioeconomic activities (oil industry, salt industry, shrimp farming, fishing and tourism) are dependent on this river and its conservation. The environmental monitoring is necessary because it is an area under constant action of coastal processes and at high risk of oil spill. The acquisition and interpretation of hydrodynamic, sonographic and sediment data was conducted in two campaigns, dry season (2010) and rainy season (2011), using respectively the current profiler ADCP Doppler effect, the side-scan sonar and Van Veen sampler. In these estuaries: Açu, Cavalos and Conchas were identified the following types of bedforms: flatbed and Dunes 2-D and 3-D (small to medium size), generated at lower flow regime (Froude number <1). Structures such as ripples were observed in the Açu estuary mouth. The higher values of flow discharge and velocity were recorded in the Açu estuary (434,992 m³.s-¹ and 0,554 m.s-¹). In rainy season, despite the record of highest values of discharge and flow velocities at the mouth, the energy rates upstream did not differ much from the data of the dry season. However, in all estuaries were recorded an increase in speed and flow, with reservation to the flow in the Açu estuary and flow at the mouth of the Conchas estuary. Sediment grain sizes tend to increase towards the mouth of the estuary and these ranged from very fine sand to very coarse sand, medium sand fraction being the most recurrent. Based on the data acquired and analyzed, the estuaries Açu, Cavalos and Conchas are classified as mixed , dominated by waves and tides. According to their morphology, they are classified as estuaries constructed by bar and according to the classification by salinity, estuaries Conchas and Cavalos were ranked as hypersaline estuaries, and Açu as hypersaline and vertically well mixed type C

Use of a condom in sex relations by HIV carriers

Para estudar a ocorrência da utilização do preservativo masculino em relações sexuais pelos portadores do HIV, foram entrevistados 132 indivíduos, sendo 82 homens e 50 mulheres. A maioria do Estado de São Paulo e algumas de outras regiões do País, atendidas na Faculdade de Medicina de Botucatu. As mulheres eram mais jovens, tinham menor escolaridade, pior qualificação profissional que os homens, e ainda, maior proporção era de viúvas, separadas, desquitadas e divorciadas. Verificou-se que 43,9% dos homens e 72% das mulheres foram contaminados pela via sexual, mas apenas 41,2% dos primeiros e 31,8% das mulheres referiram utilização do preservativo após o diagnóstico de infecção, a maioria de homens e mulheres preferindo observar abstinência sexual. Os resultados permitem concluir que ainda há necessidade de se manter informação continuada sobre a importância do uso do preservativo, além de se garantir sua distribuição gratuita, pelos baixos níveis de instrução e qualificação profissional dos indivíduos. Sugerem, ainda, que as campanhas de divulgação de medidas preventivas considerem as diferenças sociais e culturais das mulheres que se infectam.

Levels of DNA damage in blood leukocyte samples from non-diabetic and diabetic female rats and their fetuses exposed to air or cigarette smoke

dThe objective of the present study was to evaluate DNA damage level in blood leukocytes from diabetic and non-diabetic female Wistar rats exposed to air or to cigarette smoke, and to correlate the findings with levels of DNA damage detected in blood leukocyte samples from their fetuses. A total of 20 rats were distributed into four experimental groups: non-diabetic (control; G1) and diabetic exposed to filtered air (G2): non-diabetic (G3) and diabetic (G4) exposed to cigarette smoke. Rats placed into whole-body exposure chambers were exposed for 30 min to filtered air (control) or to tobacco smoke generated from 10 cigarettes, twice a day, for 2 months. Diabetes was induced by a pancreatic beta-cytotoxic agent, streptozotocin (40 mg/kg b.w.). At day 21 of pregnancy, each rat was anesthetized and humanely killed to obtain maternal and fetal blood samples for genotoxicity analysis using the alkaline comet assay. G2, G3 and G4 dams presented higher DNA damage values in tail moment and tail length as compared to G1 group. There was a significant positive correlation between DNA damage levels in blood leukocyte samples from G2 and G3 groups (tail moment); G3 and G4 groups (tail length) and G3 group (tail intensity) and their fetuses. Thus, this study showed the association of severe diabetes and tobacco cigarette smoke exposure did not exacerbate levels of maternal and fetal DNA damages related with only diabetes or cigarette smoke exposure. Based on the results obtained and taking into account other published data, maternal diabetes requires rigid clinical control and public health and education campaigns should be increased to encourage individuals, especially pregnant women, to stop smoking. (C) 2008 Elsevier B.V. All rights reserved.

Toxic and essential elements in blood from delivering women in selected areas of São Paulo State, Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Fatores associados à vacinação contra influenza em idosos em município do Sudeste do Brasil

OBJETIVO: Mesmo gratuita e disponível no Brasil desde 1999, a cobertura vacinal contra a influenza ainda é inadequada em diversos municípios do País. O objetivo da pesquisa foi estimar a cobertura vacinal e identificar fatores relacionados à vacinação contra a influenza em idosos. MÉTODOS: Realizou-se inquérito domiciliar em amostra aleatória sistemática (N=365) da população urbana maior de 60 anos em Botucatu, São Paulo. Foi aplicado modelo de regressão logística múltipla, cuja variável dependente foi ter sido vacinado em 2002. Foram testadas no modelo as covariáveis: sexo, idade, socioeconômicas (renda per capita, número de pessoas por cômodo, escolaridade, estado civil, ocupação, tempo de moradia), antecedentes mórbidos, de internação, hábito de fumar, sintomas respiratórios nos últimos 15 dias e atividades comunitárias (trabalho voluntário, atividades no bairro, igreja). RESULTADOS: Registrou-se cobertura vacinal de 63,2% (IC 95%: 58,3-68,2). Foi observado menor percentual de vacinados entre os idosos na faixa etária de 60 a 64 anos. As variáveis que se mostraram associadas à vacinação e permaneceram no modelo final foram: idade (OR=1,09 por ano; IC 95%: 1,06-1,13); hipertensão arterial (OR=1,92; IC 95%: 1,18-3,13); inserção em atividades na comunidade (OR=1,63; IC 95%: 1,01-2,65). A vacinação em portadores de doenças crônicas não atingiu níveis adequados conforme esperado para este grupo de risco, com exceção dos hipertensos. A participação em atividades comunitárias e sociais foi relacionada com o estado vacinal. CONCLUSÕES: Condições socioeconômicas, hábitos e idade não restringiram o acesso à campanha vacinal. Por outro lado, campanhas específicas, endereçadas a indivíduos da faixa de 60 a 64 anos, podem ampliar a cobertura da vacinação.

Comparison between the counter immunoelectrophoresis test and mouse neutralization test for the detection of antibodies against rabies virus in dog sera

The detection of rabies antibodies is extremely valuable for epidemiological studies, determination of immune status in man, animals, and for the diagnosis of the disease. Several serological procedures have been described for this purpose. The present study reports a comparison between counterimmunoelectrophoresis test (CIET) and mouse neutralization test (MNT) in the detection of antibodies against rabies virus from 212 serum samples of vaccinated dogs. The agreement between both techniques was 79.7% and a significative association was demonstrated. The correlation coefficients between MNT and the CIET titers was determined considering 88 samples showing positive results in both techniques [CIET = 2 and MNT = 5 (0.13 IU/ml)] and resulted r² = 0.7926 (p < 0.001). The performance of CIET system was technically simple, cheap and rapid, and thereby it could be useful for serological monitoring of dog vaccination campaigns as well as for individual analysis.

Evaluating the knowledge of sports participants regarding dental emergency procedures

Dental trauma is a common consequence of sports practice to which emergency treatment is critical. The purpose of this study was to evaluate the knowledge of sports participants about dental trauma procedures, particularly tooth avulsion. A specific questionnaire concerning concepts, experiences and behaviors after dental trauma and the use of mouthguard was standardized and validated with 80 people. The validated questionnaire was then distributed to 310 sports participants. The results showed that 28.4% had experienced a kind of dental trauma; 42.6% would look for a dentist for treatment; 51.7% reimplanted or would reimplant the avulsed tooth; 6.5% would maintain the avulsed tooth in milk. Although 47.4% of the participants were aware of the possibility of accidents during sports practice, only 13.9% reported to use a mouthguard. This study showed an overall lack of knowledge of sportsmen and sportswomen with regards to tooth avulsion, thus reinforcing the need for educational campaigns to improve the immediate emergency treatment of tooth avulsion.

Benthic macroinvertebrates in the Paranapanema reservoir cascade (southeast Brazil)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Assessment of Donana National Park contamination in Procambarus clarkii: Integration of conventional biomarkers and proteomic approaches

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Fish assemblages in stream stretches occupied by cattail (Typhaceae, Angiospermae) stands in Southeast Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Optimal and sub-optimal control in Dengue epidemics

This work concerns the application of the optimal control theory to Dengue epidemics. The dynamics of this insect-borne disease is modelled as a set of non-linear ordinary differential equations including the effect of educational campaigns organized to motivate the population to break the reproduction cycle of the mosquitoes by avoiding the accumulation of still water in open-air recipients. The cost functional is such that it reflects a compromise between actual financial spending (in insecticides and educational campaigns) and the population health (which can be objectively measured in terms of, for instance, treatment costs and loss of productivity). The optimal control problem is solved numerically using a multiple shooting method. However, the optimal control policy is difficult to implement by the health authorities because it is not practical to adjust the investment rate continuously in time. Therefore, a suboptimal control policy is computed assuming, as the admissible set, only those controls which are piecewise constant. The performance achieved by the optimal control and the sub-optimal control policies are compared with the cases of control using only insecticides when Breteau Index is greater or equal to 5 and the case of no-control. The results show that the sub-optimal policy yields a substantial reduction in the cost, in terms of the proposed functional, and is only slightly inferior to the optimal control policy. Copyright (C) 2001 John Wiley & Sons, Ltd.

PM2.5 and PM10: The influence of sugarcane burning on potential cancer risk

In Brazil, sugarcane fields are often burned to facilitate manual harvesting, and this burning causes environmental pollution from the large amounts of soot released into the atmosphere. This material contains numerous organic compounds such as PAHs. In this study, the concentrations of PAHs in two particulate-matter fractions (PM2.5 and PM10) in the city of Araraquara (SE Brazil, with around 200,000 inhabitants and surrounded by sugarcane plantations) were determined during the sugarcane harvest (HV) and non-harvest (NHV) seasons in 2008 and 2009. The sampling strategy included four campaigns, with 60 samples in the NHV season and 220 samples in the HV season. The PM2.5 and PM10 fractions were collected using a dichotomous sampler (10 L min(-1), 24 h) with Teflon (TM) filters. The filter sets were extracted (ultrasonic bath with hexane/acetone (1:1 v/v)) and analyzed by HPLC/Fluorescence. The median concentration for total PAHs (PM2.5 in 2009) was 0.99 ng m(-3) (NHV) and 3.3 ng m(-3) (HV). In the HV season, the total concentration of carcinogenic PAHs (benz(a)anthracene, benzo(b)fluoranthene, benzo(k)fluoranthene, and benzo(a)pyrene) was 5 times higher than in the NHV season. B(a)P median concentrations were 0.017 ng m(-3) and 0.12 ng m(-3) for the NHV and HV seasons, respectively. The potential cancer risk associated with exposure through inhalation of these compounds was estimated based on the benzo[a]pyrene toxic equivalence (BaPeq), where the overall toxicity of a PAR mixture is defined by the concentration of each compound multiplied by its relative toxic equivalence factor (TEF). BaPeq median (2008 and 2009 years) ranged between 0.65 and 1.0 ng m(-3) and 1.2-1.4 ng m(-3) for the NHV and HV seasons, respectively. Considering that the maximum permissible BaPeq in ambient air is 1 ng m(-3), related to the increased carcinogenic risk, our data suggest that the level of human exposure to PAHs in cities surrounded by sugarcane crops where the burning process is used is cause for concern. (C) 2010 Published by Elsevier Ltd.