Mortality from Circulatory System Diseases and Malformations in Children in the State of Rio de Janeiro

Abstract Background: The epidemiological profile of mortality in a population is important for the institution of measures to improve health care and reduce mortality Objective: To estimate mortality rates and the proportional mortality from cardiovascular diseases and malformations of the circulatory system in children and adolescents. Methods: This is a descriptive study of mortality from cardiovascular diseases, malformations of the circulatory system, from all causes, ill-defined causes and external causes in children and adolescents in the state of Rio de Janeiro from 1996 to 2012. Populations were obtained from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística - IBGE) and deaths obtained from the Department of Informatics of the Unified Health System (DATASUS)/Ministry of Health. Results: There were 115,728 deaths from all causes, 69,757 in males. The annual mortality from cardiovascular diseases was 2.7/100,000 in men and 2.6/100,000 in women. The annual mortality from malformations of the circulatory system was 7.5/100,000 in men and 6.6/100,000 in women. Among the specific causes of circulatory diseases, cardiomyopathies had the highest rates of annual proportional mortality, and from malformations of the circulatory system, it occurred due to unspecified malformations of the circulatory system, at all ages and in both genders. Conclusion: Mortality from malformations of the circulatory system was most striking in the first years of life, while cardiovascular diseases were more relevant in adolescents. Low access to prenatal diagnosis or at birth probably prevented the proper treatment of malformations of the circulatory system.

The Paranuclear corpuscles in poikilothermic vertebrates: description of a new species of Pirhemocyton in Iguana iguana of Venezuela, with remarks on the nature of these organisms and their relation to applied parasites

This paper discusses the relations between the genera Toddia and Pirhemocyton, describing certain cytochemical reactions that clarify their nature, and discussing the position of these organisms as being of a parasitic or viral nature. A new species of Pirhemocyton is described form Iguana iguana from Mamo, Marapa (Dto. Federal) of Venezuela; characterized by rectangular globoids with rounded borders. Attempts at experimental infections of other genera of lizerds indicate that the new species, Pirhemocyton iguanae, is specific to the natural host, Iguana iguana. The course of the parasitemia in the lizard is described.

Health education for children in the control of Schistosomasis

Health education for children is an important measure in the control of schistosomiasis especially considering the characteristics of the disease during childhood, such as high prevalence, high percent of treatment resistance, high rates of egg elimination and high level of reinfection, as reported in studies conducted in endemic areas. All of these facts indicate that children play a role in the maintenance and transmission of schistosomiasis. Historically in Brazil, Health Education concerning the major Brazilian endemies consists of a kind of vertical, interventionist and temporary action. An alternative would be to create a permanent health education process by assigning health education teachers to elementary schools. This would require expansion and improvement of teacher training and the development of programs taking into account: 1) the cognitive aspects of the child, the child's perception of reality and of the health/illness process; 2) the adaptation of instruction means and materials to the age group; 3) a "pedagogy of liberation" approach emphasizing the possibility of transforming life conditions since schistosomiasis is related to the lack of public services such as basic sanitation and clean domestic water supply.

Object recognition for autonomous objects: comparison of two approaches

Report for the scientific sojourn at the Swiss Federal Institute of Technology Zurich, Switzerland, between September and December 2007. In order to make robots useful assistants for our everyday life, the ability to learn and recognize objects is of essential importance. However, object recognition in real scenes is one of the most challenging problems in computer vision, as it is necessary to deal with difficulties. Furthermore, in mobile robotics a new challenge is added to the list: computational complexity. In a dynamic world, information about the objects in the scene can become obsolete before it is ready to be used if the detection algorithm is not fast enough. Two recent object recognition techniques have achieved notable results: the constellation approach proposed by Lowe and the bag of words approach proposed by Nistér and Stewénius. The Lowe constellation approach is the one currently being used in the robot localization project of the COGNIRON project. This report is divided in two main sections. The first section is devoted to briefly review the currently used object recognition system, the Lowe approach, and bring to light the drawbacks found for object recognition in the context of indoor mobile robot navigation. Additionally the proposed improvements for the algorithm are described. In the second section the alternative bag of words method is reviewed, as well as several experiments conducted to evaluate its performance with our own object databases. Furthermore, some modifications to the original algorithm to make it suitable for object detection in unsegmented images are proposed.

Research needs in allergy: an EAACI position paper, in collaboration with EFA.

In less than half a century, allergy, originally perceived as a rare disease, has become a major public health threat, today affecting the lives of more than 60 million people in Europe, and probably close to one billion worldwide, thereby heavily impacting the budgets of public health systems. More disturbingly, its prevalence and impact are on the rise, a development that has been associated with environmental and lifestyle changes accompanying the continuous process of urbanization and globalization. Therefore, there is an urgent need to prioritize and concert research efforts in the field of allergy, in order to achieve sustainable results on prevention, diagnosis and treatment of this most prevalent chronic disease of the 21st century.The European Academy of Allergy and Clinical Immunology (EAACI) is the leading professional organization in the field of allergy, promoting excellence in clinical care, education, training and basic and translational research, all with the ultimate goal of improving the health of allergic patients. The European Federation of Allergy and Airways Diseases Patients' Associations (EFA) is a non-profit network of allergy, asthma and Chronic Obstructive Pulmonary Disorder (COPD) patients' organizations. In support of their missions, the present EAACI Position Paper, in collaboration with EFA, highlights the most important research needs in the field of allergy to serve as key recommendations for future research funding at the national and European levels.Although allergies may involve almost every organ of the body and an array of diverse external factors act as triggers, there are several common themes that need to be prioritized in research efforts. As in many other chronic diseases, effective prevention, curative treatment and accurate, rapid diagnosis represent major unmet needs. Detailed phenotyping/endotyping stands out as widely required in order to arrange or re-categorize clinical syndromes into more coherent, uniform and treatment-responsive groups. Research efforts to unveil the basic pathophysiologic pathways and mechanisms, thus leading to the comprehension and resolution of the pathophysiologic complexity of allergies will allow for the design of novel patient-oriented diagnostic and treatment protocols. Several allergic diseases require well-controlled epidemiological description and surveillance, using disease registries, pharmacoeconomic evaluation, as well as large biobanks. Additionally, there is a need for extensive studies to bring promising new biotechnological innovations, such as biological agents, vaccines of modified allergen molecules and engineered components for allergy diagnosis, closer to clinical practice. Finally, particular attention should be paid to the difficult-to-manage, precarious and costly severe disease forms and/or exacerbations. Nonetheless, currently arising treatments, mainly in the fields of immunotherapy and biologicals, hold great promise for targeted and causal management of allergic conditions. Active involvement of all stakeholders, including Patient Organizations and policy makers are necessary to achieve the aims emphasized herein.

Elections in 2009? Progress and obstacles in the construction of peace in the Ivory Coast

In 2002 in the Ivory Coast three months of armed conflict ended with the division of the country. Two regions were separated by an interposition line controlled by the French Forces Licorne. This significant peace process was maintained over time, but characterized for lack of mutual confidence and political immobility, which led to an impasse and the continuation of Laurent Gbagbo in the presidency. Moreover, the peace building process was less successful because the different political agreements failed to address some of the main national problems, such as land property and identity issues. The following paper aims first to analyze the main facts and causes that instigated the conflict since the coup d’état in 2002. Secondly, the paper will analyze the peace process and point out the key elements of the Ouagadougou Peace Agreement (2007): the creation of a new and unique armed forces structure, as well as the identification of the population and implementation of an electoral process. The main goal is to provide the International Catalan Institute for Peace (ICIP) a working tool in order to send an electoral observation mission to this African country by November 2009.

Multimodel inference and multimodel averaging in empirical modeling of occupational exposure levels.

Empirical modeling of exposure levels has been popular for identifying exposure determinants in occupational hygiene. Traditional data-driven methods used to choose a model on which to base inferences have typically not accounted for the uncertainty linked to the process of selecting the final model. Several new approaches propose making statistical inferences from a set of plausible models rather than from a single model regarded as 'best'. This paper introduces the multimodel averaging approach described in the monograph by Burnham and Anderson. In their approach, a set of plausible models are defined a priori by taking into account the sample size and previous knowledge of variables influent on exposure levels. The Akaike information criterion is then calculated to evaluate the relative support of the data for each model, expressed as Akaike weight, to be interpreted as the probability of the model being the best approximating model given the model set. The model weights can then be used to rank models, quantify the evidence favoring one over another, perform multimodel prediction, estimate the relative influence of the potential predictors and estimate multimodel-averaged effects of determinants. The whole approach is illustrated with the analysis of a data set of 1500 volatile organic compound exposure levels collected by the Institute for work and health (Lausanne, Switzerland) over 20 years, each concentration having been divided by the relevant Swiss occupational exposure limit and log-transformed before analysis. Multimodel inference represents a promising procedure for modeling exposure levels that incorporates the notion that several models can be supported by the data and permits to evaluate to a certain extent model selection uncertainty, which is seldom mentioned in current practice.

Molecular Genetic Analysis of Multi-drug Resistance in Indian Isolates of Mycobacterium tuberculosis

A total of 116 isolates from patients attending the out-patient department at the All India Institute of Medical Sciences, New Delhi and the New Delhi Tuberculosis Centre, New Delhi, India were collected. They were analyzed for resistance to drugs prescribed in the treatment for tuberculosis. The drug resistance was initially determined by microbiological techniques. The Bactec 460TB system was employed to determine the type and level of resistance in each isolate. The isolates were further characterized at molecular level. The multi-drug loci corresponding to rpo b, gyr A, kat G were studied for mutation(s) by the polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) technique. The SSCP positive samples were sequenced to characterize the mutations in rpo b, and gyr A loci. While previously reported mutations in the gyr A and rpo b loci were found to be present, several novel mutations were also scored in the rpo b locus. Interestingly, analysis of the gyr A locus showed the presence of point mutation(s) that could not be detected by PCR-SSCP. Furthermore, rifampicin resistance was found to be an important marker for checking multi-drug resistance (MDR) in clinical isolates of Mycobacterium tuberculosis. This is the first report on molecular genetic analysis of MDR tuberculosis one from India, highlights the increasing incidence of MDR in the Indian isolates of M. tuberculosis.

Treatment of extraintestinal manifestations in inflammatory bowel disease.

Inflammatory bowel disease (IBD) is a systemic disease associated with a large number of extraintestinal manifestations (EIM). EIM are present in 15-20% of patients with ulcerative colitis and in 20-40% of patients with Crohn's disease. The management of EIM is best provided by a multidisciplinary team, which includes specialists in the affected organ systems with training in the treatment of IBD. Therapeutic strategy is often empirical. This is explained by the paucity of randomized-controlled studies for the specific treatment of EIM in IBD and by the fact that treatment models are based on extrapolation from patients with similar conditions but without IBD. For most EIM, the mainstay of therapy is the treatment of the underlying active IBD. However, some EIM such as axial arthritis, pyoderma gangrenosum, uveitis and primary sclerosing cholangitis run a clinical course independent of IBD activity and need specific therapy (e.g. TNF antagonists in ankylosing spondylitis and skin manifestations). This review summarizes the conventional and novel (e.g. anti-TNF) treatment modalities, and the therapeutic implications for the management of extraintestinal symptoms in IBD, in order to assist clinicians in optimizing treatment strategies for IBD patients with EIM.

Preliminary estimates and forecasts of the population prevalence of self reported of hypertension, of ischaemic heart disease and stroke in the Republic of Ireland from 2005 - 2015

Ireland and Northern Ireland’s Population Health Observatory (INIsPHO) recently published estimates of the population prevalence of diabetes in 2005 and forecasts to 2010 and 2015 for the island of Ireland, at the national and sub-national levels. These estimates are based the PBS Model developed by York and Humber Public Health Observatory (YHPHO), Brent NHS Trust and the School of Health and Related Research (ScHARR).The Department of Health and Children (DoHC) has requested additional estimates and forecasts for hypertension.This paper outlines the results from preliminary work from the initial steps towards a more systematic approach to monitoring the prevalence of other chronic diseases on the island.

Longstanding health conditions among three-year-old children in the Republic of Ireland in 2011

Access audio, video and slides from the launch of the report The Institute of Public health in Ireland (IPH) produces population prevalence estimates and forecasts for a number of chronic conditions among adults. IPH has now applied the methodology to longstanding health conditions among young children across the island of Ireland. This report, based on a systematic analysis of data from the Growing Up in Ireland National Longitudinal Study of Children in the Republic of Ireland, is the first comprehensive look at longstanding health conditions among young children in Ireland. Estimated prevalence (per cent and number of cases) of longstanding health conditions among three-year-olds in the Republic of Ireland in 2011 by administrative counties/cities. The conditions are carer-reported: - "Longstanding illness, condition or disability” (where longstanding was defined as “anything that has troubled him/her over a period of time or that is likely to affect him/her over a period of time”) - Diagnosed asthma or asthma symptoms - Diagnosed eczema/any kind of skin allergy - Sight problem that required correction - Hearing problem that required correction - The estimates are based on data from the Growing Up in Ireland National Longitudinal Study of Children (www.growingup.ie) and population data. See the Chronic Conditions Hub for more details.  

Longstanding health conditions among three-year-old children in the Republic of Ireland in 2011: Executive Summary

Access audio, video and slides from the launch of the report The Institute of Public health in Ireland (IPH) produces population prevalence estimates and forecasts for a number of chronic conditions among adults. IPH has now applied the methodology to longstanding health conditions among young children across the island of Ireland. This report, based on a systematic analysis of data from the Growing Up in Ireland National Longitudinal Study of Children in the Republic of Ireland, is the first comprehensive look at longstanding health conditions among young children in Ireland. Estimated prevalence (per cent and number of cases) of longstanding health conditions among three-year-olds in the Republic of Ireland in 2011 by administrative counties/cities. The conditions are carer-reported: - "Longstanding illness, condition or disability” (where longstanding was defined as “anything that has troubled him/her over a period of time or that is likely to affect him/her over a period of time”) - Diagnosed asthma or asthma symptoms - Diagnosed eczema/any kind of skin allergy - Sight problem that required correction - Hearing problem that required correction - The estimates are based on data from the Growing Up in Ireland National Longitudinal Study of Children (www.growingup.ie) and population data. See the Chronic Conditions Hub for more details.    

Longstanding health conditions among three-year-old children in the Republic of Ireland in 2011: Factsheet

Access audio, video and slides from the launch of the report The Institute of Public health in Ireland (IPH) produces population prevalence estimates and forecasts for a number of chronic conditions among adults. IPH has now applied the methodology to longstanding health conditions among young children across the island of Ireland. This report, based on a systematic analysis of data from the Growing Up in Ireland National Longitudinal Study of Children in the Republic of Ireland, is the first comprehensive look at longstanding health conditions among young children in Ireland. Estimated prevalence (per cent and number of cases) of longstanding health conditions among three-year-olds in the Republic of Ireland in 2011 by administrative counties/cities. The conditions are carer-reported: - "Longstanding illness, condition or disability” (where longstanding was defined as “anything that has troubled him/her over a period of time or that is likely to affect him/her over a period of time”) - Diagnosed asthma or asthma symptoms - Diagnosed eczema/any kind of skin allergy - Sight problem that required correction - Hearing problem that required correction - The estimates are based on data from the Growing Up in Ireland National Longitudinal Study of Children (www.growingup.ie) and population data. See the Chronic Conditions Hub for more details.    

Educational pathways of minority youth in Norway: intersections of gender, ethnicity and social class

Educational aspirations during lower secondary school and choice of upper secondary education are important for young people’s future trajectories into higher education and labour market positions. In line with ideas about reflexive, autonomous individuals (Giddens, 1991), choice of education is often represented as a young person’ individual decision, and educational guidance as aimed at discovering what ‘fits’ an individual’s personality, interests and abilities. Educational aspirations and choices are also social patterns that are reproduced. Some population categories represent exceptions from expected patterns of social reproduction of educational level and professions. In several countries, one such category is young people from families with migration experiences (Lauglo, 2000; Modood, 2004). In Norway, students have a legal right to non-compulsory upper secondary schooling and 96 percent of the students continue from lower to upper secondary school. In spite of positive developments regarding minority youths’ completion of upper secondary and higher education in later years, studies still persistently show lower educational attainment among minority youth, particularly among boys (Fekjaer, 2006). However, in lower secondary school, minor ity youth tend to have markedly higher educational aspirations and stronger learning motivation than their majority peers, as well as greater effort in school and strong adherence to school values (Lauglo, 2000) despite lower educational attainment or lower socio-economic backgrounds. In addition, gender differences in educational aspirations seem to be smaller among minority youth. The principal objective of the study in progress that will be presented in this paper, is to describe how processes relating to gendered, ethnic and class-based identities influence young people’s educational choices. The study is undertaken as a PhD project in social anthropology. The methodological approach is ethnographic longitudinal fieldwork in two multicultural lower secondary schools in Oslo. The study is part of a larger project that also include quantitative analyses of longitudinal data covering 9th graders in Oslo 2006 through four data collections during lower and upper secondary school.

Teacher training in "multicultural" Sweden

This paper builds on the experience of the on-going, mainly ethnographic, research project called Teacher training in’ multicultural’ Sweden. Class, gender and ethnicity. In this multi-disciplinary project a number of scholars conduct research through participant observation in, and through the study and analysis of documents from, a number of teacher training colleges in Sweden. In this paper I will use empirical material gathered from two teacher training colleges to discuss this basic issue. One college is situated in a suburb outside Stockholm and it consciously portrays itself as a college for ‘multicultural’ students who will later teach in ‘multicultural’ suburbs. The other college is situated in a small town and although ‘multiculturalism’ is seen as important in the educational system students with mainly ‘Swedish’ background are recruited. In the first college ‘differences’ are lauded and students are encouraged to ponder upon and develop their ethnic profile. In the second ‘similarities’ are more taken for granted. I will argue, however, that within these colleges ‘differences’ and ’similarities’ are not only discussed but actually created against a backdrop of macro-constraints which are not much scrutinized within these colleges.