Nuances in the embedment of ESDCG in the Azorean curriculum

Este capítulo tem origem na conferência «A Child's World - Working Together for a Better Future», que decorreu em Aberystwyth (Wales) entre 27 e 29 de Junho de 2012.

Risk-factors for antepartum fetal deaths in the city of São Paulo, Brazil

OBJECTIVE: To assess risk factors for antepartum fetal deaths. METHODS: A population-based case-control study was carried out in the city of São Paulo from August 2000 to January 2001. Subjects were selected from a birth cohort from a linked birth and death certificate database. Cases were 164 antepartum fetal deaths and controls were drawn from a random sample of 313 births surviving at least 28 days. Information was collected from birth and death certificates, hospital records and home interviews. A hierarchical conceptual framework guided the logistic regression analysis. RESULTS: Statistically significant factors associated with antepartum fetal death were: mother without or recent marital union; mother's education under four years; mothers with previous low birth weight infant; mothers with hypertension, diabetes, bleeding during pregnancy; no or inadequate prenatal care; congenital malformation and intrauterine growth restriction. The highest population attributable fractions were for inadequacy of prenatal care (40%), hypertension (27%), intrauterine growth restriction (30%) and absence of a long-standing union (26%). CONCLUSIONS: Proximal biological risk factors are most important in antepartum fetal deaths. However, distal factors - mother's low education and marital status - are also significant. Improving access to and quality of prenatal care could have a large impact on fetal mortality.

Evaluating the efficiency of a vegetal coagulant in the treatment of industrial effluents

The present work aims at evaluating the efficiency of an organic polymer from vegetal source used as coagulant for treating different types of industrial effluents. This coagulant (Flox-QT) is obtained from the Black Acacia (Acacia mearnsii). The effluents studied were produced in petrochemical, leather, cork stoppers, metalworking, olive oil, glue, paint (printing), textile and paper industries. The parameters analyzed in the effluents before and after treatment were selected according to the type of wastewater and included pH, conductivity, apparent colour, turbidity, total suspended solids (TSS), chemical oxygen demand (COD) and some metals. The coagulant proved to be efficient for almost all effluents tested. The best results were obtained for the paper industry wastewater, with 91% removal of chemical oxygen demand and 95% of total suspended solids removal. The estimated cost of this treatment would be only 0.24 Euro per cubic meter of treated effluent, only regarding the price of the coagulant and the required dosage. The use of this coagulant is also adequate for the valorisation of the sludge obtained, which in this case could be recycled for paper production.

Implications of the Intervention Program for Physical Activity (IPPA) in the perception of illness and wellbeing in people with Multiple Sclerosis (MS)

The aim of this study is to examine the implications of the IPPA in the perception of illness and wellbeing in MS patients. Methods - This is a quasi experimental study non-randomized study with 24 MS patients diagnosed at least 1 year before, and with an EDSS score of under 7. We used the IPPA in 3 groups of eight people in 3 Portuguese hospitals (Lisbon, Coimbra, and Porto). The sessions were held once a week for 90 minutes, over a period of 7 weeks. The instruments used were: We asked the subjects the question “Please classify the severity of your disease?” and used the Personal Wellbeing Scale (PWS) at the beginning (time A) and end (time B) of the IPPA. We used the SPSS version 20. A non-parametric statistical hypothesis test (Wilcoxon test) was used for the variable analysis. The intervention followed the recommendations of the Helsinki Declaration. Results – The results suggest that there are differences between time A and B, the perception of illness decreased (p<0.08), while wellbeing increased (p<0.01). Conclusions: The IPPA can play an important role in modifying the perception of disease severity and personal wellbeing.

Integration of biomonitoring and instrumental techniques to assess the air quality in an industrial area located in the coastal of Central Asturias, Spain

Throughout the world, epidemiological studies were established to examine the relationship between air pollution and mortality rates and adverse respiratory health effects. However, despite the years of discussion the correlation between adverse health effects and atmospheric pollution remains controversial, partly because these studies are frequently restricted to small and well-monitored areas. Monitoring air pollution is complex due to the large spatial and temporal variations of pollution phenomena, the high costs of recording instruments, and the low sampling density of a purely instrumental approach. Therefore, together with the traditional instrumental monitoring, bioindication techniques allow for the mapping of pollution effects over wide areas with a high sampling density. In this study, instrumental and biomonitoring techniques were integrated to support an epidemiological study that will be developed in an industrial area located in Gijon in the coastal of central Asturias, Spain. Three main objectives were proposed to (i) analyze temporal patterns of PM10 concentrations in order to apportion emissions sources, (ii) investigate spatial patterns of lichen conductivity to identify the impact of the studied industrial area in air quality, and (iii) establish relationships amongst lichen conductivity with some site-specific characteristics. Samples of the epiphytic lichen Parmelia sulcata were transplanted in a grid of 18 by 20 km with an industrial area in the center. Lichens were exposed for a 5-mo period starting in April 2010. After exposure, lichen samples were soaked in 18-MΩ water aimed at determination of water electrical conductivity and, consequently, lichen vitality and cell damage. A marked decreasing gradient of lichens conductivity relative to distance from the emitting sources was observed. Transplants from a sampling site proximal to the industrial area reached values 10-fold higher than levels far from it. This finding showed that lichens reacted physiologically in the polluted industrial area as evidenced by increased conductivity correlated to contamination level. The integration of temporal PM10 measurements and analysis of wind direction corroborated the importance of this industrialized region for air quality measurements and identified the relevance of traffic for the urban area.

The usefulness of ultrasound in the classification of chronic liver disease

Chronic Liver Disease is a progressive, most of the time asymptomatic, and potentially fatal disease. In this paper, a semi-automatic procedure to stage this disease is proposed based on ultrasound liver images, clinical and laboratorial data. In the core of the algorithm two classifiers are used: a k nearest neighbor and a Support Vector Machine, with different kernels. The classifiers were trained with the proposed multi-modal feature set and the results obtained were compared with the laboratorial and clinical feature set. The results showed that using ultrasound based features, in association with laboratorial and clinical features, improve the classification accuracy. The support vector machine, polynomial kernel, outperformed the others classifiers in every class studied. For the Normal class we achieved 100% accuracy, for the chronic hepatitis with cirrhosis 73.08%, for compensated cirrhosis 59.26% and for decompensated cirrhosis 91.67%.

A comprehensive approach to evaluate nutritional status in Crohn's patients in the era of biologic therapy: a case-control study

Objectives - Evaluate the nutritional status of patients with inactive or mildly active Crohn's disease (CD), and identify possible causes for potential deficiencies. Methods - A total of 78 CD patients and 80 healthy controls were evaluated in respect of nutritional status, dietary intake, and life styles factors. Results - These 73/78 CD patients were on immunomodulating therapies. Mean body mass index (BMI) was lower in patients as compared to controls (P= 0.006) but 32% of CD patients and 33.8% of controls had a BMI > 25, whereas 8% and 23.8% in each group, respectively, were obese (BMI > 30Kg/m(2)). Fat free mass was significantly decreased in both genders (P < 0.05) whereas fat mass was decreased only in males (P= 0.01). Energy intake was significantly lower in CD patients (P < 0.0001) and we observed significantly lower adjusted mean daily intakes of carbohydrates, monounsaturated fat, fiber, calcium, and vitamins C, D, E, and K (P < 0.05). 29% of patients had excluded grains from their usual diet, 28% milk, 18% vegetables, and 11% fruits. Milk exclusion resulted in a significantly lower consumption of calcium and vitamin K (P < 0.001) and the exclusion of vegetables was associated to a lower consumption of vitamins C and E (P < 0.05). Physical activity was significantly lower in CD patients (P= 0.01) and this lack of physical activity was inversely correlated with increased fat mass percentage (r=-0.315, P= 0.001). Conclusions - Results showed that the most prevalent form of malnutrition in CD patients was an excess of body weight, which was concomitant with an inadequate dietary intake, namely micronutrients, clearly related to dietary exclusion of certain foods.

Helmet use among motorcyclists: observational study in the city of Mar del Plata, Argentina

The objective of the study was to assess the use of helmets in a community where helmet use is mandatory but low as there is no police enforcement. A sample comprising 451 motorcyclists in the city of Mar del Plata, Argentina, was studied in 2006. The following variables were studied: gender, type of motorcycle, weather conditions, time of the day, city area and type of road where motorcyclists traveled. Data were analyzed through a multiple logistic regression model. An overall 40% prevalence (95% CI: 35.5;44.5) of helmet use was found. Higher rates of helmet use were seen among women, and under unfavorable weather conditions, lower rates were found in the city outskirts, and variable use was seen according to the type of motorcycle. There is a need to improve law enforcement and to promote education of motorcyclists.

Complementarity of conventional and molecular methods in the assessment of fungal contamination caused by Aspergillus fumigatus complex in one Portuguese composting plant

The handling of waste and compost that occurs frequently in composting plants (compost turning, shredding, and screening) has been shown to be responsible for the release of dust and air borne microorganisms and their compounds in the air. Thermophilic fungi, such as A. fumigatus, have been reported and this kind of contamination in composting facilities has been associated with increased respiratory symptoms among compost workers. This study intended to characterize fungal contamination in a totally indoor composting plant located in Portugal. Besides conventional methods, molecular biology was also applied to overcome eventual limitations.

Application of wetland systems in the treatment of acid rock mine drainage

The presented work was conducted within the Dissertation / Internship, branch of Environmental Protection Technology, associated to the Master thesis in Chemical Engineering by the Instituto Superior de Engenharia do Porto and it was developed in the Aquatest a.s, headquartered in Prague, in Czech Republic. The ore mining exploitation in the Czech Republic began in the thirteenth century, and has been extended until the twentieth century, being now evident the consequences of the intensive extraction which includes contamination of soil and sub-soil by high concentrations of heavy metals. The mountain region of Zlaté Hory was chosen for the implementation of the remediation project, which consisted in the construction of three cells (tanks), the first to raise the pH, the second for the sedimentation of the formed precipitates and a third to increase the process efficiency in order to reduce high concentrations of metals, with special emphasis on iron, manganese and sulfates. This project was initiated in 2005, being pioneer in this country and is still ongoing due to the complex chemical and biological phenomenon’s inherent to the system. At the site where the project was implemented, there is a natural lagoon, thereby enabling a comparative study of the two systems (natural and artificial) regarding the efficiency of both in the reduction/ removal of the referred pollutants. The study aimed to assist and cooperate in the ongoing investigation at the company Aquatest, in terms of field work conducted in Zlaté Hory and in terms of research methodologies used in it. Thereby, it was carried out a survey and analysis of available data from 2005 to 2008, being complemented by the treatment of new data from 2009 to 2010. Moreover, a theoretical study of the chemical and biological processes that occurs in both systems was performed. Regarding the field work, an active participation in the collection and in situ sample analyzing of water and soil from the natural pond has been attained, with the supervision of Engineer, Irena Šupiková. Laboratory analysis of water and soil were carried out by laboratory technicians. It was found that the natural lagoon is more efficient in reducing iron and manganese, being obtained removal percentages of 100%. The artificial lagoon had a removal percentage of 90% and 33% for iron and manganese respectively. Despite the minor efficiency of the constructed wetland, it must be pointed out that this system was designed for the treatment and consequent reduction of iron. In this context, it can conclude that the main goal has been achieved. In the case of sulphates, the removal optimization is yet a goal to be achieved not only in the Czech Republic but also in other places where this type of contamination persists. In fact, in the natural lagoon and in the constructed wetland, removal efficiencies of 45% and 7% were obtained respectively. It has been speculated that the water at the entrance of both systems has different sources. The analysis of the collected data shows at the entrance of the natural pond, a concentration of 4.6 mg/L of total iron, 14.6 mg/L of manganese and 951 mg/L of sulphates. In the artificial pond, the concentrations are 27.7 mg/L, 8.1 mg/L and 382 mg/L respectively for iron, manganese and sulphates. During 2010 the investigation has been expanded. The study of soil samples has started in order to observe and evaluate the contribution of bacteria in the removal of heavy metals being in its early phase. Summarizing, this technology has revealed to be an interesting solution, since in addition to substantially reduce the mentioned contaminants, mostly iron, it combines the low cost of implementation with an reduced maintenance, and it can also be installed in recreation parks, providing habitats for plants and birds.

Imported and autochthonous cases in the dynamics of dengue epidemics in Brazil

OBJECTIVE: To estimate the basic reproduction number (R0) of dengue fever including both imported and autochthonous cases. METHODS: The study was conducted based on epidemiological data of the 2003 dengue epidemic in Brasília, Brazil. The basic reproduction number is estimated from the epidemic curve, fitting linearly the increase of initial cases. Aiming at simulating an epidemic with both autochthonous and imported cases, a "susceptible-infectious-resistant" compartmental model was designed, in which the imported cases were considered as an external forcing. The ratio between R0 of imported versus autochthonous cases was used as an estimator of real R0. RESULTS: The comparison of both reproduction numbers (only autochthonous versus all cases) showed that considering all cases as autochthonous yielded a R0 above one, although the real R0 was below one. The same results were seen when the method was applied on simulated epidemics with fixed R0. This method was also compared to some previous proposed methods by other authors and showed that the latter underestimated R0 values. CONCLUSIONS: It was shown that the inclusion of both imported and autochthonous cases is crucial for the modeling of the epidemic dynamics, and thus provides critical information for decision makers in charge of prevention and control of this disease.

Presumed unconstrained dispersal of Aedes aegypti in the city of Rio de Janeiro, Brazil

OBJECTIVE: To evaluate dispersal of Aedes aegypti females in an area with no container manipulation and no geographic barriers to constrain mosquito flight. METHODS: A mark-release-recapture experiment was conducted in December 2006, in the dengue endemic urban district of Olaria in Rio de Janeiro, Southeastern Brazil, where there is no evident obstacle to the dispersal of Ae. aegypti females. Mosquito traps were installed in 192 houses (96 Adultraps and 96 MosquiTRAPs). RESULTS: A total of 725 dust-marked gravid females were released and recapture rate was 6.3%. Ae. aegypti females traveled a mean distance of 288.12 m and their maximum displacement was 690 m; 50% and 90% of females flew up to 350 m and 500.2 m, respectively. CONCLUSIONS: Dispersal of Ae. aegypti females in Olaria was higher than in areas with physical and geographical barriers. There was no evidence of a preferred direction during mosquito flight, which was considered random or uniform from the release point.