Neonatal mortality in intensive care units of Central Brazil

OBJECTIVE: To identify potential prognostic factors for neonatal mortality among newborns referred to intensive care units. METHODS: A live-birth cohort study was carried out in Goiânia, Central Brazil, from November 1999 to October 2000. Linked birth and infant death certificates were used to ascertain the cohort of live born infants. An additional active surveillance system of neonatal-based mortality was implemented. Exposure variables were collected from birth and death certificates. The outcome was survivors (n=713) and deaths (n=162) in all intensive care units in the study period. Cox's proportional hazards model was applied and a Receiver Operating Characteristic curve was used to compare the performance of statistically significant variables in the multivariable model. Adjusted mortality rates by birth weight and 5-min Apgar score were calculated for each intensive care unit. RESULTS: Low birth weight and 5-min Apgar score remained independently associated to death. Birth weight equal to 2,500g had 0.71 accuracy (95% CI: 0.65-0.77) for predicting neonatal death (sensitivity =72.2%). A wide variation in the mortality rates was found among intensive care units (9.5-48.1%) and two of them remained with significant high mortality rates even after adjusting for birth weight and 5-min Apgar score. CONCLUSIONS: This study corroborates birth weight as a sensitive screening variable in surveillance programs for neonatal death and also to target intensive care units with high mortality rates for implementing preventive actions and interventions during the delivery period.

Sensing Cloud Optimization to Solve ED of Units with Valve-Point Effects and Multi-fuels

In this paper a solution to an highly constrained and non-convex economical dispatch (ED) problem with a meta-heuristic technique named Sensing Cloud Optimization (SCO) is presented. The proposed meta-heuristic is based on a cloud of particles whose central point represents the objective function value and the remaining particles act as sensors "to fill" the search space and "guide" the central particle so it moves into the best direction. To demonstrate its performance, a case study with multi-fuel units and valve- point effects is presented.

Potential poultry and meat products contamination by aflatoxin B1 due to fungal presence in Portuguese poultry units

The impact of mycotoxins on human and animal health is well recognized. Aflatoxin B1 (AFB1) is by far the most prevalent and the most potent natural carcinogen and is usually the major aflatoxin produced by toxigenic fungal strains. Data available, points to an increasing frequency of poultry feed contamination by aflatoxins. Since aflatoxin residues may accumulate in body tissues, this represents a high risk to human health. Samples from commercial poultry birds have already presented detectable levels of aflatoxin in liver. A descriptive study was developed in order to assess fungal contamination by species from Aspergillus flavus complex in seven Portuguese poultry units. Air fungal contamination was studied by conventional and molecular methods. Air, litter and surfaces samples were collected. To apply molecular methods, air samples of 300L were collected using the Coriolis μ air sampler (Bertin Technologies), at 300 L/min airflow rate. For conventional methodologies, all the collected samples were incubated at 27ºC for five to seven days. Through conventional methods, Aspergillus flavus was the third fungal species (7%) most frequently found in 27 indoor air samples analysed and the most commonly isolated species (75%) in air samples containing only the Aspergillus genus...

Multi-criteria design optimization study of solvent extraction in mixer–settler units

Solvent extraction is considered as a multi-criteria optimization problem, since several chemical species with similar extraction kinetic properties are frequently present in the aqueous phase and the selective extraction is not practicable. This optimization, applied to mixer–settler units, considers the best parameters and operating conditions, as well as the best structure or process flow-sheet. Global process optimization is performed for a specific flow-sheet and a comparison of Pareto curves for different flow-sheets is made. The positive weight sum approach linked to the sequential quadratic programming method is used to obtain the Pareto set. In all investigated structures, recovery increases with hold-up, residence time and agitation speed, while the purity has an opposite behaviour. For the same treatment capacity, counter-current arrangements are shown to promote recovery without significant impairment in purity. Recycling the aqueous phase is shown to be irrelevant, but organic recycling with as many stages as economically feasible clearly improves the design criteria and reduces the most efficient organic flow-rate.

Occupational exposure to particulate matter in 2 Portuguese waste-sorting units

Objectives - This study intended to characterize work environment contamination by particles in 2 waste-sorting plants. Material and Methods - Particles were measured by portable direct-reading equipment. Besides mass concentration in different sizes, data related with the number of particles concentration were also obtained. Results - Both sorting units showed the same distribution concerning the 2 exposure metrics: particulate matter 5 (PM5) and particulate matter 10 (PM10) reached the highest levels and 0.3 μm was the fraction with a higher number of particles. Unit B showed higher (p < 0.05) levels for both exposure metrics. For instance, in unit B the PM10 size is 9-fold higher than in unit A. In unit A, particulate matter values obtained in pre-sorting and in the sequential sorting cabinet were higher without ventilation working. Conclusions - Workers from both waste-sorting plants are exposed to particles. Particle counting provided additional information that is of extreme value for analyzing the health effects of particles since higher values of particles concentration were obtained in the smallest fraction.

DOTS in primary care units in the city of Rio de Janeiro, Southeastern Brazil

OBJECTIVE: To describe the implantation and the effects of directly-observed treatment short course (DOTS) in primary health care units. METHODS: Interviews were held with the staff of nine municipal health care units (MHU) that provided DOTS in Rio de Janeiro City, Southeastern Brazil, in 2004-2005. A dataset with records of all tuberculosis treatments beginning in 2004 in all municipal health care units was collected. Bivariate analyses and a multinomial model were applied to identify associations between treatment outcomes and demographic and treatment process variables, including being in DOTS or self-administered therapy (SAT). RESULTS: From 4,598 tuberculosis cases treated in public health units administrated by the municipality, 1,118 (24.3%) were with DOTS and 3,480 (75.7%) with SAT. The odds of DOTS were higher among patients with age under 50 years, tuberculosis relapse and prior history of default or treatment failure. The odds of death were 52.0% higher among patients on DOTS as compared to SAT. DOTS modality including community health workers (CHWs) showed the highest treatment success rate. A reduction of 21.0% was observed in the odds of default (vs. cure) among patients on DOTS as compared to patients on SAT, and a reduction of 64.0% among patients on DOTS with CHWs as compared to those without CHWs. CONCLUSIONS: Patients with a "low compliance profile" were more likely to be included in DOTS. This strategy improves the quality of care provided to tuberculosis patients, although the proposed goals were not achieved.

Programming atomic multicasts in CAN

In Distributed Computer-Controlled Systems (DCCS), a special emphasis must be given to the communication infrastructure, which must provide timely and reliable communication services. CAN networks are usually suitable to support small-scale DCCS. However, they are known to present some reliability problems, which can lead to an unreliable behaviour of the supported applications. In this paper, an atomic multicast protocol for CAN networks is proposed. This protocol explores the CAN synchronous properties, providing a timely and reliable service to the supported applications. The implementation of such protocol in Ada, on top of the Ada version of Real-Time Linux is presented, which is used to demonstrate the advantages and disadvantages of the platform to support reliable communications in DCCS.

Cartografia geológica do Mesozóico na AML e aspectos relativos à normalização

Cartografia Geológica Aplicada a Áreas Urbanas

How to integrate stories and ICT in content-based units of work for English learning

The aim of this article is to show how it is possible to integrate stories and ICT in Content Language Integrated Learning (CLIL) for English as a foreign language (EFL) learning in bilingual schools. Two Units of Work are presented. One, for the second year of Primary, is based on a Science topic, ‘Materials’. The story used is ‘The three little pigs’ and the computer program ‘JClic’. The other one is based on a Science and Arts topic for the sixth year of Primary, the story used is ‘Charlotte’s Web’ and the computer program ‘Atenex’.

Prevalence of health promotion programs in primary health care units in Brazil

OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil.

Spatial distribution of specialized cardiac care units in the state of Santa Catarina

OBJECTIVE To analyze the methodology used for assessing the spatial distribution of specialized cardiac care units. METHODS A modeling and simulation method was adopted for the practical application of cardiac care service in the state of Santa Catarina, Southern Brazil, using the p-median model. As the state is divided into 21 health care regions, a methodology which suggests an arrangement of eight intermediate cardiac care units was analyzed, comparing the results obtained using data from 1996 and 2012. RESULTS Results obtained using data from 2012 indicated significant changes in the state, particularly in relation to the increased population density in the coastal regions. The current study provided a satisfactory response, indicated by the homogeneity of the results regarding the location of the intermediate cardiac care units and their respective regional administrations, thereby decreasing the average distance traveled by users to health care units, located in higher population density areas. The validity of the model was corroborated through the analysis of the allocation of the median vertices proposed in 1996 and 2012. CONCLUSIONS The current spatial distribution of specialized cardiac care units is more homogeneous and reflects the demographic changes that have occurred in the state over the last 17 years. The comparison between the two simulations and the current configuration showed the validity of the proposed model as an aid in decision making for system expansion.

Renewable power forecast to scheduling of thermal units

In this work is discussed the importance of the renewable production forecast in an island environment. A probabilistic forecast based on kernel density estimators is proposed. The aggregation of these forecasts, allows the determination of thermal generation amount needed to schedule and operating a power grid of an island with high penetration of renewable generation. A case study based on electric system of S. Miguel Island is presented. The results show that the forecast techniques are an imperative tool help the grid management.

Difficulties in access and estimates of public beds in intensive care units in the state of Rio de Janeiro

ABSTRACT OBJECTIVE To estimate the required number of public beds for adults in intensive care units in the state of Rio de Janeiro to meet the existing demand and compare results with recommendations by the Brazilian Ministry of Health. METHODS The study uses a hybrid model combining time series and queuing theory to predict the demand and estimate the number of required beds. Four patient flow scenarios were considered according to bed requests, percentage of abandonments and average length of stay in intensive care unit beds. The results were plotted against Ministry of Health parameters. Data were obtained from the State Regulation Center from 2010 to 2011. RESULTS There were 33,101 medical requests for 268 regulated intensive care unit beds in Rio de Janeiro. With an average length of stay in regulated ICUs of 11.3 days, there would be a need for 595 active beds to ensure system stability and 628 beds to ensure a maximum waiting time of six hours. Deducting current abandonment rates due to clinical improvement (25.8%), these figures fall to 441 and 417. With an average length of stay of 6.5 days, the number of required beds would be 342 and 366, respectively; deducting abandonment rates, 254 and 275. The Brazilian Ministry of Health establishes a parameter of 118 to 353 beds. Although the number of regulated beds is within the recommended range, an increase in beds of 122.0% is required to guarantee system stability and of 134.0% for a maximum waiting time of six hours. CONCLUSIONS Adequate bed estimation must consider reasons for limited timely access and patient flow management in a scenario that associates prioritization of requests with the lowest average length of stay.

Reactivity of syringyl and guaiacyl lignin units and delignification kinetics in the kraft pulping of eucalyptus globulus wood using Py-Gc-Ms/FID

Eucalyptus globulus sapwood and heartwood showed no differences in lignin content (23.0% vs. 23.7%) and composition: syringyl-lignin (17.9% vs. 18.0%) and guaiacyl-lignin (4.8% vs. 5.2%). Delignification kinetics of S- and G-units in heartwood and sapwood was investigated by Py-GC–MS/FID at 130, 150 and 170 °C and modeled as double first-order reactions. Reactivity differences between S and G-units were small during the main pulping phase and the higher reactivity of S over G units was better expressed in the later pulping stage. The residual lignin composition in pulps was different from wood or from samples in the initial delignification stages, with more G and H-units. S/G ratio ranged from 3 to 4.5 when pulp residual lignin was higher than 10%, decreasing rapidly to less than 1. The S/H was initially around 20 (until 15% residual lignin), decreasing to 4 when residual lignin was about 3%.

Location model for CCA-treated - wood waste remediation units

Dissertação apresentada como requisito parcial para obtenção do grau de Mestre em Ciência e Sistemas de Informação Geográfica