Evaluation of the impact of access to free influenza vaccine on immunization rates for children with cystic fibrosis

Children with cystic fibrosis are at increased risk of seasonal influenza associated complications, which makes them a judicious target of interventions designed to increase influenza vaccination rates. The Baylor College of Medicine/Texas Children's Hospital Pediatric Cystic Fibrosis (BCM/TCH CF) Care Center implemented an enhanced multi-component initiative designed to increase influenza vaccination rates in its patient population during the 2011-2012 influenza season. We evaluated the impact of specific components of this intervention on vaccination rates among the clinic's patient population via a historical medical chart review and examined the relationship between vaccination status and the number of pulmonary exacerbations requiring hospital admission during the influenza season. The multi-component intervention was comprised of providing influenza free of charge in the CF Care Center, reminders via phone call and letters, and drive through influenza vaccine clinics on nights and weekends. The intervention to increase influenza vaccination rates led to overall improved vaccination rates among the patients at the BCM/TCH CF Care Center, increasing from 90% adherence observed during the 2010-2011 season to 94% adherence during the 2011-2012 season. The availability of free influenza vaccine in the CF Care Center, combined with reminders about being vaccinated early in the season proved to be the most effective practices for improving the vaccination rate in the CF Care Center.^

Bases sociais e interiorização: o predomínio eleitoral do PSDB paulista (1994-2014)

Desde 1994, ininterruptamente o PSDB elege seus candidatos ao governo do Estado de São Paulo. Hegemonia eleitoral de tamanha duração vitória em seis eleições consecutivas não foi alcançada por nenhum outro partido em pleitos estaduais na história democrática brasileira recente. Tal feito é ainda mais relevante ao levarmos em conta a trajetória eleitoral paulista, historicamente associada a quadros partidários e resultados das urnas surpreendentes. Assim, o objetivo desta pesquisa é identificar as bases sociais e territoriais do voto nos principais partidos do Estado de São Paulo, com ênfase no PSDB. Para tanto, utilizamos as seguintes variáveis: pesquisas eleitorais estratificadas por renda e escolaridade; tamanho dos municípios; nível de desenvolvimento médio das localidades (ao nível das zonas eleitorais e municípios) para duas regiões previamente estabelecidas a Grande São Paulo e o interior. Identificamos que o partido tucano obtém apoio crescente na medida em que se elevam os índices socioeconômicos do eleitorado. O partido, porém, mantém um importante suporte entre os setores populares sobretudo no interior do Estado. Por fim, ainda que obtenha penetração elevada em todos os municípios paulistas, o PSDB possui melhores resultados nas pequenas localidades. Ao final, discutimos estes achados à luz do panorama eleitoral, partidário e federativo no Brasil.

Eficiência do metotrexato na artrite psoriática

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

The role of temporal synchrony in the facilitation of perceptual learning during prenatal development

This study explored the critical features of temporal synchrony for the facilitation of prenatal perceptual learning with respect to unimodal stimulation using an animal model, the bobwhite quail. The following related hypotheses were examined: (1) the availability of temporal synchrony is a critical feature to facilitate prenatal perceptual learning, (2) a single temporally synchronous note is sufficient to facilitate prenatal perceptual learning, with respect to unimodal stimulation, and (3) in situations where embryos are exposed to a single temporally synchronous note, facilitated perceptual learning, with respect to unimodal stimulation, will be optimal when the temporally synchronous note occurs at the onset of the stimulation bout. To assess these hypotheses, two experiments were conducted in which quail embryos were exposed to various audio-visual configurations of a bobwhite maternal call and tested at 24 hr after hatching for evidence of facilitated prenatal perceptual learning with respect to unimodal stimulation. Experiment 1 explored if intermodal equivalence was sufficient to facilitate prenatal perceptual learning with respect to unimodal stimulation. A Bimodal Sequential Temporal Equivalence (BSTE) condition was created that provided embryos with sequential auditory and visual stimulation in which the same amodal properties (rate, duration, rhythm) were made available across modalities. Experiment 2 assessed: (a) whether a limited number of temporally synchronous notes are sufficient for facilitated prenatal perceptual learning with respect to unimodal stimulation, and (b) whether there is a relationship between timing of occurrence of a temporally synchronous note and the facilitation of prenatal perceptual learning. Results revealed that prenatal exposure to BSTE was not sufficient to facilitate perceptual learning. In contrast, a maternal call that contained a single temporally synchronous note was sufficient to facilitate embryos’ prenatal perceptual learning with respect to unimodal stimulation. Furthermore, the most salient prenatal condition was that which contained the synchronous note at the onset of the call burst. Embryos’ prenatal perceptual learning of the call was four times faster in this condition than when exposed to a unimodal call. Taken together, bobwhite quail embryos’ remarkable sensitivity to temporal synchrony suggests that this amodal property plays a key role in attention and learning during prenatal development.

Tests of the Intersensory Redundancy Hypothesis across early postnatal development

The Intersensory Redundancy Hypothesis (IRH; Bahrick & Lickliter, 2000, 2002, 2012) predicts that early in development information presented to a single sense modality will selectively recruit attention to modality-specific properties of stimulation and facilitate learning of those properties at the expense of amodal properties (unimodal facilitation). Vaillant (2010) demonstrated that bobwhite quail chicks prenatally exposed to a maternal call alone (unimodal stimulation) are able to detect a pitch change, a modality-specific property, in subsequent postnatal testing between the familiarized call and the same call with altered pitch. In contrast, chicks prenatally exposed to a maternal call paired with a temporally synchronous light (redundant audiovisual stimulation) were unable to detect a pitch change. According to the IRH (Bahrick & Lickliter, 2012), as development proceeds and the individual's perceptual abilities increase, the individual should detect modality-specific properties in both nonredundant, unimodal and redundant, bimodal conditions. However, when the perceiver is presented with a difficult task, relative to their level of expertise, unimodal facilitation should become evident. The first experiment of the present study exposed bobwhite quail chicks 24 hr after hatching to unimodal auditory, nonredundant audiovisual, or redundant audiovisual presentations of a maternal call for 10min/hr for 24 hours. All chicks were subsequently tested 24 hr after the completion of the stimulation (72 hr following hatching) between the familiarized maternal call and the same call with altered pitch. Chicks from all experimental groups (unimodal, nonredundant audiovisual, and redundant audiovisual exposure) significantly preferred the familiarized call over the pitch-modified call. The second experiment exposed chicks to the same exposure conditions, but created a more difficult task by narrowing the pitch range between the two maternal calls with which they were tested. Chicks in the unimodal and nonredundant audiovisual conditions demonstrated detection of the pitch change, whereas the redundant audiovisual exposure group did not show detection of the pitch change, providing evidence of unimodal facilitation. These results are consistent with predictions of the IRH and provide further support for the effects of unimodal facilitation and the role of task difficulty across early development.

The Role of Temporal Synchrony in the Facilitation of Perceptual Learning during Prenatal Development

This study explored the critical features of temporal synchrony for the facilitation of prenatal perceptual learning with respect to unimodal stimulation using an animal model, the bobwhite quail. The following related hypotheses were examined: (1) the availability of temporal synchrony is a critical feature to facilitate prenatal perceptual learning, (2) a single temporally synchronous note is sufficient to facilitate prenatal perceptual learning, with respect to unimodal stimulation, and (3) in situations where embryos are exposed to a single temporally synchronous note, facilitated perceptual learning, with respect to unimodal stimulation, will be optimal when the temporally synchronous note occurs at the onset of the stimulation bout. To assess these hypotheses, two experiments were conducted in which quail embryos were exposed to various audio-visual configurations of a bobwhite maternal call and tested at 24 hr after hatching for evidence of facilitated prenatal perceptual learning with respect to unimodal stimulation. Experiment 1 explored if intermodal equivalence was sufficient to facilitate prenatal perceptual learning with respect to unimodal stimulation. A Bimodal Sequential Temporal Equivalence (BSTE) condition was created that provided embryos with sequential auditory and visual stimulation in which the same amodal properties (rate, duration, rhythm) were made available across modalities. Experiment 2 assessed: (a) whether a limited number of temporally synchronous notes are sufficient for facilitated prenatal perceptual learning with respect to unimodal stimulation, and (b) whether there is a relationship between timing of occurrence of a temporally synchronous note and the facilitation of prenatal perceptual learning. Results revealed that prenatal exposure to BSTE was not sufficient to facilitate perceptual learning. In contrast, a maternal call that contained a single temporally synchronous note was sufficient to facilitate embryos’ prenatal perceptual learning with respect to unimodal stimulation. Furthermore, the most salient prenatal condition was that which contained the synchronous note at the onset of the call burst. Embryos’ prenatal perceptual learning of the call was four times faster in this condition than when exposed to a unimodal call. Taken together, bobwhite quail embryos’ remarkable sensitivity to temporal synchrony suggests that this amodal property plays a key role in attention and learning during prenatal development.

(Table 1) Mean statistics for acoustic parameters measured for both brown skua (Catharacta antarctica lonnbergi) sexes

Bird vocalisations are often essential for sex recognition, especially in species that show little morphological sex dimorphism. Brown skuas (Catharacta antarctica lonnbergi), which exhibit uniform plumage across both sexes, emit three main calls: the long call, the alarm call and the contact call. We tested the potential for sex recognition in brown skua calls of 42 genetically sexed individuals by analysing 8-12 acoustic parameters in the temporal and frequency domains of each call type. For every call type, we failed to find sex differences in any of the acoustic parameters measured. Stepwise discriminant function analysis (DFA) revealed that sexes cannot be unambiguously classified, with increasing uncertainty of correct classification from contact calls to long calls to alarm calls. Consequently, acoustic signalling is probably not the key mechanism for sex recognition in brown skuas.

Sistemas de cálculo, análise e operação virtual: interferências de campos elétricos e magnéticos produzidas por estações radio base de acesso múltiplo por divisão de código em banda larga - WCDMA

In this work it was developed mathematical resolutions taking as parameter maximum intensity values for the interference analysis of electric and magnetic fields and was given two virtual computer system that supports families of CDMA and WCDMA technologies. The first family were developed computational resources to solve electric and magnetic field calculations and power densities in Radio Base stations , with the use of CDMA technology in the 800 MHz band , taking into account the permissible values referenced by the Commission International Protection on non-Ionizing Radiation . The first family is divided into two segments of calculation carried out in virtual operation. In the first segment to compute the interference field radiated by the base station with input information such as radio channel power; Gain antenna; Radio channel number; Operating frequency; Losses in the cable; Attenuation of direction; Minimum Distance; Reflections. Said computing system allows to quickly and without the need of implementing instruments for measurements, meet the following calculated values: Effective Radiated Power; Sector Power Density; Electric field in the sector; Magnetic field in the sector; Magnetic flux density; point of maximum permissible exposure of electric field and power density. The results are shown in charts for clarity of view of power density in the industry, as well as the coverage area definition. The computer module also includes folders specifications antennas, cables and towers used in cellular telephony, the following manufacturers: RFS World, Andrew, Karthein and BRASILSAT. Many are presented "links" network access "Internet" to supplement the cable specifications, antennas, etc. . In the second segment of the first family work with more variables , seeking to perform calculations quickly and safely assisting in obtaining results of radio signal loss produced by ERB . This module displays screens representing propagation systems denominated "A" and "B". By propagating "A" are obtained radio signal attenuation calculations in areas of urban models , dense urban , suburban , and rural open . In reflection calculations are present the reflection coefficients , the standing wave ratio , return loss , the reflected power ratio , as well as the loss of the signal by mismatch impedance. With the spread " B" seek radio signal losses in the survey line and not targeted , the effective area , the power density , the received power , the coverage radius , the conversion levels and the gain conversion systems radiant . The second family of virtual computing system consists of 7 modules of which 5 are geared towards the design of WCDMA and 2 technology for calculation of telephone traffic serving CDMA and WCDMA . It includes a portfolio of radiant systems used on the site. In the virtual operation of the module 1 is compute-: distance frequency reuse, channel capacity with noise and without noise, Doppler frequency, modulation rate and channel efficiency; Module 2 includes computes the cell area, thermal noise, noise power (dB), noise figure, signal to noise ratio, bit of power (dBm); with the module 3 reaches the calculation: breakpoint, processing gain (dB) loss in the space of BTS, noise power (w), chip period and frequency reuse factor. Module 4 scales effective radiated power, sectorization gain, voice activity and load effect. The module 5 performs the calculation processing gain (Hz / bps) bit time, bit energy (Ws). Module 6 deals with the telephone traffic and scales 1: traffic volume, occupancy intensity, average time of occupancy, traffic intensity, calls completed, congestion. Module 7 deals with two telephone traffic and allows calculating call completion and not completed in HMM. Tests were performed on the mobile network performance field for the calculation of data relating to: CINP , CPI , RSRP , RSRQ , EARFCN , Drop Call , Block Call , Pilot , Data Bler , RSCP , Short Call, Long Call and Data Call ; ECIO - Short Call and Long Call , Data Call Troughput . As survey were conducted surveys of electric and magnetic field in an ERB , trying to observe the degree of exposure to non-ionizing radiation they are exposed to the general public and occupational element. The results were compared to permissible values for health endorsed by the ICNIRP and the CENELEC .

Small strain elastic behaviour of unsaturated soil investigated by bender/extender element testing

The aim of this project was to investigate very small strain elastic behaviour of soils under unsaturated conditions, using bender/extender element (BEE) testing. The behaviour of soils at very small strains has been widely studied under saturated conditions, whereas much less work has been performed on very small strain behaviour under unsaturated conditions. A suction-controlled double wall triaxial apparatus for unsaturated soil testing was modified to incorporate three pairs of BEEs transmitting both shear and compression waves with vertical and horizontal directions of wave transmission and wave polarisation. Various different techniques for measuring wave travel time were investigated in both the time domain and the frequency domain and it was concluded that, at least for the current experimental testing programme, peak-to-first-peak in the time domain was the most reliable technique for determining wave travel time. An experimental test programme was performed on samples of compacted speswhite kaolin clay. Two different forms of compaction were employed (i.e. isotropic and anisotropic). Compacted kaolin soil samples were subjected to constant suction loading and unloading stages at three different values of suction, covering both unsaturated conditions (s= 50kPa and s= 300kPa) and saturated conditions (s=0). Loading and unloading stages were performed at three different values of stress ratio (η=0, η=1 and η=-1 ). In some tests a wetting-drying cycle was performed before or within the loading stage, with the wetting-drying cycles including both wetting-induced swelling and wetting-induced collapse compression. BEE tests were performed at regular intervals throughout all test stages, to measure shear wave velocity Vs and compression wave velocity Vp and hence to determine values of shear modulus G and constrained modulus M. The experimental test programme was designed to investigate how very small strain shear modulus G and constrained modulus M varied with unsaturated state variables, including how anisotropy of these parameters developed either with stress state (stress-induced anisotropy) or with previous straining (strain-induced anisotropy). A new expression has been proposed for the very small strain shear modulus G of an isotropic soil under saturated and unsaturated conditions. This expression relates the variation of G to only mean Bishop’s stress p* and specific volume v, and it converges to a well-established expression for saturated soils as degree of saturation approaches 1. The proposed expression for G is able to predict the variation of G under saturated and unsaturated conditions at least as well as existing expressions from the literature and it is considerably simpler (employing fewer state variables and fewer soil constants). In addition, unlike existing expressions from the literature, the values of soil constants in the proposed new expression can be determined from a saturated test. It appeared that, in the current project at least, any strain-induced anisotropy of very small strain elastic behaviour was relatively modest, with the possible exception of loading in triaxial extension. It was therefore difficult to draw any firm conclusion about evolution of strain-induced anisotropy and whether it depended upon the same aspects of soil fabric as evolution of anisotropy of large strain plastic behaviour. Stress-induced anisotropy of very small strain elastic behaviour was apparent in the experimental test programme. An attempt was made to extend the proposed expression for G to include the effect of stress-induced anisotropy. Interpretation of the experimental results indicated that the value of shear modulus was affected by the values of all three principal Bishop’s stresses (in the direction of wave transmission, the direction of wave polarisation and the third mutually perpendicular direction). However, prediction of stress-induced anisotropy was only partially successful, and it was concluded that the effect of Lode angle was also significant.

Percepción de la seguridad y salud en el trabajo en una población perteneciente a 11 clínicas odontológicas particulares de Bogotá, D.C, 2016.

Objetivo: Establecer la relación entre la percepción de seguridad con los factores ocupacionales y socio demográficos de los trabajadores pertenecientes a 11 clínicas odontológicos particulares en Bogotá. Materiales y métodos: Estudio de corte transversal en población de trabajadores pertenecientes a clínicas odontológicas particulares de Bogotá (Colombia). La muestra incluyó 105 odontólogos y 107 auxiliares pertenecientes a 11 clínicas odontológicas privadas en Bogotá que cumplieron con los criterios de selección. Se incluyeron variables ocupacionales y socio demográficas y las relacionadas con el sistema de seguridad y salud en el trabajo. Se aplicó el “Cuestionario Nórdico Sobre Seguridad en el Trabajo. Para los factores socio-demográficos de la población estudiada, se utilizó estadística descriptiva, medidas de frecuencia absoluta y porcentual, las variables cuantitativas se describieron con medidas de tendencia central y de dispersión; para la asociación de las variables cualitativas con el tipo de percepción se usó la prueba Ji Cuadrado de Pearson o el test exacto de Fisher para valores esperados menores de 5. Resultados: Las dimensiones con mejor percepción fueron las relacionadas con la confianza en la eficacia de los sistemas de seguridad (D7 3.35±0.43) y la Administración de justicia de seguridad (D3 3.1±0.55). Las dimensiones que evalúan la Gestión de empoderamiento de seguridad (D2 2.74±0.99) y la prioridad de los trabajadores con la seguridad (D5 2.64±0.54) tuvieron la menor percepción. La percepción de seguridad fue buena en general teniendo en cuenta que el promedio de todas las dimensiones fue superior a 2.5; percepción mayor significativamente en los hombres (3.78±0.38), odontólogos (3.89±0.38) y personal que tienen o han tenido pareja (3.83±0.4). Las personas con más trabajos adicionales (4.07±0.17), mayor nivel educativo (3.89±0.31), mayor antigüedad laboral (3.92±0.51) y trabajadores mayores de 30 años (3.89±0.35), mostraron mejor percepción de seguridad. En el análisis multivariado los factores cargo y antigüedad laboral encontraron asociación en las dimensiones 2, 4 y 6 (p<0.001), mientras que para las variables numéricas, las dimensiones 1, 3, 4 y 6 tuvieron asociación significativa las variables género y posición (p<0.001). Conclusiones: La percepción de seguridad en las siete dimensiones se relacionó con el género, edad, estado civil, nivel educativo, cargo, posición y antigüedad laboral. No se encontraron diferencias significativas por turno de trabajo o clínica.

Las funciones y las relaciones sociales, económicas y políticas de los miembros del Cabildo Catedralicio de la Diócesis de Nicaragua y Costa Rica (1531-1859).

ResumenEl artículo analiza las funciones del cabildo catedralicio de la Diócesis de Nicaragua y Costa Rica con el fin de explicar las relaciones sociales, políticas y económicas de sus miembros y determinar la importancia del cabildo en el funcionamiento de la diócesis entre los años 1531 y 1859. Las fuentes primarias coloniales sobre el cabildo catedralicio, los testamentos y padrones de diezmos, entre otros; revelan que los miembros del cabildo catedralicio de León tuvieron funciones específicas dentro de la diócesis tanto durante la sede vacante como cuando existía Obispo al frente de la diócesis. Los miembros del cabildo catedralicio no constituyeron un cuerpo capitular aislado de la sociedad, sino que mantuvieron relaciones de confianza, económicas y sociales entre ellos y con la sociedad que los rodeaba, por tanto, fueron un cuerpo capitular crucial para el funcionamiento de la diócesis durante su sede vacante y cuando fueron el consejo asesor del ObispoAbstractThe article analyzes the functions of the cathedral chapter of the Diocese of Nicaragua and Costa Rica with the purpose of explaining the social, political and economic relations of its members and determining the importance of the chapter in the operation of the diocese between the years 1531 and 1859. Colonial primary sources, including testaments and tithe registers, among others, reveal that the members of the cathedral chapter of Leon had specific functions within the diocese, both when the see was vacant and when there was a Bishop in office. The members of the cathedral chapter did not constitute a capitular body isolated from the rest of society. Rather, they maintained economic and social relations of trust among themselves and with the society that surrounded them. Therefore, they were a capitular body crucial to the operation of the diocese, both when they served as the bishops advisory committee and when they governed the diocese in the absence of a Bishop.

Opportunistic and partisan election cycles in Brazil: new evidence at the municipal level

This article tests the hypothesis of opportunistic and partisan cycle models using a new large data set of Brazilian municipalities over the 1989-2005 period. The results show an increase in total and current expenditures and a decrease in municipal investments, local tax revenues, and budget surplus in election years. They also show that partisan ideology exerts a relative influence on the performance of the local public accounts. These results confirm that both opportunistic and partisan cycles have occurred in the management of the budgets of Brazilian municipalities after the end of the military government.

Geographic call variation and further notes on habitat of Ameerega flavopicta (Anura, Dendrobatidae)

We describe habitat and inter-populational call variation of the dendrobatid frog Ameerega flavopicta. Data were collected in the Brazilian states ofminas Gerais and Goias. Principal component analysis separated the Goias population from others because of its higher call rates and shorter calls. The Paranaiba Rivermay represent themajor geographic barrier. We recognize the cephalic amplexus as themain type for the species. Although habitat disturbances increased since 1990, we did not notice differences in the density of callingmales at Serra do Cipo. Ameerega flavopicta appears to be quite resistant to alterations in its natural habitats caused by human activities.