Efficacy of entecavir and tenofovir in chronic hepatitis B under treatment in the public health system in southern Brazil

There are about 350 million hepatitis B virus (HBV) carriers worldwide and chronic HBV is considered a major public health problem. The objective of the present study was to assess the effectiveness of the nucleos(t)ide analogues tenofovir (TDF) and entecavir (ETV) in the treatment of chronic HBV. A cross-sectional study was carried out from March-December 2013, including all patients with chronic HBV, over 18 years of age, undergoing therapy through the public health system in southern Brazil. Only the data relating to the first treatments performed with TDF or ETV were considered. Retreatment, co-infection, transplanted or immunosuppressed patients were excluded. Six hundred and forty patients were evaluated, of which 336 (52.5%) received TDF and 165 (25.8%) ETV. The other 139 (21.7%) used various combinations of nucleos(t)ide analogues and were excluded. The negativation of viral load was observed in 87.3% and 78.8% and the negativation of hepatitis B e antigen was achieved in 79% and 72% of those treated with ETV or TDF, respectively. Negativation of hepatitis B surface antigen was not observed. There was no occurrence of adverse effects. This is a real-life study demonstrating that long-term treatment with ETV and TDF is both safe and effective.

Perception of HIV among pregnant women in the public health system in two municipalities of the state of São Paulo

Aim: To verify the knowledge of pregnant women on mother-to-child transmission (MTCT) of HIV, the availability of HIV tests in the public health system and counseling on the disease in two cities, Birigui and Piacatu, São Paulo State, Brazil. Methods: This is a descriptive and exploratory research using as samples, the files of 141 pregnant women attending the Basic Health Unit. Data were collected by survey, followed by a semi-structured questionnaire with open and closedend questions. Data were analyzed on Epi Info™ 7.1.4, by the Chi-square and Exact Fisher tests. Results: From all the 141 pregnant women, 119 were interviewed and 92.4% reported to have been informed about the need of taking the HIV test during prenatal exams. However, only 5.9% were counseled and 20.2% reported to be aware of how to prevent MTCT of HIV, usually mentioning lactation suppression and prescribed medication. The association between the knowledge about how to prevent MTCT of HIV and some social, demographic and economic variables like ethnics, educational level, home location, occupation, age and parenting was not verified. Conclusions: It is necessary to advise pregnant women on the importance of taking the HIV test regardless of the examination outcome, which was not observed in the cities where the research was conducted.

Optimization of bus allocation to depots by minimizing dead kilometers

In metropolitan cities, public transportation service plays a vital role in mobility of people, and it has to introduce new routes more frequently due to the fast development of the city in terms of population growth and city size. Whenever there is introduction of new route or increase in frequency of buses, the nonrevenue kilometers covered by the buses increases as depot and route starting/ending points are at different places. This non-revenue kilometers or dead kilometers depends on the distance between depot and route starting point/ending point. The dead kilometers not only results in revenue loss but also results in an increase in the operating cost because of the extra kilometers covered by buses. Reduction of dead kilometers is necessary for the economic growth of the public transportation system. Therefore, in this study, the attention is focused on minimizing dead kilometers by optimizing allocation of buses to depots depending upon the shortest distance between depot and route starting/ending points. We consider also depot capacity and time period of operation during allocation of buses to ensure parking safety and proper maintenance of buses. Mathematical model is developed considering the aforementioned parameters, which is a mixed integer program, and applied to Bangalore Metropolitan Transport Corporation (BMTC) routes operating presently in order to obtain optimal bus allocation to depots. Database for dead kilometers of depots in BMTC for all the schedules are generated using the Form-4 (trip sheet) of each schedule to analyze depot-wise and division-wise dead kilometers. This study also suggests alternative locations where depots can be located to reduce dead kilometers. Copyright (C) 2015 John Wiley & Sons, Ltd.

Impacto del Sistema Integrado de Transporte Público de Bogotá en la Productividad de la Empresa Transportes Bermúdez S.A.

En el Plan Maestro de Movilidad se definió y acordó la estructura que tendrá el Sistema Integrado de Transporte Público que empezó a operar en Bogotá a partir del 30 de Junio de 2012. Las implicaciones de este nuevo sistema afectan tanto a los bogotanos, como a las 66 empresas que estaban habilitadas como operadoras del transporte público colectivo y a los transportadores, entre muchos otros factores involucrados. Para la puesta en marcha del SITP, Bogotá se dividió en 13 zonas, las cuales van a estar cubiertas por 432 rutas y tan solo 13 empresas que quedarán como las operadoras del sistema. La implementación del SITP ha sido criticado fuerte y negativamente por parte de los bogotanos, las empresas operadoras, los transportadores y entidades gubernamentales. Esto, debido a varios factores, como las condiciones de la malla vial, el proceso de chatarrización al que entrarán más de 6000 vehículos en el primer año, las exigencias medioambientales con las que deben cumplir los vehículos antiguos que quedarán circulando, los problemas con el nuevo sistema de recaudo, pero sobre todo por la falta de información que se ha dado a la sociedad sobre este cambio, que aunque paulatino, afectará de manera crucial la vida de los Bogotanos.

Modelo de recolección de residuos sólidos botellas plásticas y latas utilizando como aliado el sistema de transporte masivo en Bogotá

En las grandes ciudades, la disposición de residuos se ha convertido en un problema ambiental de magnitud mundial con impacto negativo por el manejo inadecuado de los residuos sólidos diarios. El propósito es utilizar el sistema de transporte publico de Bogotá (Transmilenio) como punto de recolección de botellas plásticas y latas, para crear un proyecto de responsabilidad ambiental el cual tendrá resultados positivos a nivel cultural, social, y a largo plazo, financieramente. A través del estudio de diferentes propuestas tanto locales como internacionales, fueron identificados los principales factores de éxito de estos proyectos los cuales se incluyeron para adecuar la presente propuesta para la ciudad de Bogotá teniendo en cuenta sus actuales condiciones. Después de identificar las características requeridas para Bogotá, se realizó un estudio demográfico para poder saber cuántos ciudadanos estarían dispuestos a participar. Como resultado, muchos pasajeros de Transmilenio esperan una retribución económica en el costo del pasaje del sistema. La prueba piloto se diseñó de acuerdo con la cantidad de envases recolectados, incluyendo el tipo de vehículos, como también la cantidad de personas y maquinas necesarias para el éxito del proyecto. Con la propuesta del proyecto completa, se realiza una evaluación financiera y económica para identificar los costos y gastos. La conclusión final de esta propuesta es que el modelo propuesto puede ser aplicado en Bogotá dadas sus características. Los beneficios sociales y ambientales también se destacan, como también el cambio cultural por parte de los ciudadanos hacia las prácticas ecológicas.

A importância da fiscalização do serviço público como instrumento de gestão e política pública: uma breve análise do Sistema de Transporte Coletivo Urbano de Passageiros da Cidade de São Paulo

O trabalho tem por objetivo analisar a importância da fiscalização do serviço público como instrumento de gestão e política pública. Para tanto, propõe-se estudar o Sistema de Transporte Coletivo Urbano da Cidade de São Paulo, a partir do modelo instituído através da Lei nº 13.241/01, assim como toda a estrutura jurídica e elementos característicos presentes nessa forma de delegação. Sem a preocupação de esgotar o tema, com base na doutrina, o trabalho pretende abordar os principais conceitos que envolvem a prestação de serviços públicos, o dever legal de fiscalização e a estrutura legal da prestação dos serviços de transporte coletivo. E, a partir disso, verificar se o sistema de transporte municipal possui instrumentos jurídicos adequados á fiscalização dos serviços delegados. Além disso, busca-se avaliar se isso é suficiente para a prestação de um “serviço adequado”, ou seja, se os instrumentos de fiscalização utilizados, por si só, são efetivamente capazes de garantir as condições de regularidade, continuidade, eficiência, segurança, atualidade, generalidade, cortesia na prestação e modicidade das tarifas, conforme preceitua a lei. Em síntese, entende-se que o ordenamento jurídico dispõe de diversos mecanismos que permitem a fiscalização dos serviços públicos. Ademais, que encontra-se juridicamente adequado o modelo de fiscalização adotado pelo Município de São Paulo, para o sistema de transporte público. Todavia, apesar de ser correto, o modelo ainda necessita de melhorias, tanto no que diz respeito às obrigações estabelecidas nos contratos de concessão e permissão em vigor (e respectivos regulamentos, como é o caso do RESAM – Regulamento de Sanções e Multas), quanto na sua operação e, principalmente, na sua fiscalização. Por fim, o trabalho aponta que, tanto a regulação, quanto a fiscalização ou até mesmo a gestão, quando realizadas de forma inadequada, fomentam a prestação de um serviço público com má qualidade, ou seja, inferior à esperada pela população.

Adensamento e habitação: a implantação do programa Minha Casa Minha Vida na cidade de Bauru (SP) sob a ótica da sustentabilidade

Pós-graduação em Engenharia de Produção - FEB

O transporte coletivo urbano em São José do Rio Preto - SP e sua relação com as transformações do espaço urbano

The process of urbanization that happened in Brazil during the twentieth century led to processes of structuring and re-organization of space, besides the emergence of many urban problems. Industrialization and urbanization are some of the main causes that could be cited as consequences of this process. As a result of the steep rise of cities, the transport systems became fundamental in boosting flows (immaterial) and the mobility of people and stuff (materials) in the territory. The urban model created for the city of São Paulo in the 1930s was repeated over the years in the medium-sized cities, being repeated the same problems that occurred in the metropolis. In this context our work fits in analyzing the changes occurring in the urban area of São José do Rio Preto - SP, from his relationship with the public transportation system in the face of intra-urban spatial configuration of the city. Transport, while it is recognized by authors as being really important for the analysis and intra-urban spatial configuration, has been little analyzed as the object of study by a geographer, and so, our work has more value

Modelos de rede de transporte público e individual para estudos de acessibilidade em São Paulo.

O presente estudo tem como objetivo comparar a eficiência dos sistemas de transporte público e individual através da modelagem de redes em SIG. Foram revisados os conceitos de acessibilidade e indicadores de acessibilidade, modelos de rede de transportes, abordadas as etapas para criação dos modelos de rede, bases de dados utilizadas, configurações e atributos no sistema SIG. Os comparativos foram realizados através de dois níveis de detalhamento (simples e avançado) para as redes de transporte e elaborados índices de acessibilidade para os bairros do município de São Paulo através de parâmetros extraídos das redes modeladas. O estudo de caso consiste na medição de um índice de acessibilidade para empregos de baixa renda. Como resultado, os bairros centrais do município apresentam maior acessibilidade, porém, para o transporte público, alguns bairros fora da zona central também apresentaram alta acessibilidade devido à oferta de transporte público (metrô).

Spatial-temporal mining of archived automatic vehicle location (AVL) data for transit service planning applications

An Automatic Vehicle Location (AVL) system is a computer-based vehicle tracking system that is capable of determining a vehicle's location in real time. As a major technology of the Advanced Public Transportation System (APTS), AVL systems have been widely deployed by transit agencies for purposes such as real-time operation monitoring, computer-aided dispatching, and arrival time prediction. AVL systems make a large amount of transit performance data available that are valuable for transit performance management and planning purposes. However, the difficulties of extracting useful information from the huge spatial-temporal database have hindered off-line applications of the AVL data. ^ In this study, a data mining process, including data integration, cluster analysis, and multiple regression, is proposed. The AVL-generated data are first integrated into a Geographic Information System (GIS) platform. The model-based cluster method is employed to investigate the spatial and temporal patterns of transit travel speeds, which may be easily translated into travel time. The transit speed variations along the route segments are identified. Transit service periods such as morning peak, mid-day, afternoon peak, and evening periods are determined based on analyses of transit travel speed variations for different times of day. The seasonal patterns of transit performance are investigated by using the analysis of variance (ANOVA). Travel speed models based on the clustered time-of-day intervals are developed using important factors identified as having significant effects on speed for different time-of-day periods. ^ It has been found that transit performance varied from different seasons and different time-of-day periods. The geographic location of a transit route segment also plays a role in the variation of the transit performance. The results of this research indicate that advanced data mining techniques have good potential in providing automated techniques of assisting transit agencies in service planning, scheduling, and operations control. ^

Management of Public Road Transport System in Trivandrum City

An efficient passenger road transport system is a boon to any city and an inefficient one its bane. Passenger bus transport operation involves various aspects like passenger convenience, profitability of operation and social, technological and environmental factors. The author’s interest in this area was aroused when he conducted a traffic survey of Trivandrum City in 1979. While some studies on the performance of the Kerala State Road Transport Corporation in specific areas like finance, inventory control etc. have already been made, no study has been made from the operational point of view. The study is also the first one of its kind in dealing with the transportation problems for a second order city like Trivandrum. The objective of this research study is to develop a scientific basis for analysing and understanding the various operational aspects of urban bus transport management like assessing travel demand, depot location, fleet allocation, vehicle scheduling, maintenance etc. The operation of public road transportation in Trivandrum City is analysed on the basis of this theoretical background. The studies made have relevance to any medium sized city in India or even abroad. If not properly managed, deterioration of any public utility system is a natural process and it adversely affects the consumers, the economy and the nation. Making any system more efficient requires careful analysis, judicious decision making and proper implementation. It is hoped that this study will throw some light into the various operational aspects of urban passenger road transport management which can be of some help to make it perform more efficiently

Enhancing the experience of public transport users with urban screens and mobile applications

Public transportation is an environment with great potential for applying location-based services through mobile devices. This paper provides the underpinning rationale for research that will be looking at how the real-time passenger information system deployed by the Translink Transit Authority across all of South East Queensland in Australia can provide a core platform to improve commuters’ user experiences. This system relies on mobile computing and GPS technology to provide accurate information on transport vehicle locations. The proposal builds on this platform to inform the design and development of innovative social media, mobile computing and geospatial information applications. The core aim is to digitally augment the public transport environment to enhance the user experience of commuters for a more enjoyable journey.

Opportunities of public transport experience enhancements with mobile services and urban screens

Public transportation is an environment with great potential for applying innovative ubiquitous computing services to enhance user experiences. This paper provides the underpinning rationale for research that will be looking at how real-time passenger information system deployed by transit authorities can provide a core platform to improve commuters’ user experiences during all stages of their journey. The proposal builds on this platform to inform the design and development of innovative social media, mobile computing and geospatial information applications, with the hope to create fun and meaningful experiences for passengers during their everyday travel. Furthermore, we present the findings of our pilot study that aims to offer a better understanding of passengers’ activities and social interactions during their daily commute.

Planning for transit system reliability using productive performance and risk assessment

Urban transit system performance may be quantified and assessed using transit capacity and productive capacity for planning, design and operational management. Bunker (4) defines important productive performance measures of an individual transit service and transit line. Transit work (p-km) captures transit task performed over distance. Transit productiveness (p-km/h) captures transit work performed over time. This paper applies productive performance with risk assessment to quantify transit system reliability. Theory is developed to monetize transit segment reliability risk on the basis of demonstration Annual Reliability Event rates by transit facility type, segment productiveness, and unit-event severity. A comparative example of peak hour performance of a transit sub-system containing bus-on-street, busway, and rail components in Brisbane, Australia demonstrates through practical application the importance of valuing reliability. Comparison reveals the highest risk segments to be long, highly productive on street bus segments followed by busway (BRT) segments and then rail segments. A transit reliability risk reduction treatment example demonstrates that benefits can be significant and should be incorporated into project evaluation in addition to those of regular travel time savings, reduced emissions and safety improvements. Reliability can be used to identify high risk components of the transit system and draw comparisons between modes both in planning and operations settings, and value improvement scenarios in a project evaluation setting. The methodology can also be applied to inform daily transit system operational management.

Planning for transit system reliability using productive performance and risk assessment

Urban transit system performance may be quantified and assessed using transit capacity and productive capacity for planning, design and operational management. Bunker (4) defines important productive performance measures of an individual transit service and transit line. Transit work (p-km) captures transit task performed over distance. Transit productiveness (p-km/h) captures transit work performed over time. This paper applies productive performance with risk assessment to quantify transit system reliability. Theory is developed to monetize transit segment reliability risk on the basis of demonstration Annual Reliability Event rates by transit facility type, segment productiveness, and unit-event severity. A comparative example of peak hour performance of a transit sub-system containing bus-on-street, busway, and rail components in Brisbane, Australia demonstrates through practical application the importance of valuing reliability. Comparison reveals the highest risk segments to be long, highly productive on street bus segments followed by busway (BRT) segments and then rail segments. A transit reliability risk reduction treatment example demonstrates that benefits can be significant and should be incorporated into project evaluation in addition to those of regular travel time savings, reduced emissions and safety improvements. Reliability can be used to identify high risk components of the transit system and draw comparisons between modes both in planning and operations settings, and value improvement scenarios in a project evaluation setting. The methodology can also be applied to inform daily transit system operational management.