Carbon-based materials for water disinfection and heavy metals removal.

The presence of heavy metals and/or harmful bacteria in drinking water represents significant risks to human health. This study aimed to develop a low-cost water treatment technology using synthesized nanocomposites with metal nanoparticles supported on activated carbon (AC) for bacteria and heavy metal removal. In addition, the performance of the developed nanomaterials was compared with that of commercial materials - carbon fibers of three different typologies. The chemical and textural properties of all tested materials were characterized. To simulate a technology to be applied in a water outlet point, removal tests were carried out in a continuous system using suspensions of Escherichia coli and/or Staphylococcus aureus, wherein the contact time with the two phases was minimal (1 min). The obtained results revealed that iron and copper oxides supported on AC with a calcination treatment (CuFeO/AC-C) was the nanocomposite with the best performance, achieving a 6 log reduction for both bacteria in the same suspension up to 9 h operation. A mix of bacteria and heavy metals, simulating a real water, was treated with CuFeO/AC-C obtaining a 6 log reduction of bacteria, a Pb2+ removal >99.9% and Cd2+ removal between 97 and 98% over 180 passage times.

Comparison of Sample Preparation Techniques for the (-)ESI-FT-ICR-MS Analysis of Humic and Fulvic Acids.

Soil organic matter (SOM) plays a key role in the global carbon and nitrogen cycles. Soil biogeochemistry is regularly studied by extracting the base-soluble fractions of SOM: acid-insoluble humic acid (HA) and acid-soluble fulvic acid (FA). Electrospray ionization-Fourier transform-ion cyclotron resonance-mass spectrometry (ESI-FT-ICR-MS) is commonly utilized for molecularly characterizing these fractions. Different sample preparation techniques exist for the analysis of HA and FA though questions remain regarding data comparability following different preparations. Comparisons of different sample preparation techniques here revealed that the negative-mode ESI-FT-ICR-MS analytical window can be skewed to detect different groups of molecules, with primary differences in oxygenation, aromaticity, and molecular weight. It was also observed that HA and FA from soils versus an aquatic matrix behaved very differently. Thus, we conclude that sample preparation techniques determined to be "most optimal" in our study are in no way universal. We recommend that future studies of HA and FA involve similar comparative studies for determining the most suitable sample preparation technique for their particular type of HA or FA matrices. This will enhance data comparability among different studies and environmental systems and ultimately allow us to better understand the complex composition of environmental matrices.

Hexokinase 2: The preferential target of trehalose-6-phosphate over hexokinase 1.

Cancer-related metabolic features are in part maintained by hexokinase 2 upregulation, which leads to high levels of glucose-6-phosphate (G6P) and is needed to provide energy and biomass to support rapid proliferation. Using a humanized model of the yeast Saccharomyces cerevisiae, we explored how human hexokinase 2 (HK2) behaves under different nutritional conditions. At high glucose levels, yeast presents aerobic glycolysis through a regulatory mechanism known as catabolic repression, which exerts a metabolic adaptation like the Warburg effect. At high glucose concentrations, HK2 did not translocate into the nucleus and was not able to shift the metabolism toward a highly glycolytic state, in contrast to the effect of yeast hexokinase 2 (Hxk2), which is a crucial protein for the control of aerobic glycolysis in S. cerevisiae. During the stationary phase, when glucose is exhausted, Hxk2 is shuttled out of the nucleus, ceasing catabolic repression. Cells harvested at this condition display low glucose consumption rates. However, glucose-starved cells expressing HK2 had an increased capacity to consume glucose. In those cells, HK2 localized to mitochondria, becoming insensitive to G6P inhibition. We also found that the sugar trehalose-6-phosphate (T6P) is a human HK2 inhibitor, like yeast Hxk2, but was not able to inhibit human HK1, the isoform that is ubiquitously expressed in almost all mammalian tissues. In contrast to G6P, T6P inhibited HK2 even when HK2 was associated with mitochondria. The binding of HK2 to mitochondria is crucial for cancer survival and proliferation. T6P was able to reduce the cell viability of tumor cells, although its toxicity was not impressive. This was expected as cell absorption of phosphorylated sugars is low, which might be counteracted using nanotechnology. Altogether, these data suggest that T6P may offer a new paradigm for cancer treatment based on specific inhibition of HK2.

Structural characterization using 2D NMR spectroscopy and TMAH-GC × GC-MS: Application to humic acids from soils of an integrated agricultural system and an Atlantic native forest.

Understanding the chemical make-up of soils and their structure is critical for constraining the role of soil organic matter (SOM) into the global biogeochemical cycles, as well as to understand the capability of SOM to sequester carbon and mitigate greenhouse gas emissions. Here, we use two-dimensional 1H-13C heteronuclear single quantum coherence nuclear magnetic resonance (2D 1H-13C HSQC NMR) spectroscopy to structurally characterize the most refractory component of SOM, the humic acid (HA). The observations from 2D 1H-13C HSQC NMR were coupled with lignin phenol and fatty acid measurements using tetramethylammonium hydroxide (TMAH) thermochemolysis - two-dimensional gas chromatography - mass spectrometry (TMAH-GC × GC-MS). We studied humic acids extracted from an integrated Crop - Livestock - Forest System (CLFS) agricultural area and an undisturbed Atlantic Native Forest (NF) area. We evaluated soils from two different depths: the topsoil (0-20 cm) and subsoil (60-100 cm) layers, and reveal the presence of oxidized ligninaceous phenols as we had previously hypothesized. Collectively, our results indicate that there are significant oxidative processes with increasing soil depth which are more pronounced in the CLFS relative to the NF area. Degradation of stearic acid with increasing depth in the CLFS soils indicated that the CLFS is more microbiologically active than NF. Therefore, CLFS is less biochemically stable than we originally perceived. The enhanced bio-reactivity of CLFS is likely driving the enhanced carbon sequestration in the CLFS soils. This is perhaps due to the diversity of biomass remnants available at the CLFS soil rhizosphere which allows for more different types of biomass to be sequestered as oxidized ligninaceous phenols. Our results employing structural characterization with 2D 1H-13C HSQC NMR and TMAH-GC × GC-MS provide a new layer of knowledge about the practice of integrated agricultural systems and allow us to understand the structure and fate of sequestered carbon in soils from different soil environments.

Comparative morphology and key to Amydetinae genera, with description of three new firefly species (Coleoptera, Lampyridae).

Amydetinae is an exclusively Neotropical subfamily of fireflies, distributed among three genera: Amydetes Illiger, 1807, Magnoculus McDermott, 1964, and Memoan Silveira & Mermudes, 2013. Here, we describe three new species of Amydetinae: two belonging to Amydetes (A.alexi sp. nov. and A.marolae sp. nov.) and one to the previously monotypic Memoan (Me.conani sp. nov.). All three species are known only from the Atlantic Forest in southeastern Brazil. Endoskeletal structures of Memoan and Magnoculus species are described and compared with those of Amydetes for the first time. After studying the type material, Photinusfruhstorferi Pic, 1942 is transferred to Memoan, generating Memoanfruhstorferi comb. nov., and Me.ciceroi Silveira & Mermudes, 2013 syn. nov. is placed as a junior synonym. We also redescribe Magnoculusobscurus Olivier, 1885 and compare it to other species of genus and to other amydetine taxa to identify potential new diagnostic traits for the Amydetinae and its constituting genera. We provide an updated diagnosis for Memoan, illustrations for all four species, and a distribution map for the three new species, as well as a key to adult males of the three amydetine genera, and an updated key to Amydetes species based on males.

Reduced Reaction Mechanisms for Ethanol under Ultra-lean Conditions in Internal Combustion Engines.

Chemical kinetics models for ethanol under ultra-lean engine conditions were evaluated to couple with CFD multidimensional simulations of a spark-assisted homogeneous charge compression ignition (HCCI) rotary engine. Five reduced reaction sets proper for CFD simulations and two detailed reaction mechanisms for comparison were tested by simulating ignition delay times, laminar flame speeds, and a single-cycle HCCI engine with virtual piston dimensions. The simulated results of the new mechanism with 188 reactions were well-fitted to both experimental ignition delay times for ultra-lean ethanol/air conditions and laminar flame speeds at high pressures. This reaction set resulted in better-simulated ignition delay times at 30 and 40 bar for ultra-lean ethanol/air conditions than other chemical kinetics models. Maximum temperatures and pressures of 2500-2580 K and 280-289 bar, respectively, were observed for hydrous ethanol/air under ultra-lean conditions in HCCI engine. In addition, the simulation results of the HCCI ethanol engine presented high pressure rise rates of 8-26 bar/CAD at 3600 rpm. These results indicated that the engine test should be carried out at 2500 rpm with 2 bar of boost pressure for CFD model calibration with the new optimized reaction mechanism.

Long-term results of the treatment of primary hyperhidrosis with oxybutynin: follow-up of 1,658 cases.

BACKGROUND: Hyperhidrosis (HH) is characterized by exaggerated sweating in a specific region due to hyperfunction of the sweat glands. In the late 2000s, we started treating patients with an anticholinergic, oxybutynin, that was not being used until then. OBJECTIVES: To present, after 12 years of utilizing this medication in our service, the substantial experience obtained with the use of oxybutynin as an initial treatment of HH in a large series of 1,658 patients. METHODS: We analyzed 1,658 patients treated with oxybutynin for HH from May 2006 to June 2018. The patients were divided into four groups according to the main site of HH: the plantar group, the axillary group, the facial group, and the palmar group. To measure the degree of satisfaction, a quality of life (QoL) questionnaire was used. RESULTS: Pre-treatment QoL was poor or very poor in more than 94% of the cases, and the palmar group had the worst quality of life. After treatment, we observed an improvement in the quality of life in 77% of patients. More than 70% of the patients in all groups present moderate or optimal subjective clinical improvement in sweating after treatment. The group with the best result was the facial group. Intense dry mouth was reported in 24.9% of all patients in all groups. CONCLUSIONS: This study included a large number of patients followed for a long period and demonstrated the good effectiveness of treatment with oxybutynin for hyperhidrosis in the main sites of sweating.

Breakpoint delineation in 5p- patients leads to new insights about microcephaly and the typical high-pitched cry.

BACKGROUND: Cri du chat syndrome (CdCS) is a rare syndrome caused by a partial or complete deletion of the short arm of chromosome 5 (5p-). The main clinical features include a high-pitched cry, facial asymmetry, microcephaly, round face at birth, epicanthal folds, hypotonia, delayed growth and development. METHODS: We studied 14 Brazilian patients with CdCS using genomic array in order to better define the 5p breakpoints and recognize copy number variations (CNVs) that contribute to clinical manifestations associated with the syndrome. RESULTS: Array confirmed terminal deletions in 13 patients and an interstitial deletion in one patient. It was also possible to map the breakpoints and associate a genomic region of 4.7 Mb to the development of head circumference and cat-like cry. We also found other CNVs concomitant to the 5p deletion including a 9p duplication, a 17q deletion, and a 22q deletion in three different patients. CONCLUSION: With advancements of molecular cytogenomic methods in the last two decades, it was possible to evidence cryptic alterations and improve the genotype-phenotype correlation. In this work, we describe a new genomic region associated with microcephaly and cat-like cry and highlight the importance of precise delineation of 5p deletion breakpoints and detection of other CNVs in CdCS patients to improve genotype-phenotype correlation to perform a complete clinical and molecular diagnosis.

Uanauna gen. nov., a new genus of fireflies endemic to the Brazilian Atlantic forest (Coleoptera: Lampyridae), with key to brazilian genera of Lucidotina.

Here, we propose Uanauna gen. nov. (Lampyridae: Photinini), a new monotypic genus of fireflies endemic to the Brazilian Atlantic Forest. Uanauna angaporan sp. nov. occurs in Submontane and Montane forest habitats at the Serra do Mar mountain range, in the Southern Fluminense region (Rio de Janeiro State, Southeastern Brazil). The new species was recorded both on the mainland, at the municipality of Itaguaí and Rio de Janeiro, and at the continental island of Ilha Grande, in Angra dos Reis, at the Rio de Janeiro State. An occurrence map and illustrations of diagnostic features are given for the new taxa, as well as a key to Lucidotina genera in Brazil.

Mosaic Trisomy 12 Associated with Overgrowth Detected in Fibroblast Cell Lines.

Mosaic trisomy 12 is a rare anomaly, and only 9 cases of live births with this condition have been reported in the literature. The clinical phenotype is variable, including neuropsychomotor developmental delay, congenital heart disease, microcephaly, cutaneous spots, facial asymmetry, prominent ears, hypotonia, retinopathy, and sensorineural hearing loss. A 2-year-old female presented with neuropsychomotor developmental delay, prominent forehead, dolichocephaly, patchy skin pigmentation, and unexpected overgrowth at birth. Cytogenetic analysis of her peripheral blood showed normal results, suggesting the presence of a chromosomal alteration in other tissues. Further studies using G-banding and FISH performed on fibroblasts from both hyper- and hypopigmented regions identified a 47,XX,+12/46,XX karyotype. To the best of our knowledge, no patients with mosaic trisomy 12 associated with overgrowth have been reported to date. Congenital overgrowth and neonatal overgrowth have been frequently linked to Pallister-Killian syndrome (PKS; OMIM 601803). This case suggests the possibility of an association of genes present in the 12p region with fetal overgrowth, considering that chromosomal duplications could lead to an increase in the production of aberrant transcripts and disturbing gene dosage effects. This case highlights the importance of cytogenetic analysis in different tissues to provide relevant information to the specific genotype/phenotype correlation.

Tiger Beetles' (Coleoptera: Carabidae, Cicindelinae) pupal stage: current state of knowledge and future perspectives.

The tiger beetles (Carabidae: Cicindelinae) include about 2,822 species and 120 genera around the world. They are one of the most widely studied families of Coleoptera. However, the knowledge about their immature stages is incipient and usually restricted to the larval stages. Pupal characteristics have been among the most ignored aspects of tiger beetle biology. Here we compile and update the current knowledge of tiger beetle pupae.

Long-term results of the use of oxybutynin for the treatment of plantar hyperhidrosis.

BACKGROUND: Plantar hyperhidrosis is a common illness with significant impact on quality of life. Oxybutynin presents good short-term results, but longer follow-up results are lacking. We evaluated oxybutynin effectiveness in patients who were not surgically treated and who had at least six months of follow-up. METHODS: From September 2007 to September 2013, 85 consecutive patients were enrolled in our institutional protocol for the "pharmacological-first" treatment of primary plantar hyperhidrosis with oxybutynin. Eight patients were lost to follow-up, 15 patients have not yet been under treatment for six months, and data were available for 39 patients (all female) treated for at least six months. Data at the start of the protocol, six weeks after beginning treatment, and at their final visit were analyzed. RESULTS: Twenty-three of the 77 patients (29.87%) did not improve after pharmacological therapy. From the 39 patients with more than six months of follow-up (median 16.9 months, range 9-71), 79.5% reported moderate/great improvement in excessive plantar sweating after six weeks of treatment, and this rate increased to 84.7% in the last follow-up visit; 82.85% showed improvement in other sites presenting hyperhidrosis. Dry mouth was the most common side effect; 51.6% of patients reported it to be moderate/severe at the last visit. CONCLUSION: In patients with good initial response to oxybutynin, more than 82% presented moderate or great improvement in plantar and other sites' excessive sweating; dry mouth was the most common side effect but was tolerable and did not lead any patient to interrupt treatment.

Long-Term Efficacy of Oxybutynin for Palmar and Plantar Hyperhidrosis in Children Younger than 14 Years.

Oxybutynin for treating hyperhidrosis in children has been evaluated only in short-term studies. We aimed to investigate the long-term effects of oxybutynin in treating children with palmar and plantar hyperhidrosis who had not undergone surgery and who were monitored for at least 6 months (median 19.6 mos). A cohort of 97 patients was evaluated retrospectively, with particular attention to 59 children (ages 4-14 yrs) who were treated for longer than 6 months. Their quality of life (QOL) was evaluated using a validated clinical questionnaire before and after 6 weeks of pharmacologic therapy. A self-assessment of hyperhidrosis was performed after 6 weeks and after the last consultation. By their final office visit, more than 91% of the children with hyperhidrosis treated with oxybutynin experienced moderate or great improvement in their level of sweating and 94.9% experienced improvement in QOL. More than 90% of children reported improvement of hyperhidrosis at other sites. Dry mouth was the most common side effect. Oxybutynin appears to be an effective treatment option for children with hyperhidrosis, and positive results are maintained over the long term (median 19.6 mos).

Long-term results of oxybutynin treatment for palmar hyperhidrosis.

PURPOSE: Palmar hyperhidrosis (PH) is a common illness that significantly impacts Quality of Life (QOL). Oxybutynin offers excellent short-term results, but long-term follow-up results are limited. We evaluated its effectiveness in a large group of patients who did not have surgery and who had at least 6 months of follow-up. METHODS: Between September 2007 and September 2013, 570 consecutive patients were enrolled in our institutional protocol regarding the "pharmacological-first" treatment of primary PH with oxybutynin. Fifty-nine were lost to follow-up, and the data were available for 511 patients treated for at least 6 weeks. Data recorded at the start of the protocol, 6 weeks after beginning treatment, and during patients' final visits were analyzed. RESULTS: 112 patients (21.9 %) did not improve and were referred for surgery (sympathectomy). Eight (1.56 %) developed significant side effects (e.g., dry mouth) and discontinued therapy. Thirty (5.9 %) preferred surgery over pharmacological treatment. 111 have not yet received treatment for 6 months. The 246 patients with more than 6 months of follow-up (median 16 months, range 6-72) were analyzed, as follows: 90.2 % experienced moderate or great improvement in their PH; 90.34 % experienced improvement at other sites of hyperhidrosis following a median of 16 months. CONCLUSION: Among patients with good initial responses to oxybutynin, more than 90 % experienced moderate or great improvement in their palmar sweating, as well as in their hyperhidrosis in other sites, after 6 months. The results were particularly favorable in those patients with BMI <25 kg/m(2), and in those who noted an improved QOL after 6 weeks.

Prevalence, severity and etiology of dental wear in patients with eating disorders.

OBJECTIVE: The purpose of this study was to evaluate the prevalence, distribution and associated factors of dental wear among patients with eating disorders (EDs). MATERIALS AND METHODS: An epidemiological cross-sectional survey was conducted by trained, calibrated examiners, using the dental wear index. The sample was composed of 30 patients with EDs (experimental group - G1) and 30 control patients without current or previous history of EDs (G2). A questionnaire was used to assess the etiological factors of dental wear. The univariate analyses using the Chi-square (χ(2)) test were used to compare the tooth wear prevalence between groups according to the surface and tooth (P > 0.05). RESULTS: The dental wear was similar for both group; however, the G1 presented more moderate wear in molars when compared with G2 (P = 0.048). The majority of EDs patients related have one or more oral habits (n = 26; 86.6%) and only 13.4% (n = 4) affirmed did not have oral habits. The etiological factors of tooth wear related with dental wear were biting objects (P = 0.04) and pain in temporomandibular disorders (P = 0.03). CONCLUSION: The highest prevalence of dental wear was observed in the molars teeth. Differences in the extent and pattern of dental wear were found in an individual, emphasized the relevance of clinical parameter.

Incidência de infecção do sítio cirúrgico e fatores de risco associados na clínica cirúrgica de pequenos animais / Incidence of surgical site infection and their associated risk factors in the surgical small animal clinic

A infecção do sítio cirúrgico (ISC) apresenta-se como um complicador que possui muitos fatores de risco associados, e a maior parte das informações utilizadas nessa área pela medicina veterinária provém da medicina humana. Objetivou-se com este trabalho determinar a taxa de ISC no HVT-UFV, assim como correlacionar sua incidência com os seguintes fatores de risco: quantidade de pessoas presentes durante a cirurgia, classificação do potencial de contaminação da ferida cirúrgica e utilização de antimicrobiano profilático e ou terapêutico. Para isso, foram colhidas informações sobre a ocorrência de ISC, bem como os fatores de risco citados de 401 prontuários. Esses dados passaram por análise estatística, e foram obtidos os seguintes resultados: 21 pacientes diagnosticados com ISC, o que gerou uma taxa de infecção de 5,24 por cento e associação entre incidência de ISC e cirurgias com risco de contaminação maior que 5 por cento. Os demais fatores de risco avaliados não apresentaram associação, porém, em valores absolutos, foi detectada maior ocorrência de infecção nos procedimentos com maior quantidade de pessoas na sala de cirurgia. Portanto, foi possível observar a importância da obtenção fidedigna de dados e a necessidade do desenvolvimento de um sistema de vigilância epidemiológica voltado para a medicina veterinária...

The surgical site infection (SSI) is a complicating factor that has many risk factors, and most of the information used in this area for veterinary medicine comes from human medicine. The aim of this work was to determine the rate of SSI in the VTH-UFV, and to correlate the incidence of SSI with the following risk factors: surgical wound classification, use of antimicrobial prophylaxis, and therapy and the number of people in the operating room during surgery. For that, information about the occurrence of SSI and the risk factors referred to were collected from 401 medical records. These data underwent statistical analysis and obtained the following results: 21 patients diagnosed with SSI resulting in an infection rate of 5.24 percent and a significant association between the occurrence of SSI and the surgical procedures with contamination risk higher than 5 percent. Other risk factors evaluated showed no association. However, in absolute values, a higher incidence of infection was detected in procedures with a greater number of people in the operating room. Therefore, it was possible to observe the importance of obtaining reliable data and the requirement for developing a surveillance system specific for Veterinary Medicine...

Relation of T-wave alternans to mortality and nonsustained ventricular tachycardia in patients with non-ST-segment elevation acute coronary syndrome from the MERLIN-TIMI 36 trial of ranolazine versus placebo.

We explored the utility of T-wave alternans (TWA) in predicting mortality in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Maximum TWA was calculated using Modified Moving Average method from continuous electrocardiographic recordings in patients with left ventricular ejection fraction <40% and ventricular tachycardia (VT) ≥4 beats during index hospitalization or sudden cardiac death during the follow-up year and age- and sex-matched controls in the Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST Elevation Acute Coronary Syndrome-Thrombolysis In Myocardial Infarction (MERLIN-TIMI) 36 trial. All patients received standard therapy for NSTEACS plus ranolazine (n = 109) or placebo (n = 101). Median follow-up was 1 year. Baseline clinical characteristics did not differ between patients with elevated TWA (≥47 µV) compared with lower levels. Patients with TWA ≥47 µV at admission had increased risk of total mortality (adjusted odds ratio [ORadj] 2.35, p = 0.04) during follow-up and VT ≥4 beats (ORadj 2.70, p = 0.01) during hospitalization with a trend toward increased cardiovascular death risk (ORadj 2.18, p = 0.07) during follow-up. In patients receiving placebo, TWA ≥47 µV on day 6 was associated with increased risk of total mortality (OR 4.12, 95% confidence interval 1.25 to 13.64, p = 0.02) and cardiovascular death (OR 4.73, p = 0.01) during follow-up. No deaths occurred among patients with TWA ≥47 µV assigned to ranolazine. In conclusion, in patients with NSTEACS and left ventricular ejection fraction <40%, TWA ≥47 µV early after admission is associated with increased risk of mortality at 1 year and with nonsustained VT during hospitalization. TWA may be useful in risk estimation in patients with NSTEACS. The possibility that TWA may serve as a therapeutic target deserves further exploration.

Avaliação de um programa de capacitação em fonoaudiologia para agentes comunitários de saúde na Amazônia brasileira / Evaluation of a training program in Speech-Language and Hearing Sciencesfor community health agents in Brazilian Amazon / Evaluación de un programa de capacitación en fonoaudiología para agentes comunitarios de la salud en la Amazonia brasileña

Introdução: O agente comunitário de saúde (ACS) tem um papel fundamental no trabalho com a comunidade e na implementação do sistema de saúde brasileiro vigente devido ao seu contato direto com a população. Essa população sofre a transição demográfica e epidemiológica tendo um quadro crescente de número de pessoas idosas, e assim, as alterações inerentes ao envelhecimento. Objetivo: Avaliar um programa de capacitação para os ACS do município de Monte Negro, Estado de Rondônia, quanto aos seus conhecimentos sobre o processo de envelhecimento e suas patologias relacionadas à área da Fonoaudiologia. Métodos: Trata-se de um estudo transversal, cuja amostra foi composta por 29 ACS, sendo estes solicitados a preencher um questionário socioeconômico validado e outro sobre conhecimentos relacionados à Fonoaudiologia e ao processo de envelhecimento, em um momento pré, e outro pós realização do curso de capacitação. Resultados: Pode-se observar que a análise socioeconômica mostrou que 90% da amostra encontra-se na classe baixa superior, 79% reside na área rural e 45% possui ensino médio completo. Ao se comparar os dados das coletas realizada pré e pós-programa de capacitação, apenas uma área da Fonoaudiologia sofreu diminuição de acertos (Motricidade Orofacial), sendo que as demais apresentaram aumento na quantidade de acertos, havendo diferença estatisticamente significativa em duas áreas (Audiologia; Fala e Linguagem). Conclusão: O curso de capacitação atingiu seus objetivos ao fornecer subsídios para formar recursos humanos e transmitindo conhecimentos aos ACS para que possam atuar junto à comunidade, proporcionando melhoras em sua qualidade de vida.(AU)

Introduction: Community health agents (CHA) are professional health workers that develop an important work with Brazilian community and in the public health system implementation, due to their direct contact with the community. This population is experimenting epidemiological and demographic transitions drawing an increasing number of elderly people, thus the changes associated with aging process. Purpose: This study aimed to evaluate a training program for community health agents (CHA) from the city of Monte Negro, State of Rondônia, Brazil, regarding their knowledge on the aging process and its pathologies related to the Speech-language and Hearing Sciences. Methods: It was performed a cross-sectional study where the sample was constituted by 29 CHA, who were asked to fill a validated questionnaire about their socioeconomic status and another containing knowledge about SLP and the aging process pre and post training program. Results: The results presented the socioeconomic analysis showing that 90% of the sample was in the higher lower class and 45% have completed high school. Comparing data pre and post training program only one area presented a worsening score (Oral facial motor skills) and the others showed an improvement, while statistically significant difference occurred only in two areas (Audiology; Speech and Language). Conclusion: The training program met its objectives for the CHA by providing grants to train human resources and forwarding knowledge for those who need to work with the community by providing improvements on the quality of life.(AU)

Introducción: Los agentes comunitarios de salud (ACS) tienen un papel clave en el trabajo con la comunidad y en la implementación del sistema de salud brasileño debido a su contacto directo con la población. Esta población pasa por la transición demográfica y epidemiológica con creciente número de adultos mayores y así, de cambios asociados al envejecimiento. Objetivo: Evaluar un programa de capacitación para los ACS del condado de Monte Negro, Estado de Rondônia, cuanto sus conocimientos sobre de el proceso de envejecimiento y patologías relacionadas al área de Fonoaudiología. Métodos: Se trata de un estudio transversal cuya población fue compuesta por 29 ACS que fueran invitados a llenar un cuestionario socioeconómico validado y otro sobre conocimientos relacionados a la Fonoaudiología y al proceso de envejecimiento, antes y después de la realización del curso de capacitación. Resultados: El análisis socioeconómica mostró que el 90% de la población está en la case baja superior, el 79% vive en zonas rurales y el 45% ha terminado la escuela secundaria. Al comparar los datos de las tomadas antes y después del programa de capacitación, sólo un área fonoaudiología sufrió disminución en los puntos correctos (Motricidad oral), mientras el resto mostró aumento en el número de puntos correctos, habiendo una diferencia estadísticamente significativa en dos áreas (Audiología; Habla y Lenguaje). Conclusión: El curso de capacitación ha logrado sus objetivos al proveer subsidios para formar recursos humanos y transmitir conocimientos a los ACS, para que puedan actuar con la comunidad proporcionando mejoras en su calidad de vida.(AU)

Avaliação de um programa de capacitação em fonoaudiologia para agentes comunitários de saúde na Amazônia brasileira / Evaluation of a training program in Speech-Language and Hearing Sciencesfor community health agents in Brazilian Amazon / Evaluación de un programa de capacitación en fonoaudiología para agentes comunitarios de la salud en la Amazonia brasileña

Introdução: O agente comunitário de saúde (ACS) tem um papel fundamental no trabalho com a comunidade e na implementação do sistema de saúde brasileiro vigente devido ao seu contato direto com a população. Essa população sofre a transição demográfica e epidemiológica tendo um quadro crescente de número de pessoas idosas, e assim, as alterações inerentes ao envelhecimento. Objetivo: Avaliar um programa de capacitação para os ACS do município de Monte Negro, Estado de Rondônia, quanto aos seus conhecimentos sobre o processo de envelhecimento e suas patologias relacionadas à área da Fonoaudiologia. Métodos: Trata-se de um estudo transversal, cuja amostra foi composta por 29 ACS, sendo estes solicitados a preencher um questionário socioeconômico validado e outro sobre conhecimentos relacionados à Fonoaudiologia e ao processo de envelhecimento, em um momento pré, e outro pós realização do curso de capacitação. Resultados: Pode-se observar que a análise socioeconômica mostrou que 90% da amostra encontra-se na classe baixa superior, 79% reside na área rural e 45% possui ensino médio completo. Ao se comparar os dados das coletas realizada pré e pós-programa de capacitação, apenas uma área da Fonoaudiologia sofreu diminuição de acertos (Motricidade Orofacial), sendo que as demais apresentaram aumento na quantidade de acertos, havendo diferença estatisticamente significativa em duas áreas (Audiologia; Fala e Linguagem). Conclusão: O curso de capacitação atingiu seus objetivos ao fornecer subsídios para formar recursos humanos e transmitindo conhecimentos aos ACS para que possam atuar junto à comunidade, proporcionando melhoras em sua qualidade de vida...

Introduction: Community health agents (CHA) are professional health workers that develop an important work with Brazilian community and in the public health system implementation, due to their direct contact with the community. This population is experimenting epidemiological and demographic transitions drawing an increasing number of elderly people, thus the changes associated with aging process. Purpose: This study aimed to evaluate a training program for community health agents (CHA) from the city of Monte Negro, State of Rondônia, Brazil, regarding their knowledge on the aging process and its pathologies related to the Speech-language and Hearing Sciences. Methods: It was performed a cross-sectional study where the sample was constituted by 29 CHA, who were asked to fill a validated questionnaire about their socioeconomic status and another containing knowledge about SLP and the aging process pre and post training program. Results: The results presented the socioeconomic analysis showing that 90% of the sample was in the higher lower class and 45% have completed high school. Comparing data pre and post training program only one area presented a worsening score (Oral facial motor skills) and the others showed an improvement, while statistically significant difference occurred only in two areas (Audiology; Speech and Language). Conclusion: The training program met its objectives for the CHA by providing grants to train human resources and forwarding knowledge for those who need to work with the community by providing improvements on the quality of life...

Introducción: Los agentes comunitarios de salud (ACS) tienen un papel clave en el trabajo con la comunidad y en la implementación del sistema de salud brasileño debido a su contacto directo con la población. Esta población pasa por la transición demográfica y epidemiológica con creciente número de adultos mayores y así, de cambios asociados al envejecimiento. Objetivo: Evaluar un programa de capacitación para los ACS del condado de Monte Negro, Estado de Rondônia, cuanto sus conocimientos sobre de el proceso de envejecimiento y patologías relacionadas al área de Fonoaudiología. Métodos: Se trata de un estudio transversal cuya población fue compuesta por 29 ACS que fueran invitados a llenar un cuestionario socioeconómico validado y otro sobre conocimientos relacionados a la Fonoaudiología y al proceso de envejecimiento, antes y después de la realización del curso de capacitación. Resultados: El análisis socioeconómica mostró que el 90% de la población está en la case baja superior, el 79% vive en zonas rurales y el 45% ha terminado la escuela secundaria. Al comparar los datos de las tomadas antes y después del programa de capacitación, sólo un área fonoaudiología sufrió disminución en los puntos correctos (Motricidad oral), mientras el resto mostró aumento en el número de puntos correctos, habiendo una diferencia estadísticamente significativa en dos áreas (Audiología; Habla y Lenguaje). Conclusión: El curso de capacitación ha logrado sus objetivos al proveer subsidios para formar recursos humanos y transmitir conocimientos a los ACS, para que puedan actuar con la comunidad proporcionando mejoras en su calidad de vida...

Measles mortality in high and low burden districts of India: estimates from a nationally representative study of over 12,000 child deaths.

BACKGROUND: Direct estimates of measles mortality in India are unavailable. Our objective is, to use a nationally-representative study of mortality to estimate the number and distribution of, measles deaths in India with a focus on 264 high burden districts. METHODS: We used physician coded verbal autopsy data from the Million Death Study which surveyed, over 12,000 deaths in children aged 1 month to under 15 years from 1.1 million nationally, representative households in 2001-2003. RESULTS: We estimate there were 92,000 (99% CI 63,000-137,000) measles deaths in children 1-59, months of age in India in 2005, representing a mortality rate of 3.3 (99% CI 2.3-5.0) per 1000 live, births and about 6% of all 1-59 month deaths. In children under 15 years of age, there were 107,000, (99% CI 74,000-158,000) measles deaths. The measles mortality rate was nearly 70% greater in girls, than in boys, and 60% of the deaths were in three populous states Uttar Pradesh, Bihar, and Madhya, Pradesh. The 1-59 month measles mortality rate in high burden districts was 4.48 (99% CI 3.94-5.02) compared to 2.40 (99% CI 2.28-2.52) per 1000 live births in other districts. CONCLUSION: Measles killed over 100,000 children in India in 2005 and girls were at higher risk than boys. The majority of measles deaths occurred in a few states and high burden districts. The results of this study highlight the importance of focusing measles supplementary immunization activities in high burden districts.