Comparison of pre-treatments mediated by endoglucanase and TEMPO oxidation for eco-friendly low-cost energy production of cellulose nanofibrils.

Specific kinds of enzymes have been used as an eco-friendly pre-treatment for mechanical extraction of cellulose nanofibrils (CNFs) from vegetal pulps. Another well-established pre-treatment is the 2,2,6,6-tetramethylpiperidine 1-oxyl (TEMPO)-mediated oxidation, which has gained considerable attention. Pre-treatments assist in fiber swelling, facilitating mechanical fibrillation, and reducing energy consumption; however, some of these methods are extremely expensive. This work aimed to evaluate the influence of enzymatic pre-treatment with endoglucanase on the energy consumption during mechanical fibrillation of cellulose pulps. Bleached pulps from Eucalyptus sp. and Pinus sp. were pre-treated with endoglucanase enzyme compared to TEMPO-meditated oxidation. Average diameters of CNFs pre-treated with enzymes were close to that found for TEMPO-oxidized nanofibrils (TOCNFs). Results showed that enzymatic pre-treatment did not significantly modify the pulp chemical and morphological characteristics with efficient stabilization of the CNFs suspension at higher supernatant turbidity. Energy consumption of pulps treated with endoglucanase enzymes was lower than that shown by pulps treated with TEMPO, reaching up to 58% of energy savings. The enzyme studied in the pulp treatment showed high efficiency in reducing energy consumption during mechanical fibrillation and production of films with high mechanical quality, being an eco-friendly option for pulp treatment.

Risk clusters of Schistosoma mansoni infection in an endemic state of Brazil: space-time modelling and association with socio-economic and environmental factors.

BACKGROUND: We analysed the spatial distribution and the socio-economic and environmental factors (SEFs) associated with Schistosoma mansoni infection in the state of Alagoas, an important tourist area in northeastern Brazil. METHODS: We conducted an ecological time-series study (2007-2016) on schistosomiasis cases and SEFs. We evaluated the temporal trends of schistosomiasis cases (annual percentage change [APC]) and their correlation with SEFs. Spatial analysis maps were built using QGIS and TerraView software. RESULTS: We observed that 4.9% of the municipalities had a high prevalence of S. mansoni infection and were located mainly in the coastal strip of Alagoas state. The positivity rate for schistosomiasis decreased during the period (8.1% in 2007 to 4.9% in 2016; APC=-5.71). There was a reduction in the number of tests performed (APC=-5.05). There was a negative correlation between S. mansoni infection and the municipal human development index (ρ=-0.34) and schooling rate (ρ=-0.24). The main species of snail was Biomphalaria glabrata (94.79%), but Biomphalaria straminea showed a higher percentage of S. mansoni detection (10.11%). Lastly, Biomphalaria tenagophila specimens were identified for the first time in Alagoas (n=28). CONCLUSIONS: Despite a reduction in the number of cases, intestinal schistosomiasis still represents a serious public health concern in Alagoas. It urgently requires planning and improvements in diagnosis, prevention programs and the state's socio-economic indicators.

Space-time risk cluster of visceral leishmaniasis in Brazilian endemic region with high social vulnerability: An ecological time series study.

BACKGROUND: Despite visceral leishmaniasis (VL) being epidemic in most Brazilian regions, the Northeast region is responsible for the highest morbidity and mortality outcomes within the country. OBJECTIVE: To analyse the spatiotemporal dynamics of VL cases to identify the temporal trends and high-risk areas for VL transmission, as well as the association of the disease with social vulnerability in Brazilian Northeast. METHODS: We carried out an ecological time series study employing spatial analysis techniques using all VL confirmed cases of 1,794 municipalities of Brazilian Northeast between the years 2000 to 2017. The Social Vulnerability Index (SVI) was used to represent the social vulnerability. Incidence rates were standardized and smoothed by the Local Empirical Bayesian Method. Time trends were examined through segmented linear regression. Spatiotemporal analysis consisted of uni- and bivariate Global and Local Moran indexes and space-time scan statistics. RESULTS: Incidence rate remained stable and ranged from 4.84 to 3.52 cases/100,000 inhabitants. There was higher case prevalence between males (62.71%), children and adolescents (63.27%), non-white (69.75%) and urban residents (62.58%). Increasing trends of new cases were observed among adult male subjects (≥ 40 years old) and urban residents. Importantly, VL incidence showed a direct spatial dependence. Spatial and space-time clusters were identified in sertão and meio-norte sub-regions, overlapping with high social vulnerability areas. CONCLUSIONS: VL is a persistent health issue in Brazilian Northeast and associated with social vulnerability. Space-time clustering of VL cases in socially vulnerable municipalities demands intersectoral public policies of surveillance and control, with focus on reducing inequalities and improving living conditions for regional inhabitants.

Determining the association between dengue and social inequality factors in north-eastern Brazil: A spatial modelling.

Dengue is a global public health problem. The Dengue Virus (DENV) serotypes are transmitted by an Aedes aegypti mosquito. Vector control is among the primary methods to prevent the disease, especially in tropical countries. This study aimed to analyze the spatial distribution of dengue and its relationship with social inequalities using spatial modelling. An ecological study with temporal and spatial analysis was conducted in the state of Sergipe, Northeast Brazil, over a period of 18 years. Spatial modelling was used to determine the influence of space on dengue incidence and social inequalities. The epidemic rates in 2008, 2012, and 2015 were identified. Spatial modelling explained 40% of the influence of social inequalities on dengue incidence in the state. The main social inequalities related to the occurrence of dengue were the percentage of people living in extreme poverty and inadequate sanitation. The epidemic situation even increased the risk of dengue in the population of the state of Sergipe. These results demonstrate the potential of spatial modelling in determining the factors associated with dengue epidemics and are useful in planning the intersectoral public health policies.

Análise da acessibilidade masculina aos serviços de Atenção Primária à Saúde (APS) em um município do Nordeste da Bahia, Brasil / Learning assessment strategies applied to undergraduate nursing education in Brazil

Resumen:

Introducción: el objetivo del estudio fue evaluar los factores socioculturales que impiden a los hombres el acceso a los servicios de Atención Primaria de Salud (APS) en un municipio en el noreste de Bahía, Brasil. Método: se trata de un estudio exploratorio y descriptivo, con enfoque cuantitativo. La muestra, con método de muestreo aleatorio simple, fue de 102 usuarios del sexo masculino de 20 a 59 años, adscritos a la Estrategia de Salud de la Familia (ESF). El instrumento de recolección de datos fue una entrevista semiestructurada. Todos los análisis estadísticos se realizaron con el programa BioEstat (Versión 5.0). Resultados: la mayoría de los encuestados no conocen al equipo multidisciplinario de la Estrategia de Salud de la Familia (ESF) al cual pertenece. La demanda de asistencia sanitaria primaria se limita a las condiciones de enfermedad. El 97,06% de los hombres no conocen la atención o no la solicitan, alegando como principales impedimentos motivos como horario de atención (55,88%), temor a descubrir alguna enfermedad (9,81%) y los prejuicios (2,94%). Conclusión: es necesaria la divulgación y el desarrollo de actividades de promoción de la salud humana con el fin de reducir las bajas tasas de acceso masculino a las Unidades de Salud de la Familia (USF).

Abstract:

Introduction: The study was aimed at assessing sociocultural factors preventing men from accessing Primary Care (PC) services in Bahía, a North-Eastern Brazilian town.

Methods: An exploratory, descriptive study was carried out using a quantitative approach. A simple random sampling method was used to recruit 102 men aged 20 to 59 years assigned to the Family Health Strategy (FHS). Data collection was based on semi-structured interviews. All statistical analyses were performed with the statistical package BioEstat (release 5.0). Results: Most respondents did not know the multidisciplinary team they were assigned to within the Family Health Strategy (FHS). Primary care demands were limited to disease conditions. Most men (97.06%) do not know or do not request available healthcare, the most commonly alleged reasons being inappropriate opening times (55.88%), fear of a disease being found (9.81%), and prejudices (2.94%). Conclusion: Human health promotion activities should be developed and details on them should be disseminated in order to improve the current poor rates of access to Family Health Units (FHU) by men.

Introdução: o estudo objetiva conhecer os fatores socioculturais que inviabilizam a acessibilidade dos homens aos serviços de Atenção Primária à Saúde (APS) em um município do nordeste da Bahia, Brasil. Método: trata-se de um estudo exploratório e descritivo com abordagem quantitativa. A amostra, aleatória simples randomizada, correspondeu a 102 usuários do sexo masculino na faixa etária de 20 a 59 anos, adscritos na Estratégia Saúde da Família (ESF). O instrumento de coleta de dados foi a entrevista semiestruturada. Todas as análises estatísticas foram realizadas no programa BioEstat (Versão 5.0). Resultado: grande parte dos entrevistados não conhece a equipe multidisciplinar da Estratégia de Saúde da Família (ESF) a qual pertence; a procura pela atenção primária a saúde está restrita a condições de doença; 97,06% dos homens não conhecem ou não procuram a ESF alegando horário de atendimento (55,88%), medo de descobrir alguma doença (9,81%) e preconceito (2,94%) como principais fatores impeditivos. Conclusão: faz-se necessário a divulgação e o desenvolvimento de atividades voltadas para a promoção da saúde do homem a fim de reduzir os baixos índices de acesso masculino às Unidades de Saúde da Família (USF).