Sífilis congênita no Município do Rio de Janeiro, 2016-2020: perfil epidemiológico e completude dos registros / Congenital syphilis in the city of Rio de Janeiro, 2016-2020: epidemiological profile and completeness of records

Introdução: A sífilis congênita mantém-se como problema de saúde no Brasil, especialmente na cidade do Rio de Janeiro, com números para esse agravo acima da média do país. Essa doença é um marcador para a avaliação da qualidade da assistência à saúde materno-infantil, por poder ser evitada a partir de medidas como diagnóstico precoce e tratamento da gestante. Objetivos: Este estudo transversal descreveu o perfil epidemiológico dos casos de sífilis congênita (SC) no município do Rio de Janeiro, nos anos de 2016 a 2020, no que se refere a dados sociodemográficos maternos, do pré-natal e da evolução do quadro, assim como as taxas de incidência totais e segundo esses fatores. Adicionalmente, foram calculadas as taxas de mortalidade fetal e infantil. Também se avaliou o grau de completude das variáveis da ficha de SC. Métodos: Foram incluídos todos os casos notificados de sífilis congênita na cidade durante o período estudado, a partir dos registros do Sistema de Informações de Agravos de Notificação (SINAN). Foram utilizados o Sistema de Informações sobre Nascidos Vivos (SINASC) e o Sistema de Informações sobre Mortalidade (SIM) como base de dados para os cálculos das taxas de incidência e de mortalidade. Resultados: Entre 2016 e 2020, a cidade do Rio de Janeiro apresentou elevadas taxas de sífilis congênita, chegando a uma incidência de 18,6/1000 nascidos vivos em 2020, com mais de 90% de casos de SC recente. A maioria ocorreu em mulheres em situação de vulnerabilidade social ­ pretas, adolescentes, com baixa escolaridade e sem acesso à assistência pré-natal. Destaca-se ainda o baixo grau de completude de algumas variáveis e a divergência encontrada entre os dados de mortalidade do SIM e do SINAN, ambos fatores que prejudicam o adequado conhecimento do agravo. Conclusão: Conclui-se que, apesar dos avanços, muito ainda precisa ser realizado para o controle da sífilis congênita no município do Rio de Janeiro (AU).

Introduction: Congenital syphilis remains an important national health issue, especially in Rio de Janeiro, which presents numbers above the country's rate for this offense. This disease is a marker for the assessment of the quality of care delivered to mothers and children since it can be avoided through early diagnosis and treatment during pregnancy. Objective: This cross-sectional study described the epidemiological profile of congenital syphilis cases in the city of Rio de Janeiro, in 2016-2020, according to maternal sociodemographic data, prenatal care, and cases' evolution. Furthermore, incidence rates for these factors and the fetal and infant mortality rates were calculated. The completeness of the records was also assessed. Methods: We included all notified cases of congenital syphilis in the city during 2016-2020 using SINAN records. SINASC and SIM were also used as databases for the incidence rates and the mortality rates calculation. Results: During this period, the city of Rio de Janeiro exhibited high rates of this disease, with 18,6 cases/1000 live births in 2020 and more than 90% cases of early congenital syphilis. The highest rates were related to social vulnerability ­ black and teenage women with low levels of education and no access to prenatal care. It is important to highlight the low level of completeness for some variables and the divergence found between the mortality data from SIM and SINAN, both factors that jeopardize adequate knowledge of the disease. Conclusion: Therefore, despite some advances, a lot must be done to achieve control of congenital syphilis in the city of Rio de Janeiro (AU).

Factors associated with caregiver burden of adults with epilepsy in a middle-income country.

PURPOSE: Despite the relevance of socio-economic background in burden of caregivers of persons with epilepsy (PWE), there is a dearth of knowledge about this topic in low-resource settings. Here we attempt to identify the extent of the burden in caregivers of adults with epilepsy in a middle-income country and the factors associated with it. METHODS: In this cross-sectional study, we evaluated the level of burden with the Zarit Caregiver Burden Inventory. A comprehensive questionnaire was developed to assess the demographics of patients and caregivers. Epilepsy-related factors were obtained by interview and file review. Depressive, anxiety symptoms, and sleep quality were evaluated by Beck Depression Inventory, State and Trait Anxiety Inventory, and Pittsburgh Sleep Quality Index. Stigma was evaluated by the Stigma Scale of Epilepsy. RESULTS: The caregiver's burden was mild to moderate in our sample. The factors most strongly associated with the higher caregiver burden were age-onset of epilepsy, PWE years of schooling, needs for assistance in daily life, disabilities, and caregiver's bad-quality of sleep and higher depressive and anxiety symptoms. CONCLUSION: Caregivers of PWE deserve special attention regarding mental health and other health aspects, such as sleep quality.

O tamanho do governo aumenta a corrupção? Uma análise para os municípios brasileiros / ¿El tamaño del gobierno aumenta la corrupción? Un análisis para los municipios brasileños / Does the size of the government increase corruption? An analysis for Brazilian municipalities

Resumo O artigo analisa os efeitos do tamanho do governo na corrupção dos municípios brasileiros entre 2005 e 2016. Para tal, é utilizada uma medida de corrupção objetiva, construída com base em dados disponibilizados pela Controladoria-Geral da União (CGU) e na técnica de dados em painel. Os resultados revelaram uma relação significativa e inversa entre tamanho do governo e corrupção nos municípios brasileiros. Assim, a corrupção pode não estar relacionada ao tamanho do governo. A boa governança, em conjunto com a efetividade das normas legais, é uma forma de inibir atividades ligadas à corrupção nos municípios brasileiros.

Resumen El artículo analiza los efectos del tamaño del gobierno sobre la corrupción en los municipios brasileños entre 2005 y 2016. Para ello, se utiliza una medida objetiva de corrupción, construida a partir de los datos facilitados por la Contraloría General de la Unión (CGU) y sobre técnica de datos en panel. Los resultados revelaron una relación significativa e inversa entre el tamaño del gobierno y la corrupción en los municipios brasileños. Por tanto, la corrupción puede no estar relacionada con el tamaño del gobierno. La buena gobernanza, junto con la efectividad de las normas legales, es una forma de inhibir las actividades vinculadas a la corrupción en los municipios brasileños.

Abstract The article analyzes the effects of government size on corruption in Brazilian municipalities between 2005 and 2016. An objective corruption measure is used, constructed from data provided by the Federal Comptroller General (CGU), using the panel data technique. The results revealed a significant and inverse relationship between government size and corruption in Brazilian municipalities. Therefore, corruption in Brazilian municipalities may not be related to the government's size. In this sense, the issue of good governance in conjunction with the effectiveness of legal rules is highlighted as a way of inhibiting activities related to corruption in Brazilian municipalities.

Assessment of English language performance scores and academic performance in an English-based curriculum for pharmacy students with English as a second language.

BACKGROUND: The primary objective was to determine if there is a relationship between English language performance and graduating grade point average (GPA) in pharmacy students with English as a second language (ESL). METHODS: Students graduating from a four-year pharmacy program in 2016-2018 were invited to participate in the study. We compared pharmacy students' pre-admission ESL scores to their cumulative GPA at graduation in each of the three graduating cohorts and also determined if these results held true for both genders. Correlation of GPA to individual mathematics, chemistry, and Chinese language scores were used as points of reference to compare the degree of correlation. RESULTS: There were 148 students screened for the study with 31 students not meeting the inclusion criteria and four students declining to participate. Statistical analyses show an overall weak correlation. There was a statistically significant stronger correlation between pre-admission ESL scores and cumulative graduating GPA (r = 0.273) as compared to the correlation of GPA with mathematics (r = 0.187), chemistry (r = 0.181), or Chinese language scores (r = 0.059). The results did not change when the study population was separated by gender as English score still had the strongest correlation as compared to the other subjects. CONCLUSION: This study provides evidence that English language scores correlate more strongly with academic performance than mathematics, chemistry, or Chinese language scores in ESL pharmacy students. Also, this English language correlation is stronger for females than males.

Environmental Assessment and Evaluation of Oxidative Stress and Genotoxicity Biomarkers Related to Chronic Occupational Exposure to Benzene.

Environmental and occupational exposure to benzene from fuels is a major cause for concern for national and international authorities, as benzene is a known carcinogen in humans and there is no safe limit for exposure to carcinogens. The objective of this study was to evaluate the genotoxic effects of chronic occupational exposure to benzene among two groups of workers: filling station workers (Group I) and security guards working at vehicles entrances (Group II), both on the same busy highway in Rio de Janeiro, Brazil. Sociodemographic data on the workers were evaluated; the concentration of benzene/toluene (B/T) in atmospheric air and individual trans,trans-muconic acid (ttMA) and S-phenylmercapturic acid (S-PMA) were measured; oxidative stress was analyzed by catalase (CAT), glutathione S-transferase (GST), superoxide dismutase (SOD), thiol groups (THIOL) and malondialdehyde (MDA); genotoxicity was measured by metaphases with chromosomal abnormalities (MCA) and nuclear abnormalities, comet assay using the enzyme formamidopyrimidine DNA glycosylase (C-FPG), and methylation of repetitive element LINE-1, CDKN2B and KLF6 genes. Eighty-six workers participated: 51 from Group I and 35 from Group II. The B/T ratio was similar for both groups, but Group I had greater oscillation of benzene concentrations because of their work activities. No differences in ttMA and S-PMA, and no clinical changes were found between both groups, but linearity was observed between leukocyte count and ttMA; and 15% of workers had leukocyte counts less than 4.5 × 109 cells L-1, demanding close worker's attention. No differences were observed between the two groups for THIOL, MDA, MCA, or nuclear abnormalities. A multiple linear relationship was obtained for the biomarkers MCA and C-FPG. A significant correlation was found between length of time in current job and the biomarkers C-FPG, MCA, GST, and MDA. Although both populations had chronic exposure to benzene, the filling station workers were exposed to higher concentrations of benzene during their work activities, indicating an increased risk of DNA damage.

Molecular assessment of Gymnotus spp. (Gymnotiformes: Gymnotidae) fishing used as live baitfish in the Tietê River, Brazil

The capture of live bait for sport fishing is an important activity for fishing communities. The main species used for this purpose are members of the genus Gymnotus, which comprises numerous species of cryptic nature that are difficult to identify based on external morphology. The aims of this work were to identify through partial sequences of the COI gene Gymnotus species fished in the Jacaré-Guaçu River, SP, and to develop a molecular diagnostic approach using PCR-RFLP to identify these species. Partial COI sequences were compared to those of other species deposited in GenBank. The sequences were assessed in the NEBCutter program to determine restriction sites in the sequence and the enzymes to be tested. Phenetic analysis performed by Neighbor-Joining method showed that the specimens sampled belong to two species preliminary identified here as G. cf. sylvius and G. cf. cuia, with G. cf. sylvius accounting for 95.2% of the individuals sampled. The enzymes NlaIII and SacI generated fragments that allowed distinguishing the Gymnotus species using PCR-RFLP. This analysis can be used to accurately identify these species, which is fundamental for monitoring Gymnotus fishing and assessing the conservation of this genetic resource.(AU)

A captura de iscas-vivas para a pesca esportiva constitui uma atividade importante em comunidades de pescadores. As principais espécies utilizadas para este propósito pertencem ao gênero Gymnotus, o qual compreende inúmeras espécies de natureza críptica que dificulta a identificação baseada na morfologia externa. Os objetivos deste trabalho foram identificar através de sequências parciais do gene COI, espécies de Gymnotus capturadas no Rio Jacaré-Guaçu, Ibitinga, SP, e desenvolver um diagnóstico molecular por meio de PCR-RFLP. Sequências parciais de COI foram comparadas com outras espécies depositadas no GenBank. As sequências foram analisadas no Programa NebCutter para determinar os sítios de restrição e definir as enzimas a serem testadas. A análise fenética pelo método de Neighbor-Joining mostrou que os espécimes pertencem a duas espécies identificadas preliminarmente aqui como G. cf. sylvius e G. cf. cuia, sendo que G. cf. sylvius representou 95,2% dos indivíduos amostrados. As enzimas NlaIII e SacI geraram fragmentos que permitiram discriminar as espécies por meio de PCR-RFLP. Esta análise pode ser usada na identificação precisa destas espécies, fundamental na proposição de monitoramento da pesca de Gymnotus na região e para medidas adequadas de conservação.(AU)

Ineffective Protection in Hemodialysis Patients: Sociodemographic and Clinical Context.

PURPOSE: To analyze the association between components of the nursing diagnosis ineffective protection (00043) and sociodemographic and clinical data of hemodialysis patients. METHOD: Cross-sectional study was conducted during the first half of 2015 with a sample of 200 patients from a reference clinic of nephrology. A structured instrument containing operational definitions was used to collect data. FINDINGS: Hemodialysis patients presented defining characteristics of ineffective protection (00043) associated with sociodemographic and clinical context variables. CONCLUSION: Components of this diagnosis may be influenced by sociodemographic and clinical context of hemodialysis patients.

Mental disorders and employment status in the São Paulo Metropolitan Area, Brazil: gender differences and use of health services / Transtornos mentais e situação laboral na Região Metropolitana de São Paulo, Brasil: diferenças de gênero e uso de serviços de saúde / Trastornos mentales y situación laboral en la zona metropolitana de São Paulo, Brasil: diferencias de género y uso de servicios de salud

Abstract: Mental disorders are associated with employment status as significant predictors and as consequences of unemployment and early retirement. This study describes the estimates and associations of 12-month DSM-IV prevalence rates of mental disorders and use of health services with employment status by gender in the São Paulo Metropolitan Area, Brazil. Data from the São Paulo Megacity Mental Health Survey was analyzed (n = 5,037). This is a population-based study assessing the prevalence and determinants of mental disorders among adults, using the Composite International Diagnostic Interview. The associations were estimated by odds ratios obtained through binomial and multinomial logistic regression. This study demonstrates that having mental disorders, especially mood disorders, is associated with being inactive or unemployed among men and inactive among women, but only having a substance use disorder is associated with being unemployed among women. Among those with mental disorders, seeking health care services is less frequent within unemployed.

Resumo: Os transtornos mentais estão associados à situação laboral enquanto preditores significativos e consequências do desemprego e da aposentadoria precoce. Este estudo estima as taxas de prevalência de transtornos mentais nos últimos 12 meses de acordo com o DSM-IV, além do uso de serviços de saúde e as associações com situação laboral de acordo com gênero na Região Metropolitana de São Paulo, Brasil. Foram analisados dados do São Paulo Megacity Mental Health Survey (n = 5.037), um estudo populacional que avalia a prevalência e determinantes dos transtornos mentais entre adultos, usando a Composite International Diagnostic Interview. As associações foram estimadas através de razões de prevalência, obtidas por regressão logística binomial e multinomial. O estudo mostra que os transtornos mentais, especialmente transtornos de humor estão associados à inatividade ou ao desemprego entre os homens e à inatividade entre as mulheres, com exceção aos transtornos devido ao uso de substâncias psicoativas que também estão associados ao desemprego em as mulheres. Entre os portadores de transtornos mentais, a busca de serviços de saúde é menos frequente entre os desempregados.

Resumen: Los trastornos mentales están asociados a la situación laboral, como predictores significativos por las consecuencias que provocan el desempleo y la jubilación precoz. Este estudio estima las tasas de prevalencia de trastornos mentales en 12 meses, de acuerdo con el DSM-IV, además del uso de servicios de salud y las asociaciones existentes con la situación laboral, de acuerdo con el género en el área metropolitana de São Paulo, Brasil. Se analizaron los datos del São Paulo Megacity Mental Health Survey (n = 5.037), un estudio poblacional que evalúa la prevalencia y determinantes de los trastornos mentales entre adultos, usando la Composite International Diagnostic Interview. Las asociaciones se estimaron con razones de prevalencia, obtenidas por la regresión logística binomial y multinomial. El estudio muestra que los trastornos mentales, especialmente los trastornos de humor, están asociados a la inactividad o al desempleo en hombres y a la inactividad en mujeres, pero que sólo el trastorno de consumo de sustancias está asociado al desempleo en mujeres. Entre los portadores de trastornos mentales, la búsqueda de servicios de salud es menos frecuente entre los desempleados.

Pacientes em hemodiálise com diagnóstico de enfermagem volume de líquidosexcessivo: Aspectos socioeconômicos e clínicos / Patients receiving hemodialysis with the nursing diagnosis of fluid volume excess: socioeconomic and clinical aspects / Pacientes en hemodiálisis con diagnóstico de enfermería volumen de líquidos excesivo: aspectos socioeconómicos y clínicos

Objetivou-se descrever aspectos socioeconômicos e clínicos de pacientes renais crônicos em hemodiálise com o diagnóstico de enfermagem Volume de líquidos excessivo. Estudo transversal, realizado em hospital universitário e clínica de hemodiálise do Nordeste do Brasil, com amostra de 100 pacientes. A coleta de dados em formulário abrangeu os dados clínicos e socioeconômicos, entre dezembro de 2012 a abril de 2013. A maioria dos pacientes com diagnóstico era do sexo feminino, raça parda, aposentado, possuíam companheiro, professavam religião, tinham média de idade de 50,4 anos, 6,5 anos de estudo e dois salários mínimos. Ainda, apresentava hipertensão, azotemia e hipercalemia, com mediana de 37 meses com doença renal e 33,5 meses em hemodiálise. Em terapia medicamentosa com cloridrato de sevelamer, ácido fólico, eritropoietina humana recombinante e anti-hipertensivos. Identificar aspectos socioeconômicos e clínicos contribuiu para o conhecimento da equipe de enfermagem acerca do contexto em que os pacientes renais crônicos estão inseridos (AU).

This study aimed to describe socioeconomic and clinical aspects of chronic kidney patients receiving hemodialysis, with the nursing diagnosis of Fluid Volume Excess. It is a transversal study, undertaken in a teaching hospital and hemodialysis clinic in the Northeast of Brazil, with a sample of 100 patients. Data collection was undertaken using a questionnaire which covered clinical and social economic data, between december 2012 and April 2013. The majority of patients with a diagnosis were female, of mixed African and European descent, retired, with a companion, claimed to follow a religion, had a mean age of 50.4 years old, had studied for a mean of 6.5 years, and had a mean income of two minimum salaries. Furthermore, they had hypertension, azotemia and hyperkalemia, had had kidney disease for a median of 37 months and had been receiving hemodialysis for a median of 33.5 months. They were receiving drug treatment with sevelamer hydrochloride, folic acid, recombinant human erythropoietin and antihypertensive medications. Identifying socioeconomic and clinical aspects contributed to the nursing team's knowledge of the context in which the chronic kidney patients are inserted (AU).

El objetivo del estudio fue describir aspectos socioeconómicos y clínicos de pacientes renales crónicos en hemodiálisis con el diagnóstico de enfermería Volumen de líquidos excesivo. Estudio transversal, realizado en hospital universitario y clínica de hemodiálisis del Nordeste de Brasil, con muestra de 100 pacientes. Los datos fueron obtenidos por formulario que abarcó los datos clínicos y socioeconómicos, entre diciembre de 2012 y abril de 2013. La mayoria de los pacientes con el diagnóstico era del sexo femenino, raza parda, jubilado, tenía compañero, profesaba religión, tenía media de edad de 50,4 años, 6,5 años de estudio y dos salarios mínimos. También, presentaban hipertensión, azotemia y hipercalemia, con mediana de 37 meses con enfermedad renal y 33,5 meses en hemodiálisis. En terapia de medicamentos con clorhidrato de sevelamer, ácido fólico, eritropoyetina humana recombinante y anti-hipertensivos. Identificar aspectos socioeconómicos y clínicos contribuye para el conocimiento del equipo de enfermería acerca del contexto en que los pacientes renales crónicos están injeridos (AU)

A review of invasive alien species impacts on eucalypt stands and citrus orchards ecosystem services: towards an integrated management approach.

Multidisciplinary knowledge on the impact caused by invasive alien species (IAS) on ecosystems is crucial for guiding policy makers in the adoption of sustainable management measures. This research was focused on insect IAS impacts on two managed ecosystems: eucalypt plantations and citrus orchards. It begins with an identification of the wide range of ecosystem services (ES) and disservices provided by each of these managed ecosystems, according to the methodology proposed by the Millennium Ecosystem Assessment. Subsequently, a comprehensive review of studies that promoted the identification and valuation of direct and indirect impacts IAS impacts on these ecosystems was performed. From the synthesis of previous findings, an integrative management framework is advanced. This links the identification of ES, drivers of change and development of IAS management strategies by means of assessment processes that account for multiple dimensions of ES values. The article concludes with a discussion on the challenges underpinning assessment and valuation approaches that inform the design of inclusive strategies and interventions to tackle IAS impacts.

Association Between Nursing Diagnoses and Socioeconomic/Clinical Characteristics of Patients on Hemodialysis.

PURPOSE: To analyze the association between nursing diagnoses and socioeconomic/clinical characteristics of patients on hemodialysis. METHODS: Cross-sectional study conducted by means of interview and physical examination of 178 patients consecutively selected. FINDINGS: Nursing diagnoses within the NANDA-I domains of health promotion, nutrition, activity/rest, perception/cognition, sexuality, safety/protection, and comfort presented statistically significant association with the socioeconomic/clinical data of age, education, sex, marital status, and duration of the chronic renal disease and hemodialysis. CONCLUSION: The nursing diagnoses in this population may be influenced by the socioeconomic/clinical data. IMPLICATIONS FOR NURSING PRACTICE: The results suggest an opportunity for improved nursing intervention in this community.

Pharmacy Student and Preceptor Impressions of Faculty Liaison Visits to Experiential Training Sites.

OBJECTIVE: To characterize preceptor and student views about and experiences with faculty liaison visits to practice sites during clinical internships. METHODS: A survey was administered at the conclusion of each of the first 3 academic years of a new postbaccalaureate doctor of pharmacy (PharmD) program. RESULTS: Preceptors were satisfied overall with faculty liaison visits, while students initially were not; however, their perception increased in subsequent years. Students felt development of their patient care skills benefited, but less so their interpersonal communication skills. Each year, almost all preceptors indicated faculty liaison visits were helpful in developing and refining their mentorship skills. CONCLUSION: Faculty liaison visits provided a valuable opportunity to interact and support preceptors and students during advanced pharmacy internships in a nascent PharmD program.

Text anxiety in adolescents: the role of self-criticism and acceptance and mindfulness skills.

The current study sets out to explore test anxiety in adolescent students. The effect of sociodemographic variables on test anxiety was controlled for and the relationship between test anxiety and other psychological constructs, such as self-criticism, social anxiety, acceptance and mindfulness, was examined. In addition, the predictive effect/power of these variables was analyzed and a comparative study between high and low test anxiety adolescents was conducted. Participants in this study were 449 high school students, 211 boys and 238 girls, with a mean age of 16.28 years. These participants completed a battery of self-report questionnaires composed by the Portuguese versions of Test Anxiety Inventory (TAI), Child Acceptance and Mindfulness Measure (CAMM), Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS), and the Social Anxiety and Avoidance Scale for Adolescents (SAASA). Results showed that gender, self-criticism and competencies for acceptance and mindfulness had a significant and an independent contribution on the prediction of test anxiety. The comparative study revealed that adolescents with high test anxiety score significantly higher in negative forms of self-criticism, social anxiety and lower in self-reassurance, acceptance and mindfulness, when compared to those with low test anxiety. Despite its exploratory nature, the current study adds to the existing knowledge on the influence of psychological processes, such as self-criticism and acceptance, on test anxiety. These findings might constitute a relevant contribution to psychological intervention with adolescents.

Conhecimento e atitudes de trabalhadores de um serviço públicode emergência sobre adoção de precauções padrão / Knowledge and attitudes of workers from a public emergency service about the adoption of standard precautions / Conocimientos y actitudes de trabajadores de un servicio de emergencia pública en relacióncon la adopción de precauciones estándar

Estudo transversal realizado em um serviço de atendimento pré-hospitalar de Minas Gerais, com o qual se objetivou avaliar a adoção das medidas de precaução, por meio de conhecimento e atitudes da equipe mutiprofissional. Utilizou-se análise univariadae multivariada dos dados. Verificou-se que enfermeiros e condutores apresentaram o maior e o menor nível de conhecimento em relação às precauções padrão, respectivamente. A não adoção das medidas de precaução foi 3,76 (IC 95%: 1,48 – 9,53) vezes maior entre profissionais com idade superior a 31 anos e 6,7 (IC 95%: 1,81 – 24,75) vezes maior entre trabalhadores de unidade de suporte básico. Diante destes resultados, torna-se imprescindível implantar um programa de educação continuada para melhorar o conhecimento do profissional em relação ao controle de infecção e recomendações da biossegurança.(AU)

The aims of the study were to evaluate the adoption of the precaution measures, assessing knowledge and attitude of multiprofessional team. This is a transversal study, accomplished in an Emergency Medical Service of Minas Gerais. Univariate and multivariate analysis were used. The results showed that nurses and drivers had the highest and lowest level of knowledgeregarding the standard precautions, respectively. The possibility of non-adoption of the precautionary measures was 3.76 (95%CI: 1.48 to 9.53) times higher among professionals aged over 31 years and 6.7 (95% CI: 1.81 to 24,75) times greater among workers in crowded unit of basic support. The conclusion is that is essential to implement strategies in order to improve the professional’s knowledge related to infection control and safety recommendations.(AU)

Estudio transversal, realizado en un servicio de atención pre-hospitalaria de Minas Gerais, cuyo objetivo fue evaluar laadopción de medidas de precaución, por medio del conocimiento y de las actitudes del equipo multiprofesional. Se utilizó el análisis univariada y multivariada de los datos. Se encontró que los enfermeros y los conductores han tenido el nivel más alto y el más bajo e conocimiento en relación a las precauciones estándar, respectivamente. La no adopción de medidas deprecaución fue de 3,76 (IC 95%: 1,48 a 9,53) veces mayor para los profesionales de 31 años y 6,7 (IC 95%: 1,81 a 24,75) veces superior entre los trabajadores en la unidad de soporte básico. Teniendo en cuenta estos resultados, es esencial establecer unprograma de educación continuada para mejorar los conocimientos profesionales en relación con el control de infecciones ylas recomendaciones de bioseguridad.(AU)

Economic assessment of managing processionary moth in pine forests: a case-study in Portugal.

This paper assesses the private and social profitability of current strategies for managing processionary moth (Thaumetopoea pityocampa) in Portuguese pine forests, looking at economic and environmental costs and benefits. Costs include the expenses for forest treatment and the social costs of threats to human health (dermatitis amongst others); benefits are assessed in terms of both revenue and social benefits such as carbon fixation and recreation. The evaluation was done using Cost Benefit Analysis (CBA) as an analytical framework. While this tool is currently applied to forest and environmental assessment and specific applications to pest management strategies are to be found in agricultural economics, rather few attempts have been made in the field of forest pest management. In order to assess and compare with--without options, a case-study was analysed for the Setúbal Peninsula, south of Lisbon, an area where extensive stands of maritime pine (Pinus pinaster) grow. The exercise has shown that CBA can be a valuable tool for assessing the economic and social profitability of pest management. The results demonstrate that the loss of revenues in the no-management option is not sufficient to make pest management profitable for private forest owners in the short-term. Conversely, a social profit is gained as pest management minimizes health risks for humans and avoids possible recreational losses.

Morbidade referida e utilizaçäo dos serviços de saúde no Município de Säo Benedito do Rio Preto: Maranhäo - 1995 / Referred morbidity and health services use in the District of Säo Benedito do Rio Preto: Maranhäo - 1995

Morbidade referida e utilizaçäo dos serviços de saúde no Município de Säo Benedito do Rio Preto, Estado do Maranhäo, 1995. A morbidade referida foi feita através de inquérito domiciliar e relacionada com as variáveis sócio-econômicas e demográficas. O período recordatório em relaçäo aos eventos informados foi de 30 dias. Buscou-se a taxa de procura por assistência médica, agente de saúde, balconista de farmácia e benzedeira ou curandeiro. Investigou-se a assistência prestada às mulheres em idade fértil e a cobertura vacinal das crianças de 12 a 59 meses de idade. Das 1813 pessoas da amostra, 19,7 por cento apresentaram alguma doença, resultando num coeficiente de prevalência de morbidade de 196,91/1000 habitantes. A taxa de procura por assistência médica foi de 25,8 por cento, pelo agente de saúde 9,8 por cento e igual para o balconista de farmácia e benzedeira ou curandeiro - 6,7 por cento. Das 363 mulheres em idade fértil 27,3 por cento engravidaram e a cobertura vacinal de pré-natal foi de 12,9 por cento. A cobertura vacinal das crianças de 12 a 59 meses de idade foi de 68 por cento para a vacina Sabin, 60 por cento para a DPT, 72,8 por cento para a anti-sarampo e 78 por cento para a BCG.