Socio-spatial segregation and the level of service of public transport in Rio de Janeiro, Brazil

The Brazilian urbanization model has been consolidated in such a way that most cities, and especially the Metropolitan regions, concentrate in their cores not only wealth but also services and the labour market . This results in very high densities. Contrary to this, peripheral areas concentrate poverty and lack of services. This results in lower densities. However these areas are the ones that have been presenting the highest growth rates. What effect does this land use pattern have in the transportation field? What kind of public investments have been made to cope with this spatial configuration of Brazilian urban areas? Is there any relationship between the distribution of the population and the quality of public services, amongst them transport? The aim of this research is to evaluate the public transport system in Rio de Janeiro, taking into account not only the segregation of activities such as housing and labour market but also the stratification of the population in economic and social terms to establish what level of service is provided for people in different income groups. Rio de Janeiro is taken as the best Brazilian example as public investments and market have not only determined where and how one would live, but have also shaped the city in such a way, that good access to facilities has been the privilege of a minority. Transport, as one of the most important public services, will be used as a tool to test the hypothesis that public services are unevenly distributed among different areas in the city and consequently among different population strata. The bus mode was selected for further investigation, as being the main mode of public transport in Rio de Janeiro. A survey was carried out among users within the system in 15 selected routes. The survey findings supported the hypothesis raised initially, and significant differences in attributes such as waiting, walking and in-vehicle times and also travel costs were observed between the core and peripheral householders. One of the greatest contributions of this research was regarding to the bus drivers working conditions. The quality of the services provided, independently from the spatial variable seems to be affected by the very poor working conditions of the crews. Although improvements in the transport system are necessary, they are not sufficient to solve the problem of commuters, unless significant changes also take place in the working conditions of the drivers

Effect of poly-hexamethylene biguanide hydrochloride (PHMB) treated non-sterile medical gloves upon the transmission of Streptococcus pyogenes, carbapenem-resistant E. coli, MRSA and Klebsiella pneumoniae from contact surfaces

BACKGROUND: Reduction of accidental contamination of the near-patient environment has potential to reduce acquisition of healthcare-associated infection(s). Although medical gloves should be removed when soiled or touching the environment, compliance is variable. The use of antimicrobial-impregnated medical gloves could reduce the horizontal-transfer of bacterial contamination between surfaces. AIM: Determine the activity of antimicrobial-impregnated gloves against common hospital pathogens: Streptococcus pyogenes, carbapenem-resistant E.coli (CREC), MRSA and ESBL-producing Klebsiella pneumoniae. METHODS: Fingerpads (~1cm(2)) of PHMB-treated and untreated gloves were inoculated with 10 μL (~10(4) colony-forming-units [cfu]) of test-bacteria prepared in heavy-soiling (0.5%BSA), blood or distilled-water (no-soiling) and sampled after 0.25, 1, 10 or 15 min contact-time. Donor surfaces (~1cm(2) computer-keys) contaminated with wet/dry inoculum were touched with the fingerpad of treated/untreated gloves and subsequently pressed onto recipient (uncontaminated) computer-keys. RESULTS: Approximately 4.50log10cfu of all bacteria persisted after 15 min on untreated gloves regardless of soil-type. In the absence of soiling, PHMB-treated gloves reduced surface-contamination by ~4.5log10cfu (>99.99%) within 10 min of contact-time but only ~2.5log10 (>99.9%) and ~1.0log10 reduction respectively when heavy-soiling or blood was present. Gloves became highly-contaminated (~4.52log10-4.91log10cfu) when handling recently-contaminated computer-keys. Untreated gloves contaminated "recipient" surfaces (~4.5log10cfu) while PHMB-treated gloves transferred fewer bacteria (2.4-3.6log10cfu). When surface contamination was dry, PHMB gloves transferred fewer bacteria (0.3-0.6log10cfu) to "recipient" surfaces than untreated gloves (1.0-1.9log10; P < 0.05). CONCLUSIONS: Antimicrobial-impregnated gloves may be useful in preventing dissemination of organisms in the near-patient environment during routine care. However they are not a substitute for appropriate hand-hygiene procedures

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ESBL-producing Gram-negative organisms in the healthcare environment as a source of genetic material for resistance in human infections

BACKGROUND: The increasing prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in the healthcare setting and in the community despite established infection control guidelines indicates that these microorganisms may possess survival strategies that allow them to persist in the environment. AIMS: To determine the extent and variation in endemic ESBL-carrying species in different ward environments, and to investigate the potential for cephalosporin resistance to be transferred from environmental isolates to human pathogens. METHODS: Conventional microbiological methods were used to sample 1436 environmental surfaces for ESBL-producing bacteria. Transconjugation assays (broth mating experiments) were performed using environmental ESBL-producing isolates as donors and streptomycin-resistant Escherichia coli (NCTC 50237) as the recipient. FINDINGS: The prevalence of ESBL-producing bacteria on surfaces in a non-outbreak setting was low (45/1436; 3.1%). The sites most likely to be contaminated were the drains of handwash basins (28/105; 26.7%) and floors (14/160; 8.8%). Fifty-nine ESBL-carrying organisms were isolated. Of these, Klebsiella spp. (33.9%), Enterobacter spp. (20.3%), Pantoea spp. (15.3%) and Citrobacter spp. (13.6%) were the most common isolates. ESBL determinants were transferred successfully from three representative environmental isolates (Pantoea calida, Klebsiella oxytoca, Raoultella ornithinolytica) to the human pathogen E. coli. CONCLUSIONS: ESBL-producing Gram-negative isolates were recovered from the hospital environment in the absence of any ESBL infection on the wards. The drains of handwash basins should be considered potential long-term reservoirs of multi-drug-resistant bacteria and drug resistance genes. These genes can reside in various genera of hardy environmental organisms and be a potential source of ESBL for more common human pathogens

Ultraviolet-C decontamination of hand-held tablet devices in the healthcare environment using the Codonics D6000™ disinfection system

Mobile phones and tablet computers may be contaminated with micro-organisms and become a potential reservoir for cross-transmission of pathogens between healthcare workers and patients. There is no generally accepted guidance on how to reduce contamination on mobile devices in healthcare settings. Our aim was to determine the efficacy of the Codonics D6000™ UV-C disinfection device. Daily disinfection reduced contamination on screens and on protective cases (test) significantly, but not all cases (control) could be decontaminated. The median aerobic colony count on the control and the test cases was 52 cfu/25 cm2 (interquartile range: 33-89) and 22 cfu/25 cm2 (10.5-41), respectively, before disinfection

Sparing carbapenem usage

Background: Carbapenem resistance in Gram-negative bacteria is increasing in many countries and use of carbapenems and antibiotics to which resistance is linked should be reduced to slow its emergence. There are no directly equivalent antibiotics and the alternatives are less well supported by clinical trials. The few new agents are expensive. Objectives: To provide guidance on strategies to reduce carbapenem usage. Methods: A literature review was performed as described in the BSAC/HIS/BIA/IPS Joint Working Party on Multiresistant Gram-negative Infection Report. Results: Older agents remain active against some of the pathogens, although expectations of broad-spectrum cover for empirical treatment have risen. Education, expert advice on treatment and antimicrobial stewardship can produce significant reductions in use. Conclusions: More agents may need to be introduced onto the antibiotic formulary of the hospital, despite the poor quality of scientific studies in some cases

Diâmetro médio predominante de partículas do solo

Apresenta-se um modelo empírico capaz de representar, analiticamente, a curva de distribuição textural acumulada de partículas de um solo e, a partir desse modelo, obter uma expressão que fornece o diâmetro médio predominante de partículas (∅m), que representa o tamanho médio de partículas que ocorrem com maior freqüência no solo. Essas expressões podem ser aplicadas tanto na física do solo quanto em estudos geológicos, geomorfológicos e sedimentológicos