Demonstration project on epilepsy in Brazil - Outcome assessment

Purpose: To assess the outcome of patients with epilepsy treated at primary care health units under the framework of the demonstration project on epilepsy in Brazil, part of the WHO/ILAE/IBE Global Campaign Against Epilepsy. Method. We assessed the outcome of patients treated at four primary health units. The staff of the health units underwent information training in epilepsy. The outcome assessment was based on: 1) reduction of seizure frequency, 2) subjective perception from the patient's and the physician's point of view, 3) reduction of absenteeism, 4) social integration (school and work), and 5) sense of independence. Results: A total of 181 patients (93 women - 51%) with a mean age of 38 (range from 2 to 86) years were studied. The mean follow-up was 26 months (range from 1 to 38 months, 11 patients had follow-up of less than 12 months). Seizure frequency was assessed based on a score system, ranging from 0 (no seizure in the previous 24 months) to 7 (> 10 seizure/day). The baseline median seizure-frequency score was 3 (one to three seizures per month). At the end of the study the median seizure-frequency score was 1 (one to three seizures per year). The patients' and relatives' opinions were that in the majority (59%) the health status had improved a lot, some (19%) had improved a little, 20% experienced no change and in 2% the health status was worse. With regard to absenteeism, social integration and sense of independence, there were some modest improvements only. Discussion: The development of a model of epilepsy treatment at primary health level based on the existing health system, with strategic measures centred on the health care providers and the community, has proved to be effective providing important reductions in seizure frequency, as well as in general well being. This model can be applied nationwide, as the key elements already exist provided that strategic measures are put forward in accordance with local health providers and managers

Emotional well-being in COVID-19 mass quarantine: the role of personal response and life activity: a 14-day diary study in China

Objectives: dis study aims to explore quarantined individuals’ emotional well-being over time and how personal response and life activity predict emotional well-being and its change. Design/Methods: Daily data were collected from 134 participants wif 71 having 14 consecutive days’ data. Hierarchical linear modeling (HLM) and General Linear Model (GLM) were used to examine the primary tests. Results: Overall, positive and negative emotions declined significantly during the surveyed period. Meanwhile, differences were observed in the level of positive, depressed, and negative emotions and/or patterns of change among different population categories. The personal response of worrying about work and life was positively related to depressed and negative emotions at baseline, but was negatively related to the development of both depressed and negative emotions over time. Among life activities, family stressor was a significant predictor for both depressed and negative emotions while social support predicted positive emotions. Moreover, health & hygiene activity was positively related to positive emotions at baseline. Conclusions: The results provide scientific evidence for public health policymakers on quarantine policies and inform the general public about quarantine life. They highlight the importance of addressing the needs of vulnerable groups (parents wif young children, divorcees, clinicians) during the pandemic, and demonstrate the benefits of promoting healthcare and hygiene activity, having a sense of worry and access to social support.info:eu-repo/semantics/acceptedVersio

Primary Biliary Cholangitis: a Rare Diagnosis During Pregnancy

Primary biliary cholangitis is an autoimmune disease that mostly affects women. It is uncommon in women of childbearing age and the diagnosis during pregnancy is rare and can be challenging. Described here is a case of primary biliary cholangitis first manifesting during pregnancy, with the onset of pruritus, jaundice, biochemical liver abnormalities and positive antimitochondrial antibodies. Although treatment with ursodeoxycholic acid was started at the time of diagnosis, there was a progressive worsening of cholestatic biochemical markers throughout pregnancy. In addition, fasting hyperglycemia with polyhydramnios was diagnosed, consistent with gestational diabetes. She had a spontaneous preterm delivery at 31 weeks of gestation, of a newborn who was admitted to the neonatal intensive care unit but who subsequently had no long-term sequelae of preterm delivery. A maternal postpartum flare occurred. Treatment with ursodeoxycholic acid was well tolerated during pregnancy and lactation.info:eu-repo/semantics/publishedVersio

Violation of a Bell inequality in two-dimensional spin-orbit hypoentangled subspaces

Based on spin-orbit coupling induced by q-plates, we present a feasible experimental proposal for preparing two-dimensional spatially inhomogeneous polarizations of light. We further investigate the quantum correlations between these inhomogeneous polarizations of photon pairs generated by spontaneous parametric down-conversion, which in essence describe the so-called hypoentanglement that is established between composite spin-orbit variables of photons. The violation of the Clauser-Horne-Shimony-Holt-Bell inequality is predicted with S=2\sqrt2 to illustrate the entangled nature of the cylindrical symmetry of spatially inhomogeneous polarizations.Comment: 14pages,3 figures, submitte

Evidence of suppression of onchocerciasis transmission in the Venezuelan Amazonian focus.

BACKGROUND: The World Health Organization (WHO) has set goals for onchocerciasis elimination in Latin America by 2015. Most of the six previously endemic countries are attaining this goal by implementing twice a year (and in some foci, quarterly) mass ivermectin (Mectizan®) distribution. Elimination of transmission has been verified in Colombia, Ecuador and Mexico. Challenges remain in the Amazonian focus straddling Venezuela and Brazil, where the disease affects the hard-to-reach Yanomami indigenous population. We provide evidence of suppression of Onchocerca volvulus transmission by Simulium guianense s.l. in 16 previously hyperendemic Yanomami communities in southern Venezuela after 15 years of 6-monthly and 5 years of 3-monthly mass ivermectin treatment. METHODS: Baseline and monitoring and evaluation parasitological, ophthalmological, entomological and serological surveys were conducted in selected sentinel and extra-sentinel communities of the focus throughout the implementation of the programme. RESULTS: From 2010 to 2012–2015, clinico-parasitological surveys indicate a substantial decrease in skin microfilarial prevalence and intensity of infection; accompanied by no evidence (or very low prevalence and intensity) of ocular microfilariae in the examined population. Of a total of 51,341 S. guianense flies tested by PCR none had L3 infection (heads only). Prevalence of infective flies and seasonal transmission potentials in 2012–2013 were, respectively, under 1 % and 20 L3/person/transmission season. Serology in children aged 1–10 years demonstrated that although 26 out of 396 (7 %) individuals still had Ov-16 antibodies, only 4/218 (2 %) seropositives were aged 1–5 years. CONCLUSIONS: We report evidence of recent transmission and morbidity suppression in some communities of the focus representing 75 % of the Yanomami population and 70 % of all known communities. We conclude that onchocerciasis transmission could be feasibly interrupted in the Venezuelan Amazonian focus. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13071-016-1313-z) contains supplementary material, which is available to authorized users

A educação ambiental por meio do uso das metodologias ativas: um estudo de caso na cidade de Cabo frio (RJ)

oferta escassa nos serviços de saneamento básico, bem como a eliminação inadequada dos resíduos sólidos urbanos (RSU) são, historicamente, impasses que o Brasil enfrenta. O objetivo deste estudo é analisar e avaliar o processo ensino e aprendizagem de educando, em relação à abordagem das condições de oferta de saneamento básico e eliminação, de forma imprópria, dos RSU. O público-alvo é composto por 36 discentes: 21 mulheres e 14 homens matriculados no Curso Técnico de Hospedagem integrado ao Ensino Médio (CTHIEM) do Instituto Federal Fluminense, campus de Cabo Frio (IFF-CF). Utilizou-se como estratégia de ensino, o uso das metodologias ativas (MA), a fim de sensibilizar os participantes sobre os agravos ambientais. Investiu-se em uma abordagem pedagógica baseada em situações-problema, além de aplicar um questionário elaborado com 5 questões objetivas, formulado pelo aplicativo Quizizz, onde os participantes, após a experenciação obtiveram uma média de 93,33% de respostas corretas (DP: ±6,97; EP: ±2,95).info:eu-repo/semantics/publishedVersio

Proposta de um jogo digital para educação ambiental: saneamento básico para todos

O presente relatório apresenta um das atividades desenvolvidas pela primeira autora, no seu projeto de Doutoramento em Ciências da Informação, Especialidade em Sistemas, Tecnologias e Gestão da Informação, sob a orientação dos professores Doutor Luís Borges Gouveia e Doutora Maria Alzira Dinis, com título provisório: “As metodologias ativas como proposta de intervenção pedagógica em educação ambiental: um estudo de caso na cidade de Cabo Frio, RJ, Brasil”. O objetivo é identificar as perceções que os estudantes tiveram sobre os prejuízos causados ao meio ambiente e a saúde humana, bem como a importância dos serviços de saneamento básico por meio dos conteúdos apresentados no jogo digital: "Saneamento Básico para todos." Preliminarmente, foi feita uma avaliação do jogo por 10 estudantes, escolhidos de forma aleatória, que após jogarem sugeriram uma série de ajustes que foram efetuados junto ao desenvolvedor. Após essa fase, foi solicitado que os estudantes do Curso de Hospedagem Integrado ao Ensino Médio (CHIEM), do Instituto Federal Fluminense de Cabo Frio (IFF/CF), baixassem o jogo e após jogarem, deveriam responder a um questionário previamente elaborado, composto por 13 perguntas objetivas, aplicando a Escala Likert, e 3 perguntas subjetivas. Em termos de considerações finais, de acordo com as respostas dos educandos foi possível perceber que o jogo alerta sobre a importância da instalação da rede de saneamento básico para a cidade, portanto, 97,1% dos participantes responderam concordar com essa temática.info:eu-repo/semantics/publishedVersio

A secreted serine protease of Paracoccidioides brasiliensis and its interactions with fungal proteins

<p>Abstract</p> <p>Background</p> <p><it>Paracoccidioides brasiliensis </it>is a thermodimorphic fungus, the causative agent of paracoccidioidomycosis (PCM). Serine proteases are widely distributed and this class of peptidase has been related to pathogenesis and nitrogen starvation in pathogenic fungi.</p> <p>Results</p> <p>A cDNA (<it>Pb</it>sp) encoding a secreted serine protease (<it>Pb</it>SP), was isolated from a cDNA library constructed with RNAs of fungal yeast cells recovered from liver of infected mice. Recombinant <it>Pb</it>SP was produced in <it>Escherichia coli</it>, and used to develop polyclonal antibodies that were able to detect a 66 kDa protein in the <it>P. brasiliensis </it>proteome. <it>In vitro </it>deglycosylation assays with endoglycosidase H demonstrated that <it>Pb</it>SP is a <it>N</it>-glycosylated molecule. The <it>Pb</it>sp transcript and the protein were induced during nitrogen starvation. The <it>Pb</it>sp transcript was also induced in yeast cells infecting murine macrophages. Interactions of <it>Pb</it>SP with <it>P. brasiliensis </it>proteins were evaluated by two-hybrid assay in the yeast <it>Saccharomyces cerevisiae</it>. <it>Pb</it>SP interacts with a peptidyl prolyl cis-trans isomerase, calnexin, HSP70 and a cell wall protein PWP2.</p> <p>Conclusions</p> <p>A secreted subtilisin induced during nitrogen starvation was characterized indicating the possible role of this protein in the nitrogen acquisition. <it>Pb</it>SP interactions with other <it>P. brasiliensis </it>proteins were reported. Proteins interacting with <it>Pb</it>SP are related to folding process, protein trafficking and cytoskeleton reorganization.</p

Improving emergency plans management with SAGA

[EN] Emergency plans are the tangible result of the preparedness activities of the emergency management lifecycle. In many countries, public service organizations have the legal obligation to develop and maintain emergency plans covering all possible hazards relative to their areas of operation. However, little support is provided to planners in the development and use of plans. Often, advances in software technology have not been exploited, and plans remain as text documents whose accessibility is very limited. In this paper, we advocate for the definition and implementation of plan management processes as the first step to better produce and manage emergency plans. The main contribution of our work is to raise the need for IT-enabled planning environments, either at the national or organization-specific levels, which can lead to more uniform plans that are easier to evaluate and share, with support to stakeholders other than responders, among other advantages. To illustrate our proposal, we introduce SAGA, a framework that supports the full lifecycle of emergency plan management. SAGA provides all the actors involved in plan management with a number of tools to support all the stages of the plan lifecycle. We outline the architecture of the system, and show with a case study how planning processes can benefit from a system like SAGA.We thank J. Marzal and R. Garrido, from the UPV Prevention Service, for their cooperation in the early design of SAGA. The work of J.H. Canós, M.C. Penadés, M. Llavador and A. Gómez is partially funded by the Spanish Ministerio de Educación y Ciencia (MEC) under grant TIPEx (TIN2010-19859-C03-03). The work of M.R.S. Borges is partially supported by grant nos. 560223/2010-2 and 308003/2011-0 from CNPq (Brazil) and grant no. E-26/103.076/2011 from FAPERJ (Brazil). The cooperation between the Brazilian and the Spanish research groups was partially sponsored by the CAPES/MECD Cooperation Program, Project #169/PHB2007-0064-PC.Canos Cerda, JH.; Borges, M.; Penadés Gramage, MC.; Gómez Llana, A.; Llavador Campos, M. (2013). Improving emergency plans management with SAGA. Technological Forecasting and Social Change. 80(9):1868-1876. https://doi.org/10.1016/j.techfore.2013.02.014S1868187680