The implementation of the Medical Regulation Office and Mobile Emergency Attendance System and its impact on the gravity profile of non-traumatic afflictions treated in a University Hospital: a research study

<p>Abstract</p> <p>Background</p> <p>The public health system of Brazil is structured by a network of increasing complexity, but the low resolution of emergency care at pre-hospital units and the lack of organization of patient flow overloaded the hospitals, mainly the ones of higher complexity. The knowledge of this phenomenon induced Ribeirão Preto to implement the Medical Regulation Office and the Mobile Emergency Attendance System. The objective of this study was to analyze the impact of these services on the gravity profile of non-traumatic afflictions in a University Hospital.</p> <p>Methods</p> <p>The study conducted a retrospective analysis of the medical records of 906 patients older than 13 years of age who entered the Emergency Care Unit of the Hospital of the University of São Paulo School of Medicine at Ribeirão Preto. All presented acute non-traumatic afflictions and were admitted to the Internal Medicine, Surgery or Neurology Departments during two study periods: May 1996 (prior to) and May 2001 (after the implementation of the Medical Regulation Office and Mobile Emergency Attendance System). Demographics and mortality risk levels calculated by Acute Physiology and Chronic Health Evaluation II (APACHE II) were determined.</p> <p>Results</p> <p>From 1996 to 2001, the mean age increased from 49 ± 0.9 to 52 ± 0.9 (P = 0.021), as did the percentage of co-morbidities, from 66.6 to 77.0 (P = 0.0001), the number of in-hospital complications from 260 to 284 (P = 0.0001), the mean calculated APACHE II mortality risk increased from 12.0 ± 0.5 to 14.8 ± 0.6 (P = 0.0008) and mortality rate from 6.1 to 12.2 (P = 0.002). The differences were more significant for patients admitted to the Internal Medicine Department.</p> <p>Conclusion</p> <p>The implementation of the Medical Regulation and Mobile Emergency Attendance System contributed to directing patients with higher gravity scores to the Emergency Care Unit, demonstrating the potential of these services for hierarchical structuring of pre-hospital networks and referrals.</p

Heterotic domain wall solutions and SU(3) structure manifolds

We examine compactifications of heterotic string theory on manifolds with SU(3) structure. In particular, we study N = 1/2 domain wall solutions which correspond to the perturbative vacua of the 4D, N =1 supersymmetric theories associated to these compactifications. We extend work which has appeared previously in the literature in two important regards. Firstly, we include two additional fluxes which have been, heretofore, omitted in the general analysis of this situation. This allows for solutions with more general torsion classes than have previously been found. Secondly, we provide explicit solutions for the fluxes as a function of the torsion classes. These solutions are particularly useful in deciding whether equations such as the Bianchi identities can be solved, in addition to the Killing spinor equations themselves. Our work can be used to straightforwardly decide whether any given SU(3) structure on a six-dimensional manifold is associated with a solution to heterotic string theory. To illustrate how to use these results, we discuss a number of examples taken from the literature.Comment: 34 pages, minor corrections in second versio

Knowledge, attitudes, practices and acceptability of a school preventive chemotherapy programme for schistosomiasis and soil-transmitted helminths control in Angola

Schistosomiasis and soil-transmitted helminth (STH) control programs require target population engagement, assessed through knowledge, attitudes and practices (KAP) surveys. We report the results of a KAP survey of Angolan schoolchildren supported by a school preventive chemotherapy (PC) programme, without or with a school water, sanitation and hygiene (WASH) programme (PC+/WASH- and PC+/WASH+, respectively); and schoolchildren without a school PC or WASH program (PC-/WASH-). Schoolchildren from PC+/WASH- (N = 218), PC+/WASH+ (N = 250) and PC-/WASH- (N = 254) schools were interviewed. Descriptive statistics were used to report demographics and survey responses. Chi-square or Fisher's exact test was used to compare PC+/WASH- schoolchildren with (i) PC+/WASH+ and (ii) PC-/WASH- schoolchildren. A lower proportion of PC+/WASH- schoolchildren used latrines and a higher proportion practised open defecation at school compared with PC+/WASH+ schoolchildren. A lower proportion of PC+/WASH- schoolchildren always washed their hands after toileting and before meals at school compared with PC+/WASH+ schoolchildren. However, the PC+/WASH- schoolchildren reported better toileting and handwashing practices at school compared to PC-/WASH- schoolchildren. Over 90% of PC+ schoolchildren agreed with schistosomiasis and STH control and accepted schoolteacher PC delivery. Expanding the integration of both school PC and WASH programs will improve health behaviours relevant to reduce the risk of schistosomiasis and STHs in schoolchildren. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'

G-structures and Domain Walls in Heterotic Theories

We consider heterotic string solutions based on a warped product of a four-dimensional domain wall and a six-dimensional internal manifold, preserving two supercharges. The constraints on the internal manifolds with SU(3) structure are derived. They are found to be generalized half-flat manifolds with a particular pattern of torsion classes and they include half-flat manifolds and Strominger's complex non-Kahler manifolds as special cases. We also verify that previous heterotic compactifications on half-flat mirror manifolds are based on this class of solutions.Comment: 29 pages, reference added, typos correcte

Representações sociais sobre hipertensão arterial e o cuidado: o discurso do sujeito coletivo

OBJETIVO: Analisar as representações sociais da equipe de saúde sobre a hipertensão arterial e a maneira como desenvolvem os cuidados específicos aos hipertensos. MÉTODOS: Utilizou-se a entrevista semiestruturada com 21 profissionais de saúde que atuavam em Unidades Básicas de Saúde, a técnica do discurso do sujeito coletivo para organização dos dados e interpretação pela teoria das representações sociais. RESULTADOS: As representações dos profissionais revelaram um distanciamento entre as ações preconizadas pelo programa de controle e as que se realizam nas unidades de saúde. CONCLUSÕES: Os profissionais reconhecem a hipertensão como uma doença grave, com grandes consequências, porém as dificuldades estruturais por parte dos serviços, aliadas à desmotivação do usuário para participação em ações de promoção em saúde, não favorecem um cuidado em saúde voltado para as necessidades dos portadores de hipertensão. Tais resultados indicam a necessidade de ações interdisciplinares na prática assistencial que impactem positivamente na oferta e qualidade dos cuidados.OBJETIVO: Analizar las representaciones sociales del equipo de salud sobre la hipertensión arterial y la manera cómo desarrollan los cuidados específicos a los hipertensos. MÉTODOS: Se utilizó la entrevista semiestructurada con 21 profesionales de salud que actuaban en Unidades Básicas de Salud, la técnica del discurso del sujeto colectivo para la organización de los datos e interpretación por la teoría de las representaciones sociales. RESULTADOS: Las representaciones de los profesionales revelaron un distanciamiento entre las acciones preconizadas por el programa de control y las que se realizan en las unidades de salud. CONCLUSIONES: Los profesionales reconocen a la hipertensión como una enfermedad grave, con grandes consecuencias, sin embargo las dificultades estructurales por parte de los servicos, aliadas a la desmotivación del usuario para participar en acciones de promoción en salud, no favorecen a un cuidado en salud volcado a las necesidades de los portadores de hipertensión. Tales resultados indican la necesidad de acciones interdisciplinaris en la práctica asistencial que impacten positivamente en el ofrecimiento y calidad de los cuidados.OBJECTIVE: To analyze the social representations of the health team about arterial hypertension and the manner that develops specific care with hypertensive patients. METHODS: We used semi-structured interviews with 21 health professionals who worked in the Basic Health Units. The technique of collective subject discourse was used for organization and interpretation of the data, using the theory of social representation. RESULTS: The representations of health professionals showed a gap between the actions recommended by the control program and those taking place in health facilities. CONCLUSIONS: Professionals recognized hypertension as a serious disease, with great consequences, but the structural difficulties for part of the services, together with the user's motivation to participate in activities to promote health, did not favor health care focused on the needs of those suffering with hypertension. These results indicate the need for interdisciplinary actions in care practice that impact positively on the delivery and quality of care

Two‑Dimensional Copper Coordination Polymer Assembled with Fumarate and 5,5’‑Dimethyl‑2,2’‑bipyridine: Synthesis, Crystal Structure and Magnetic Properties

[[Cu(fum)(dmb)]·H2O]n, exhibiting weak antiferromagnetic interactions, displays a two-dimensional array comprised of rhombic dinuclear units, where the carboxylate moieties of fumarate bridging ligand displays monodentate and oxo-bridging coordination modes connecting two Cu centers.[[Cu(fum)(dmb)]·H2O]n (1) (fum = fumarate; dmb = 5,5’-dimethyl-2,2’-bipyridine) was obtained by a self-assembly solution reaction, at ambient conditions, and characterized by elemental analysis, IR spectroscopy and X-ray single crystal diffraction. Crystallographic studies show that 1 crystallizes in a triclinic system with a P-1 space group, with a = 8.2308(2) Å, b = 9.7563(2) Å, c = 10.3990(2) Å; α = 80.3444(4)°, β = 77.9517(4)°, γ = 82.0440(5)°; V = 800.45(3) Å3. The Cu(II) centers are five-coordinated with a distorted square pyramidal configuration. The formation of a two-dimensional (2D) array in 1 can be explained by the presence of two different coordination modes in the fumarate ligand: μ-η1:η0 and μ2-η2:η0, both in a bridging monodentate manner, the latter generating distinctive rhombic-dinuclear units. The thermal stability of 1 has also been analyzed. Magnetic measurements revealed that this polymer exhibits weak antiferromagnetic ordering.Universidad Autonoma del Estado de México Universidad Nacional Autónoma de Méxic