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For patients with methicillin-resistant Staphylococcus aureus (MRSA) colonization, a traditional fist-bump greeting did not significantly reduce MRSA transfer in comparison to a handshake. However, transfer was reduced with a modified fist bump that minimized the surface area of contact and when hand hygiene was performed before the handshake.
Depression is very common among institutionalized elders. Because of the increased risk of cognitive impairment/dementia, and mortality we want to describe the evolution of depression and analyze predictive factors.
In the Aging Trajectories Study (Instituto Superior Miguel Torga - Coimbra), we followed up a sample of 83 nondemented persons (M ± SD baseline age = 79.51 ± 6.58; men: 17; women: 66). In a 2-year prospective cohort analysis (2010-2011, and 2013), we assessed depression using the Geriatric Depressive Scale/GDS as screening tool and the Mini International Neuropsychiatric Interview to diagnose depression. We also used the UCLA Loneliness Scale, the Geriatric Anxiety Inventory/GAI, the Positive and Negative Affect Scale/PANAS. Sociodemographics, and health were control variables. We performed a multinomial logistic regression to identify predicitive factors.
Fifty participants had depression at baseline, nine developed, 49 maintained, nine remitted, and 16 maintained without depression.
Having depression was associated with worse scores in UCLA, GAI, and PANAS. Not having depression was correlated with higher positive affect.
Baseline higher GAI and UCLA, and lower positive affect and satisfaction predicted recurrent depression.
Improvement in GDS, GAI, and positive affect predicted depression remission.
Results show that depression is a concern issue for professionals working with institutionalized elderly. Anxiety, loneliness, low positive affect and satisfaction constitute a risk factor for maintaing depression in institutionalized elderly and low anxiety and depressive symptoms are a protective factors for depression. These results could be used in depression prevention programs.
The expansion of sugarcane crop to regions with lower water supply in Brazil has increased the importance of correct estimation of crop water requirements. Currently, the irrigation management is generally done using the crop coefficient (Kc) based on the FAO 56 bulletin. Kc is used to determine the potential water demand of the crop for a given period of time and is considered constant for each crop stage. However, some recent studies have shown that Kc can be significantly variable under different evapotranspiration (ETo) rates. This paper aimed to analyse sugarcane water consumption at different scales: plant (sap flow measurements by energy balance method); canopy (Bowen ratio energy balance method); and plant–atmosphere coupling (infrared gas analyser) to reduce the uncertainties on the irrigation practices. Measurements were taken at two experimental sites, where a modern Brazilian cultivar CTC 12 was grown under drip irrigation and an old main Brazilian cultivar (RB867515) was grown under sprinkler irrigation by a central pivot. The mean crop evapotranspiration (ETc) values by the Bowen ratio energy balance method were 2.92 and 3.68 mm d−1 for RB867515 and CTC 12, respectively, resulting in a mean Kc of 0.99 at the full vegetative growth stage. Kc values were dependent on ETo and varied between 0.2 and 1.7 for both cultivars. This occurred in a crop coupled to the atmosphere (Ω = 0.37) and was the same found in other coupled crops such as coffee and citrus. In conclusion, the sugarcane Kc for southeast Brazil presented temporal variability due to coupling conditions according to reference evapotranspiration, and this should be considered in irrigation management.
The development of health technology assessment (HTA) reports is a time-consuming process that requires highly trained human resources. In many Latin American countries this type of personnel is scarce. The adaptation of HTA could be a time-saving process to get inputs for decision. The objective of this study is to determine the frequency of use of HTA adaptation process and to describe type of tools used in this process in Latin American countries.
The Health Technology Assessment Network of the Americas (REDETSA) is a non-profit network formed by ministries of health, regulatory authorities and health technology assessment agencies (PAHO/WHO). During the last meeting of REDETSA in November 2018, we performed an exploration survey to gather information related to the topic in order to promote the creation of an adaptation working group. The question was whether HTA agencies did adaptation of HTA reports and, if so, what methods and tools were used and what sections of the report were adapted.
Thirty-three institutions from fourteen Latin American countries answered to the consultation. Seven countries do adaptation of HTA (50 percent) and one country does adoption. Of those countries that adapt HTA, three do only economic transferability. Methods and tools are usually developed locally or there is not a systematic approach. In two countries, the economic study transferability tool developed by Hutter and Antoñaza is used.
Adaptation of HTA is not well developed among Latin American agencies, although it seems to be an efficient strategy when assessing efficacy and safety. Adaptation of economic studies is still controversial; nevertheless, it is used in some of the countries of the region. It is necessary to advance in the development of HTA adaptation tools, developed and adapted to local contexts in the region.
Over the last decade, the Antarctic continent has been the object of intensive scientific programmes. However, the emphasis of these studies rarely focuses on the Antarctic as a source of potential elements such as mercury. The release of mercury to the environment is known to occur at Deception Island, associated with volcanic activity. In this study, a 3D hydrodynamic model was used to assess the role of water circulation on the dispersion of released mercury. Sea level variation and tidal circulation data were obtained. Residence time was calculated using two different approaches. Internal tide generation in summer and winter were recognized and the barotropic tidal components obtained. Lagrangian tracers were used to depict particle circulation (simulating particulate mercury) in a three month summer simulation for barotropic and baroclinic conditions. The results show that particles accumulate in the northern and western parts of the bay. It is acknowledged that the results of the 3D model are associated with a non-negligible uncertainty, which can only be reduced with an ongoing commitment to monitoring. The findings of this study indicate that mercury accumulation is occurring in Port Foster (Deception Island), which is a potential threat to the local ecosystem.
Strategies for the involvement of primary care in the management of patients with presumed or diagnosed dementia are heterogeneous across Europe. We wanted to explore attitudes of primary care physicians (PCPs) when managing dementia: (i) the most popular cognitive tests, (ii) who had the right to initiate or continue cholinesterase inhibitor or memantine treatment, and (iii) the relationship between the permissiveness of these rules/guidelines and PCP's approach in the dementia investigations and assessment.
Key informant survey. Setting: Primary care practices across 25 European countries. Subjects: Four hundred forty-five PCPs responded to a self-administered questionnaire. Two-step cluster analysis was performed using characteristics of the informants and the responses to the survey. Main outcome measures: Two by two contingency tables with odds ratios and 95% confidence intervals were used to assess the association between categorical variables. A multinomial logistic regression model was used to assess the association of multiple variables (age class, gender, and perceived prescription rules) with the PCPs’ attitude of “trying to establish a diagnosis of dementia on their own.”
Discrepancies between rules/guidelines and attitudes to dementia management was found in many countries. There was a strong association between the authorization to prescribe dementia drugs and pursuing dementia diagnostic work-up (odds ratio, 3.45; 95% CI 2.28–5.23).
Differing regulations about who does what in dementia management seemed to affect PCP's engagement in dementia investigations and assessment. PCPs who were allowed to prescribe dementia drugs also claimed higher engagement in dementia work-up than PCPs who were not allowed to prescribe.
This paper describes the analysis and the design of an integrated antenna on 0.13 µm SiGe BICMOS technology. A non-resonant dipole antenna integrated on SiGe is electromagnetically coupled to a radiating element reported on a printed circuit board (PCB) substrate. This integrated solution, also compatible with system in package (SIP) concept, provides significant improvements with respect to direct System On Chip (SoC) integration. The main objective of this SIP antenna lies on the optimization of integrated millimeter wave front-ends modules, considering the immediate antenna environment (especially the lossy substrate and technological dielectric/metallic levels), in order to achieve performances compatible with short range radar specifications at 79–81 GHz. One solution, using a RT/Rogers Duroid 6006 PCB (er = 6, thickness h = 127 µm), is presented, providing a 2.93 dBi gain, and 45% radiation efficiency antenna.
Increasing rates of habitat loss and human occupation are creating demands for optimum strategies that maximize conservation efforts, despite the lack of detailed data required for implementation. Broad scale biogeographical data may furnish initial guidelines for conservation planning in a hierarchical framework for establishing conservation priorities and helping guide future research programmes. This approach may be critical in regions for which few detailed data on diversity, abundance and distribution are available, such as in the Cerrado biome of central Brazil. We used a macroecological approach, based on the extent of occurrence of 127 species of terrestrial vertebrates endemic to the Cerrado, to design a regional network of potential areas that represent all species at least once. The final network has a total of 24 regions widely distributed throughout the biome. We also evaluated these regions in terms of their human occupation by adding a cost for each cell based on 23 variables expressing variation in agricultural, demographic and cattle-ranching patterns on the Cerrado. Our analyses showed that conservation efforts should be concentrated in the south and south-east of the biome. This macroecological approach can provide broad guidelines for conservation and define the focus for more local and realistic conservation efforts.
The rapid destruction of habitat in biodiversity hotspots calls for the urgent formulation of conservation strategies. In this study, macro-scale biogeographical data for 33 species of Psittacines were used to select networks of priority areas, using an algorithm based on the complementarity concept. Human population size was also incorporated as a cost in the selection process, and the two networks of priority areas (with and without cost) were compared. In the comparison the number of cells selected to represent all species did not differ, but a rearrangement occurred between them. Two of the four cells were located in the same place, and the others changed location but stayed aggregated within the same regions. The study shows that it is possible to minimize human population size and represent all species in a network of priority areas.
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