Safe contact-based robot active search using Bayesian optimization and control barrier functions.

In robotics, active exploration and learning in uncertain environments must take into account safety, as the robot may otherwise damage itself or its surroundings. This paper presents a method for safe active search using Bayesian optimization and control barrier functions. As robot paths undertaken during sampling are continuous, we consider an informative continuous expected improvement acquisition function. To safely bound the contact forces between the robot and its surroundings, we leverage exponential control barrier functions, utilizing the derivative of the force in the contact model to increase robustness to uncertainty in the contact boundary. Our approach is demonstrated on a fully autonomous robot for ultrasound scanning of rheumatoid arthritis (RA). Here, active search is a critical component of ensuring high image quality. Furthermore, bounded contact forces between the ultrasound probe and the patient ensure patient safety and better scan quality. To the best of our knowledge, our results are both the first demonstration of safe active search on a fully autonomous robot for ultrasound scanning of rheumatoid arthritis and the first experimental evaluation of bounding contact forces in the context of medical robotics using control barrier functions. The results show that when search time is limited to less than 60 s, informative continuous expected improvement leads to a 92% success, a 13% improvement compared to expected improvement. Meanwhile, exponential control barrier functions can limit the force applied by the robot to under 5 N, even in cases where the contact boundary is specified incorrectly by -1 or +4 mm.

Chinese EFL learners different from English natives in cataphora resolution: Evidence from eye-tracking studies.

Previous studies on English natives have shown that encountering an English cataphoric pronoun triggers an active search for its antecedent and this searching process is modulated by syntactic constraints. It remains unknown whether the conclusion is universal to EFL (English as a Foreign Language) learners, particularly those with distinct L1 like Chinese in linguistic typology. Therefore, this study used two eye-tracking experiments to investigate how Chinese EFL learners resolve English cataphora. The experiments adopted the gender-mismatch paradigm. Experiment 1 investigated whether Chinese EFL learners with different proficiency would adopt the similar processing pattern to English natives and found that gender congruency elicited longer reading times than gender incongruency between the first potential antecedent and the cataphoric pronoun, the effect early observed in high-proficiency relative to low-proficiency learners. Experiment 2 explored whether the cataphora resolution process was modulated by Binding Principle B and revealed that longer first fixation durations and first pass reading times were observed in gender-mismatch than in gender-match conditions no matter the antecedents are binding-accessible or not while longer regression path durations occurred in gender-mismatch than in gender-match conditions only as the antecedents are binding-accessible. Taken together, these results indicate that Chinese EFL learners also adopt an active search mechanism to resolve cataphoric pronouns, yet along a processing path distinct from English natives'. Specifically, Chinese EFL learners predictively link a cataphoric pronoun to the first potential antecedent in the sentence but only a gender-matching antecedent can prompt them to engage in deep processing of the antecedent. Moreover, the processing time varies with the learners' English proficiency. Furthermore, unlike native English speakers' early application of syntactic constraints in their cataphora resolution, Chinese EFL learners try to establish co-reference relations between cataphoric pronouns and antecedents regardless of following or flouting Binding Principle B in early processing stages whereas they exclusively link the cataphoric pronouns to the binding-accessible antecedents in late processing stages. This study adds evidence to the Shallow Structure Hypothesis whereby L2 learners resort to lexical prior to syntactic cues to process sentences in general, which is just opposite to the fashion adopted by the natives.

Estado actual, retos y soluciones operacionales a las Búsquedas activas de TB 2019-2020, Paraguay

RESUMEN Introducción: La búsqueda activa de casos de Tuberculosis (TB) pretende garantizar la detección temprana para reducir el riesgo de malos resultados de la enfermedad y las consecuencias sociales propias de la misma, así como cortar oportunamente la cadena de transmisión en la comunidad. Objetivo: Determinar el estado actual, retos y soluciones operacionales a las Búsquedas activas en las 18 Regiones Sanitarias del Paraguay. Métodos: Estudio descriptivo retrospectivo de corte transversal, fuente de datos: registros de búsqueda activa disponibles de las regiones sanitarias, sociedad civil y Programa Nacional de Control de Tuberculosis (PNCT) del Paraguay 2019-2020 y Sistema Experto del PNCT (SEPNCT) Para el análisis estadístico se utilizaron medidas de resumen como frecuencias absolutas, relativas y proporciones. Resultados: se analizaron las visitas de campo para búsquedas activas, en tres tipos de intervenciones, 5089 personas investigadas, 26.5% fueron identificadas como SR. La positividad general fue de 5%. Se necesita en promedio de 76 personas para encontrar un caso de TB. Las búsquedas activas que tuvieron mayor impacto fueron las realizadas por el nivel nacional con 49.3% de casos de TB aportados. Conclusiones: Las intervenciones basadas en la comunidad, como el establecimiento de redes de derivación y otras actividades que acercan la información y los servicios sobre la tuberculosis a las personas con síntomas, pueden contribuir a mejorar la notificación de casos de tuberculosis, cortar la cadena de transmisión y reducir la mortalidad por tuberculosis.

SUMMARY Introduction: The active search for cases of Tuberculosis (TB) aims to ensure early detection to reduce the risk of poor outcomes of the disease and the social consequences of the disease, as well as to cut the chain of transmission in the community in a timely manner. Objective . To determine the current status, challenges and operational solutions to the Active Searches in the 18 Health Regions of Paraguay. Methods: Retrospective descriptive cross-sectional study, data source: active search records available from the health regions, civil society and National Tuberculosis Control Program (PNCT) of Paraguay 2019-2020 and Expert System of the PNCT (SEPNCT) For the statistical analysis summary measures such as absolute and relative frequencies and proportions were used. Results: field visits were analyzed for active searches, in three types of interventions, 5089 people investigated, 26.5% were identified as RH. The overall positivity was 5%. It takes an average of 76 persons to find a TB case. The active searches that had the greatest impact were those conducted by the national level with 49.3% of TB cases contributed. Conclusions: Community-based interventions, such as the establishment of referral networks and other activities that bring TB information and services closer to people with symptoms, can help improve TB case notification, cut the chain of transmission, and reduce TB mortality.

The role of proactive behavior on COVID-19 infordemic in the Chinese Sina-Microblog: a modeling study.

In order to avoid forming an information cocoon, the information propagation of COVID-19 is usually created through the action of "proactive search", an important behavior other than "reactive follow". This behavior has been largely ignored in modeling information dynamics. Here, we propose to fill in this gap by proposing a proactive-reactive susceptible-discussing-immune (PR-SFI) model to describe the patterns of co-propagation on social networks. This model is based on the forwarding quantity and takes into account both proactive search and reactive follow behaviors. The PR-SFI model is parameterized by data fitting using real data of COVID-19 related topics in the Chinese Sina-Microblog, and the model is calibrated and validated using the prediction accuracy of the accumulated forwarding users. Our sensitivity analysis and numerical experiments provide insights about optimal strategies for public health emergency information dissemination.

Semantic Active Visual Search System Based on Text Information for Large and Unknown Environments.

Different high-level robotics tasks require the robot to manipulate or interact with objects that are in an unexplored part of the environment or not already in its field of view. Although much works rely on searching for objects based on their colour or 3D context, we argue that text information is a useful and functional visual cue to guide the search. In this paper, we study the problem of active visual search (AVS) in large unknown environments. In this paper, we present an AVS system that relies on semantic information inferred from texts found in the environment, which allows the robot to reduce the search costs by avoiding not promising regions for the target object. Our semantic planner reasons over the numbers detected from door signs to decide either perform a goal-directed exploration towards unknown parts of the environment or carefully search in the already known parts. We compared the performance of our semantic AVS system with two other search systems in four simulated environments. First, we developed a greedy search system that does not consider any semantic information, and second, we invited human participants to teleoperate the robot while performing the search. Our results from simulation and real-world experiments show that text is a promising source of information that provides different semantic cues for AVS systems.

Primary Immunodeficiencies in a Mesoregion of São Paulo, Brazil: Epidemiologic, Clinical, and Geospatial Approach.

Background: Primary immunodeficiencies (PIDs) are rare genetic disorders leading to immunologic abnormalities that can affect different organs and systems. We determined the epidemiology, clinical, and geospatial characteristics of PID disorders among patients diagnosed over a 5 year period in a reference hospital covering a mesoregion in São Paulo, Brazil. Methods: A retrospective analysis of 39 patients with recognizable PIDs according to the criteria of the European Society of Primary Immunodeficiencies were enrolled. Thirty-four patients came from outpatient immunodeficiency clinics and five patients from active search. Demographic, clinical, and immunologic data were collected, and maps were constructed using a geographic information system. Results: The ratio of females to males was 1.4:1, and 48.7% of patients were younger than 17 years of age. The mean age at the onset of symptoms in children was 2.0 years [standard error of the mean (SEM), 1.7 years] and the diagnosis lag was 5.1 years (SEM, 3.1 years); the mean age at diagnosis in adults was 16.3 years (SEM, 11.8 years) and the lag was 10.8 years (SEM, 10.9 years). Antibody deficiency and common variable immunodeficiencies were the most common categories and phenotypes, respectively. The need for intravenous antibiotics and respiratory tract infections were the most prevalent warning signs, with an overall mortality rate of 15.3%. Autoimmune diseases were diagnosed in 56.4% and visceral leishmaniasis in 5.1% of patients. In the active search, 29 patients were investigated and 17.2% were diagnosed; early diagnosis, the involvement of multidisciplinary professionals, and dissemination of knowledge achieved milestone benefits. The distribution of PID networks in Brazil shows great asymmetry between regions and at a regional level; it was shown that the patients lived mainly in Presidente Prudente municipality. Conclusions: The implementation of an immunodeficiency outpatient clinic in a referral hospital covering a mesoregion with a large population has led to the generation of policies and practices to improve the diagnosis, quality of life, and care of patients with PIDs and their families. Furthermore, the search for hospitalized patients with warning signs for PIDs showed great benefits. Inequality in the distribution of PID network centers in Brazil was demonstrated.

Opportunity Finding by Nascent Entrepreneurs: Accidental or Purposeful?

PURPOSE: This research studies an important, but relatively unexplored entrepreneurial aspect: motivation and aspiration on opportunity finding/discovery. DESIGN/METHODOLOGY/APPROACH: This study surveyed 230 nascent entrepreneurs on their opportunity finding behavior. A poisson regression and a logistic analysis were conducted to discover the relationship between motivation/aspiration and opportunity search behavior. FINDINGS: Motivation and aspiration interact to influence active search in a positive way. However, only willingness to become an entrepreneur is found to search for opportunities purposefully. RESEARCH LIMITATIONS/IMPLICATIONS: Participants of the research are from a Midwest state in United States. Future research may collect sample from more and larger areas. PRACTICAL IMPLICATIONS: Bankers may use entrepreneurial opportunity search behavior as one criterion determining if to fund a person or not. ORIGINALITY/VALUE: This article answers the call to study motivation/aspiration on opportunity finding (Yitshaki and Kropp, 2018; Murnieks et al., 2020). It is one of the first studies to explore the above relationship.

Active Search for Computer-aided Drug Design.

We consider lead discovery as active search in a space of labelled graphs. In particular, we extend our recent data-driven adaptive Markov chain approach, and evaluate it on a focused drug design problem, where we search for an antagonist of an αv integrin, the target protein that belongs to a group of Arg-Gly-Asp integrin receptors. This group of integrin receptors is thought to play a key role in idiopathic pulmonary fibrosis, a chronic lung disease of significant pharmaceutical interest. As an in silico proxy of the binding affinity, we use a molecular docking score to an experimentally determined αvß6 protein structure. The search is driven by a probabilistic surrogate of the activity of all molecules from that space. As the process evolves and the algorithm observes the activity scores of the previously designed molecules, the hypothesis of the activity is refined. The algorithm is guaranteed to converge in probability to the best hypothesis from an a priori specified hypothesis space. In our empirical evaluations, the approach achieves a large structural variety of designed molecular structures for which the docking score is better than the desired threshold. Some novel molecules, suggested to be active by the surrogate model, provoke a significant interest from the perspective of medicinal chemistry and warrant prioritization for synthesis. Moreover, the approach discovered 19 out of the 24 active compounds which are known to be active from previous biological assays.

Leishmaniose visceral: cenários epidemiológicos e desafios / Visceral leishmaniasis: epidemiological scenarios and challenges

Um retrospecto histórico e epidemiológico da leishmaniose visceral (LV) no mundo e no Brasil e possíveis cenários dependentes de condicionantes ambientais, biológicos e sociais ressalta estratégias de vigilância e controle, enfatizando: associação de procedimentos com continuidade; conquistas e controvérsias em diagnóstico, tratamento, vacinação e uso de coleira com deltametrina, no cão; e ineficácia da terapêutica canina com as drogas disponíveis, mas boas perspectivas da vacina, na proteção individual, e da coleira impregnada, no controle coletivo. Considera a situação epidemiológica potencializada pela galopante urbanização da LV e sua dispersão geográfica, salientando desafios de controle por deslocamento do vetor e do cão infectado a novas áreas através do transporte rodoviário e ferroviário, e conflitos de rejeição à eutanásia canina. Alerta sobre a alta letalidade da LV humana em áreas de instalação recente e por associação crescente com HIV, impondo diagnóstico e tratamento precoces, para evitar agravamento clínico e óbitos, e adoção da busca ativa de casos humanos e caninos incorporada à rotina das visitações domiciliares periódicas da Estratégia Saúde da Família, para detecção de febre prolongada e outros sinais de LV e o encaminhamento a unidades de Saúde. Admite que a introdução do cão infectado em áreas indenes continuará um grande desafio.

A historical and epidemiological retrospect of visceral leishmaniasis (VL) in the world and in Brazil, and possible scenarios dependent of environmental, biological and social conditions stands out strategies of surveillance and control, emphasizing the association of procedures with continuity; conquests and controversies in diagnosis, treatment, vaccination and use of deltametrin collar in the dog; and ineffectiveness of canine therapy with available drugs, but good vaccine prospects, in individual protection, and impregnated collar, in collective control. It considers the epidemiological situation potentiated by the galloping urbanization of VL and its geographical dispersion, highlighting control challenges by moving the vector and the infected dog to new areas through road and rail transport, and conflicts of rejection to canine euthanasia. Alert on the high lethality of human LV in areas of recent installation and by increasing association with HIV, imposing early diagnosis and treatment, to avoid clinical worsening and death, and adoption of the active search of human and canine cases incorporated into the routine of the periodic home visits of the Family Health Strategy to detect prolonged fever and other signs of LV and referral to health units. Introducing the infected dog into free transmission areas will remain a major challenge.

Factores que dificultan la no adhesión ala práctica regular de actividad física en adultos mayores / Factors that hinder the non-adherence to regular physical activity in elderly adults / Fatores que dificultam a não adesão à prática regular de atividade física em pessoas idosas

Estudio de método mixto, con enfoque cualitativo, que utilizó la técnica de snowball. Realizado en Bahia, Brasil, entre enero/2014 y septiembre/2015. Objetivó identificar los factores que conducen a las personas a la no adhesión a la práctica regular de actividad física. Los resultados evidenciaron compromiso de salud, dificultad de conseguir un certificado médico, indisponibilidad por demandas familiares y baja motivación. Se concluye que estos saberes son necesarios para el delineamiento de la gestión y planeamiento en salud, en el sentido de guiar nuevas estrategias de promoción de salud, como consecuencia de los elevados índices de enfermedades crónicas no transmisibles en nuestro medio.(AU)

A mixed method study with a qualitative approach that implement the snowball technique. The study was developed in Bahia, Brazil, between January/2014 and September/2015. It was aimed at identifying the factors that lead people to non-adherence to regular physical activity. The results showed that the reasons were related to health problems, difficulty in getting a medical certificate, unavailability because of family demands and low motivation. We conclude that this knowledge is necessary for the delineation of management and planning in healthcare, in the sense of guiding new health promotion strategies as a result of high rates of chronic non-communicable diseases in our reality.(AU)

Estudo de método misto, ênfase no enfoque qualitativo, utilizou a técnica Snowball Sampling. Realizado na Bahia, Brasil, entre janeiro/2014 a setembro/2015. Objetivou averiguar os fatores que conduzem as pessoas a não adesão à prática regular de atividade física. Os resultados evidenciaram comprometimento de saúde, dificuldade de conseguir atestado médico, indisponibilidade por demandas familiares, e baixa motivação. Conclui-se que estes saberes são necessários ao delineamento, gestão e planejamento em saúde, posto as evidências do elevado índice de doenças crônicas não transmissíveis em nosso meio, no sentido de guiar-se pela via da promoção da saúde.(AU)

Fatores que dificultam a não adesão à prática regular de atividade física em pessoas idosas / Factors that hinder the non-adherence to regular physical activity in elderly adults / Factores que dificultan la no adhesión a la práctica regular de actividad física en adultos mayores

Estudo de método misto, ênfase no enfoque qualitativo, utilizou a técnica Snowball Sampling. Realizado na Bahia, Brasil, entre janeiro/2014 a setembro/2015. Objetivou averiguar os fatores que conduzem as pessoas a não adesão à prática regular de atividade física. Os resultados evidenciaram comprometimento de saúde, dificuldade de conseguir atestado médico, indisponibilidade por demandas familiares, e baixa motivação. Conclui-se que estes saberes são necessários ao delineamento, gestão e planejamento em saúde, posto as evidências do elevado índice de doenças crônicas não transmissíveis em nosso meio, no sentido de guiar-se pela via da promoção da saúde.

A mixed method study with a qualitative approach that implement the snowball technique. The study was developed in Bahia, Brazil, between January/2014 and September/2015. It was aimed at identifying the factors that lead people to non-adherence to regular physical activity. The results showed that the reasons were related to health problems, difficulty in getting a medical certificate, unavailability because of family demands and low motivation. We conclude that this knowledge is necessary for the delineation of management and planning in healthcare, in the sense of guiding new health promotion strategies as a result of high rates of chronic non-communicable diseases in our reality.

Estudio de método mixto, con enfoque cualitativo, que utilizó la técnica de snowball. Realizado en Bahia, Brasil, entre enero/2014 y septiembre/2015. Objetivó identificar los factores que conducen a las personas a la no adhesión a la práctica regular de actividad física. Los resultados evidenciaron compromiso de salud, dificultad de conseguir un certificado médico, indisponibilidad por demandas familiares y baja motivación. Se concluye que estos saberes son necesarios para el delineamiento de la gestión y planeamiento en salud, en el sentido de guiar nuevas estrategias de promoción de salud, como consecuencia de los elevados índices de enfermedades crónicas no transmisibles en nuestro medio.

Active search for antecedents in cataphoric pronoun resolution.

Cataphoric dependencies where a pronoun precedes its antecedent appear to call on different mechanisms in language comprehension from forward dependencies where the antecedent precedes the pronoun. Previous research has shown that the resolution of cataphoric dependencies involves predictive processes such as the active search mechanism, which hypothesizes the automatic search for an antecedent immediately after encountering a cataphoric pronoun. The current study employs gender mismatch to investigate whether the active search for an antecedent of a cataphoric pronoun is restricted only to grammatically licit positions. We present results from an event-related potential experiment on the reading comprehension of cataphoric dependencies in Dutch. Results show that gender mismatch gives rise to an anterior negativity at grammatically licit antecedent positions only. We hypothesize that this negativity reflects the prediction failure for an antecedent after encountering a pronoun, rather than a gender mismatch. We discuss the timing, topography and functionality of this negativity with respect to previous studies and how this relates to the ERPs elicited in the processing of structural constraints on pronoun resolution.

Enfermedad celíaca. Una mirada actual / Catching up on celiac disease

Knowledge about celiac disease continues to grow and amaze those who investigate, seek and treat this condition. Gone are the days when it was considered just a rare child's digestive disease. It is now recognized as a highly prevalent autoimmune condition that affects children and adults with digestive and extra-digestive symptoms of diverse intensity, disorder that may be either mono, oligo or asymptomatic from a digestive point of view. Today, it is an underdiagnosed condition, not actively considered, and often mistakes are made regarding its diagnosis, treatment and gluten-free diet monitoring. This article reviews the current definition of the disease, clinical presentations, potential patients, how to search for the disease, how the diagnosis is made and characteristics of the treatment and monitoring of celiac patients, all based on internationally agreed standards, and emphasizing those aspects that have proven to be useful in other countries regarding the management of the disease.

El conocimiento acerca de la enfermedad celíaca continúa creciendo y sorprendiendo a aquellos que la investigan, la buscan y la tratan. Lejos están los tiempos en que se la consideraba una patología digestiva del niño, poco frecuente. Actualmente se la reconoce como una condición autoinmune altamente prevalente, que afecta a niños y adultos, con manifestaciones digestivas y extra digestivas de muy diversa intensidad, pudiendo ser mono, oligo o incluso asintomática desde el punto de vista digestivo. Hoy en día está sub-diagnosticada, no se la busca activamente, se incurren en errores tanto al diagnosticarla como en la indicación del tratamiento y seguimiento de la dieta sin gluten. En este artículo revisamos la definición actual de la enfermedad, las presentaciones clínicas que se le conocen, en quiénes y cómo se debe buscar, como se hace el diagnóstico, y en qué consiste el tratamiento y seguimiento del paciente celíaco, basándonos en los criterios internacionales actualmente consensuados, y poniendo énfasis en aquellos aspectos que han demostrado ser útiles en otros países para mejorar el manejo de la enfermedad.

Diversity and aspects of the ecology of social wasps (Vespidae, Polistinae) in Central Amazonian "terra firme" forest

Diversity and aspects of the ecology of social wasps (Vespidae, Polistinae) in Central Amazonian "terra firme" forest. The knowledge of social wasp richness and biology in the Amazonian region is considered insufficient. Although the Amazonas state is the largest in the region, until now only two brief surveys were conducted there. Considering that the systematic inventory of an area is the first step towards its conservation and wise use, this study presents faunal data on social wasp diversity in a 25 km² area of "terra firme" (upland forest) at the Ducke Reserve, Manaus, Amazonas, Brazil. Wasps were collected in the understory, following a protocol of three collectors walking along 60 trails 1,000 m in extension for 16 days between August and October 2010. Methods used were active search of individuals with entomological nets and nest collecting. Fifty-eight species of social wasps, allocated in 13 genera, were recorded; 67% of the collected species belong to Polybia, Agelaia and Mischocyttarus; other genera were represented by only four species or less. The most frequent species in active searches were Agelaia fulvofasciata (DeGeer, 1773), Agelaia testacea (Fabricius, 1804) and Angiopolybia pallens (Lepeletier, 1836). Twelve species were collected in nests. Prior to this study, 65 Polistinae species were deposited at the INPA Collection. Collecting in the study grid, an area not previously sampled for wasps, resulted in an increase of 25% species, and species richness was 86. According to the results, there is evidence that the diversity of social wasps at the Ducke Reserve is even higher, making it one of the richest areas in the Brazilian Amazonia.

Diversidade de mamíferos de médio e grande porte da região do rio Urucu, Amazonas, Brasil / Diversity of medium and large sized mammals in the Urucu basin, Amazonas, Brazil

Entre abril de 2008 e maio de 2009 foram realizadas expedições para o estudo sobre a riqueza, a composição e a abundância relativa dos mamíferos de médio e grande porte na região do rio Urucu (Amazonas, Brasil). Foram empregados três métodos de amostragem: censo por transecção linear, busca ativa por vestígios e armadilhas fotográficas. No total foram registradas 41 espécies de mamíferos pertencentes a 17 famílias e oito ordens. As ordens com maior riqueza foram Primates, com 13 espécies registradas, e Carnivora, com 11 espécies registradas. Entre os grupos mais abundantes se destacaram as ordens Primates, Perissodactyla, Artiodactyla e Rodentia. A alta diversidade de espécies de mamíferos de médio e grande porte encontrada em Urucu reforça a importância desta região para a conservação da mastofauna amazônica.

Between April 2008 and May 2009, studies on the species richness, composition and relative abundance of the medium and large sized mammals were carried out in the Urucu basin (Brazilian Amazon). The survey was conducted using line transect sampling method, active search for signs and camera-traps. A total of 41 species of 17 families and eight orders were recorded. Primates was the group with the highest species richness in sympatry (13 species), followed by carnivores (11 species). Primates, Perissodactyla, Artiodactyla and Rodentia were the most abundant groups. The high diversity of medium and large sized mammals presented here indicates the importance of the region for mammals conservation in Amazonia.

Leprosy in Buriticupu, state of Maranhão: active search in the general population / Hanseníase no município de Buriticupu, estado do Maranhão: busca ativa na população geral

INTRODUCTION: This study was developed to evaluate the situation of leprosy in the general population of the municipality of Buriticupu, State of Maranhão, Brazil. METHODS: We used the method of active search to identify new cases from 2008 to 2010. Bacilloscopy of intradermal scrapings was performed in all patients with skin lesions compatible with leprosy, and histopathological examination in those who had doubts on the definition of the clinical form. RESULTS: The study included 19,104 individuals, with 42 patients diagnosed with leprosy after clinical examination, representing a detection rate of 219.84 per 100,000 inhabitants. The predominant clinical presentation was tuberculoid with 24 (57.1%) cases, followed by borderline with 11, indeterminate with four, and lepromatous with three cases. The study also allowed the identification of 81 patients with a history of leprosy and other skin diseases, such as pityriasis versicolor, dermatophytosis, scabies, vitiligo, and skin carcinoma. The binomial test showed that the proportion of cases in the headquarters was significantly higher than that in the villages (p = 0.04), and the generalized exact test showed that there was no association between age and clinical form (p = 0.438) and between age and gender (p = 0.083). CONCLUSIONS: The elevated detection rate defines the city as hyperendemic for leprosy; the active search for cases, as well as the organization of health services, is an important method for disease control.

INTRODUÇÃO: O estudo foi desenvolvido com o objetivo de avaliar a situação da hanseníase na população geral do município de Buriticupu, Estado do Maranhão, Brasil. MÉTODOS: Foi empregado o método de busca ativa na identificação de casos novos, de 2008 a 2010. Baciloscopia de raspado intradérmico foi feita em todos os pacientes com lesões de pele compatíveis com hanseníase e exame histopatológico, naqueles em que havia dúvidas na definição da forma clínica. RESULTADOS: Participaram do estudo 19.104 indivíduos, sendo que o exame clínico definiu o diagnóstico de hanseníase em 42 pacientes, o que representa um coeficiente de detecção de 219,84/100.000 habitantes. A forma clínica predominante foi a tuberculóide com 24 (57,1%) casos, seguindo-se da dimorfa, com 11, da indeterminada, com 4 e da virchowiana com 3 casos. O estudo permitiu, ainda, a identificação de 81 pacientes com passado de hanseníase, além de outras doenças da pele, tais como pitiríase versicolor, dermatofitose, escabiose, vitiligo e carcinoma de pele. O teste binomial mostrou que a proporção de casos na sede foi significativamente maior que a dos povoados, p= 0,04 e o teste exato generalizado que não há associação entre faixa etária e forma clínica (p=0,438), bem como entre faixa etária e sexo (p=0,083). CONCLUSÕES: O elevado coeficiente de detecção define o município como hiperendêmico para a hanseníase; a busca ativa de casos é um método importante, bem como a organização dos serviços de saúde, para o controle da doença.

Hanseníase no Município de Buriticupu, Estado do Maranhão: busca ativa de casos na população adulta / Leprosy in Buriticupu, State of Maranhão: active search for cases in the adult population

INTRODUÇÃO: O estudo foi desenvolvido com o objetivo de avaliar a situação da hanseníase na população adulta do Município de Buriticupu, MA. MÉTODOS: Foi empregado o método de busca ativa na identificação de casos novos, no período de 2005 a 2007. Baciloscopia de raspado intradérmico foi feita em todos os pacientes com lesões de pele compatíveis com hanseníase, enquanto exame histopatológico foi feito naqueles em que havia dúvidas na definição da forma clínica. RESULTADOS: Participaram do estudo 15.409 indivíduos, tendo o exame clínico definido o diagnóstico de hanseníase em 62 pacientes, o que representa um coeficiente de detecção de 40,23/10.000. A baciloscopia foi positiva em seis pacientes, sendo predominante a forma clínica tuberculóide, em 31 casos, seguida da forma indeterminada em 20, dimorfa em 10 e virchowiana em um. O estudo permitiu, ainda, a identificação de outras doenças da pele, tais como pitiríase versicolor, dermatofitose, escabiose, vitiligo e carcinoma de pele. CONCLUSÕES: O elevado coeficiente de detecção define o município como hiperendêmico para a hanseníase. A busca ativa de casos é um método importante para o controle da doença.

INTRODUCTION: This study aimed to analyze the leprosy situation, focusing on the adult population of the town of Buriticupu, State of Maranhão. METHODS: An active search was conducted to identify new cases from 2005 to 2007. All patients with injuries suggestive of leprosy were submitted to cutaneous bacilloscopy and biopsies were performed when defining the clinical presentation was difficulty. RESULTS: 15,409 individuals participated in the study and 62 were diagnosed with leprosy which represents a detection coefficient of 40.23/10,000. Bacilloscopy showed positive results in six patients. The predominant clinical form was tuberculoid, 31 cases, followed by the indeterminate form (20 cases), the dimorphous form (10 cases) and the lepromatous form (1 case). The study also identified other skin diseases, including pityriasis versicolor, scabies, mycosis, vitiligo and carcinoma. CONCLUSIONS: The high detection coefficient defines the town of Buriticupu, MA, as hyperendemic for leprosy. Active cases search is an important method for disease control.

A busca ativa como princípio político das práticas de cuidado no território / The active search as political principle of practices of care in the territory

Originalmente um procedimento estritamente técnico de ação em vigilância epidemiológica, a expressão busca ativa passou também a denotar uma postura política de trabalho no território. Este artigo visa mostrar como determinadas práticas no campo da saúde, sobretudo o trabalho dos acompanhantes terapêuticos, dos Agentes Comunitários de Saúde e dos redutores de danos, sob a consigna da desinstitucionalização e da integralidade, transformaram o sentido atribuído a esta expressão. Pretende-se também apresentar o potencial de politização das práticas e abertura de um campo de possíveis para a produção de novos sentidos contidos nos conceitos de desinstitucionalização e integralidade. Por último, através das reflexões de Hannah Arendt sobre o princípio de vita activa, o artigo pretende problematizar a atividade que está no cerne da experiência destes trabalhadores itinerantes e de suas práticas no território.(AU)

Originally a purely technical procedure for action in epidemiological surveillance, the term active search also became denote a political position of work in the territory. This article aims to show how certain practices in the health field, especially the work of therapeutic accompanying, community health agent and harm reduction works, down under the deinstitutionalization and integrality, transformed the meaning assigned to that expression. It is also present the potential for politicization of practice and opening a field of potential for the production of new meanings contained in the concepts of deinstitutionalization and integrality. Finally, through the reflections of Hannah Arendt about the principle of vita active, the paper aims to problematize the activity that is central to the experience of the itinerant workers and its practices in the territory.(AU)

A busca ativa como princípio político das práticas de cuidado no território / The active search as political principle of practices of care in the territory

Originalmente um procedimento estritamente técnico de ação em vigilância epidemiológica, a expressão busca ativa passou também a denotar uma postura política de trabalho no território. Este artigo visa mostrar como determinadas práticas no campo da saúde, sobretudo o trabalho dos acompanhantes terapêuticos, dos Agentes Comunitários de Saúde e dos redutores de danos, sob a consigna da desinstitucionalização e da integralidade, transformaram o sentido atribuído a esta expressão. Pretende-se também apresentar o potencial de politização das práticas e abertura de um campo de possíveis para a produção de novos sentidos contidos nos conceitos de desinstitucionalização e integralidade. Por último, através das reflexões de Hannah Arendt sobre o princípio de vita activa, o artigo pretende problematizar a atividade que está no cerne da experiência destes trabalhadores itinerantes e de suas práticas no território

Originally a purely technical procedure for action in epidemiological surveillance, the term active search also became denote a political position of work in the territory. This article aims to show how certain practices in the health field, especially the work of therapeutic accompanying, community health agent and harm reduction works, down under the deinstitutionalization and integrality, transformed the meaning assigned to that expression. It is also present the potential for politicization of practice and opening a field of potential for the production of new meanings contained in the concepts of deinstitutionalization and integrality. Finally, through the reflections of Hannah Arendt about the principle of vita active, the paper aims to problematize the activity that is central to the experience of the itinerant workers and its practices in the territory

Busca de casos de tuberculose e o retardo ao diagnóstico da tuberculose: percepção dos gestores de saúde do município de João Pessoa / Surveillance of cases of tuberculosis and delayed diagnosis of tuberculosis: the perception of the health managers in the city of Joao Pessoa

A detecção precoce dos casos de tuberculose (TB) e um tratamento eficaz são duas ferramentas poderosas para se obter êxitos no controle da TB. No entanto observa-se que além do abandono no tratamento, o retardo no diagnóstico de TB configura um dos grandes desafios a serem enfrentados pela gestão e trabalhadores de saúde na redução da incidência de TB no país. Não havendo o envolvimento dos gestores na organização do processo de trabalho das Equipes de Saúde da Família, o controle da TB pode ser fragilizado, principalmente pela deficiência na busca de casos de tuberculose, o que contribuirá para o retardo no diagnóstico da tuberculose. Esta pesquisa objetivou analisar a discursividade de gestores sobre as ações de busca de casos de tuberculose e a relação com o retardo ao diagnóstico da tuberculose no município de João Pessoa PB. Teoricamente, este estudo está respaldado à luz da interface dos conceitos de vigilância da saúde e gestão em saúde, na perspectiva da integralidade e centrado na busca de casos de tuberculose. Trata-se de uma pesquisa qualitativa, que teve seu material empírico construído através de entrevistas gravadas no período de agosto e setembro de 2009, realizadas com 16 apoiadores matriciais. A análise foi realizada conforme a técnica de Análise de Discurso de linha francesa, sendo produzidas duas formações discursivas: 1) Fatores relacionados à busca de casos de tuberculose que concorrem para o Retardo do diagnóstico da TB e 2) Relação entre as dificuldades de realização de busca de casos de tuberculose e o modelo de gestão implantado no município de João Pessoa.

This study aimed to analyze the discourse of managers on actions to search for cases of tuberculosis and its relationship with delayed diagnosis of tuberculosis in the city of João Pessoa - PB. Theoretically, this study is supported in light of the interface concepts of health monitoring and health management, seeking to integrate and focus the search for tuberculosis cases. This is a qualitative research, which had built its empirical material through interviews during August and September 2009, performed with 16 supporters matrix. The analysis was performed according to the Analysis of Discourse French, and produced two discursive formations: 1) Factors related to the search for tuberculosis cases contributing to the delay of diagnosis of TB and 2) Relationship between the difficulties of making search of cases of tuberculosis and the management model implemented in the municipality of João Pessoa.