Numerical comparison of two approaches for the study of phase transitions in small systems

We compare two recently proposed methods for the characterization of phase transitions in small systems. The validity and usefulness of these approaches are studied for the case of the q=4 and q=5 Potts model, i.e. systems where a thermodynamic limit and exact results exist. Guided by this analysis we discuss then the helix-coil transition in polyalanine, an example of structural transitions in biological molecules.Comment: 16 pages and 7 figure

Validade da perda auditiva auto-referida em adultos: desempenho de três perguntas únicas

OBJETIVO: Estimar la validez de tres preguntas únicas utilizadas para evaluar la pérdida auditiva auto-referida en comparación con la audiometría de sonidos puros en una población adulta. MÉTODOS: Estudio de validez realizado con una sub-muestra aleatoria de 188 individuos, con edad entre 30 y 65 años, seleccionados de la cuarta fase (2006) de un estudio de cohorte de base poblacional conducido en Salvador, noreste de Brasil. Datos fueron colectados en entrevistas domiciliares utilizándose cuestionarios. Fueron utilizadas tres preguntas para evaluar separadamente, la pérdida auditiva auto-referida: Q1, "Siente usted que tiene una pérdida auditiva?"; Q2, "En general, diría usted que su audición es 'excelente', 'muy buena', 'buena', 'regular', 'mala'?"; Q3, "Actualmente, considera usted que 'oye de la misma forma que oía antes', 'sólo el oído derecho escucha menos que antes', 'sólo el oído izquierdo escucha menos que antes', 'los dos oídos escuchan menos que antes'?". Para estimar las medidas de precisión se utilizaron siete medidas, incluyendo el índice de Youden. Las respuestas obtenidas para cada pregunta fueron comparadas a los resultados de la audiometría de sonidos puros. RESULTADOS: Estimaciones de sensibilidad y especificidad fueron, respectivamente, (Q1) 79,6% y 77,4%, (Q2) 66,9% y 85,1%, (Q3) 81,5% y 76,4%. El índice Youden varió de 51,9% (Q2), a 57,0% (Q1) y 57,9% (Q3). CONCLUSIONES: Cada pregunta permite obtener respuestas con precisión suficiente para recomendar el uso de la pérdida auditiva auto-referida en estudios epidemiológicos con adultos cuando la audiometría de sonidos puros no sea factible.OBJETIVO: Estimar a validade de três perguntas únicas utilizadas para avaliar a perda auditiva auto-referida em comparação com a audiometria de tons puros em uma população adulta. MÉTODOS: Estudo de validade realizado com uma sub-amostra aleatória de 188 indivíduos, com idade entre 30 e 65 anos, selecionados da quarta fase (2006) de um estudo de coorte de base populacional conduzido em Salvador, BA. Dados foram coletados em entrevistas domiciliares utilizando-se questionários. Foram utilizadas três perguntas para avaliar, separadamente, a perda auditiva auto-referida: Q1, "Você sente que você tem uma perda auditiva?"; Q2, "Em geral, você diria que sua audição é 'excelente', 'muito boa', 'boa', 'regular', 'ruim'?"; Q3, "Atualmente, você acha que 'ouve da mesma forma que ouvia antes', 'apenas o ouvido direito ouve menos do que antes', 'apenas o ouvido esquerdo ouve menos do que antes', 'os dois ouvidos ouvem menos do que ouviam antes'?". Para estimar as medidas de acurácia foram utilizadas sete medidas, incluindo o índice de Youden. As respostas obtidas para cada pergunta foram comparadas aos resultados da audiometria de tons puros. RESULTADOS: Estimativas de sensibilidade e especificidade foram, respectivamente, (Q1) 79,6% e 77,4%, (Q2) 66,9% e 85,1%, (Q3) 81,5% e 76,4%. O índice Youden variou de 51,9% (Q2), a 57,0% (Q1) e 57,9% (Q3). CONCLUSÕES: Cada pergunta permite obter respostas com acurácia suficiente para recomendar o uso da perda auditiva auto-referida em estudos epidemiológicos com adultos quando a audiometria de tons puros não for factível.OBJECTIVE: To estimate the validity of three single questions used to assess self-reported hearing loss as compared to pure-tone audiometry in an adult population. METHODS: A validity study was performed with a random sub-sample of 188 subjects aged 30 to 65 years, drawn from the fourth wave of a population-based cohort study carried out in Salvador, Northeastern Brazil. Data were collected in household visits using questionnaires. Three questions were used to separately assess self-reported hearing loss: Q1, "Do you feel you have a hearing loss?"; Q2, "In general, would you say your hearing is 'excellent,' 'very good,' 'good,' 'fair,' 'poor'?"; Q3, "Currently, do you think you can hear 'the same as before', 'less than before only in the right ear', 'less than before only in the left ear', 'less than before in both ears'?". Measures of accuracy were estimated through seven measures including Youden index. Responses to each question were compared to the results of pure-tone audiometry to estimate accuracy measures. RESULTS: The estimated sensitivity and specificity were 79.6%, 77.4% for Q1; 66.9%, 85.1% for Q2; and 81.5%, 76.4% for Q3, respectively. The Youden index ranged from 51.9% (Q2) to 57.0% (Q1) and 57.9% (Q3). CONCLUSIONS: Each of all three questions provides responses accurate enough to support their use to assess self-reported hearing loss in epidemiological studies with adult populations when pure-tone audiometry is not feasible

Fatores associados à notificação de perda auditiva induzida por ruído no Brasil, 2013-2015: estudo ecológico

Objective: To investigate factors associated with the notification of noise-induced hearing loss (NIHL) in Brazil’s Notifiable Diseases Information System. Methods: Ecological study to estimate the proportion of municipalities that notified NIHL. Logistic regression models were conducted to identify associated factors. Results: Between 2013-2015, 277 (5.0%) municipalities notified NIHL. This notification was more common among municipalities with coverage by a Worker Health Referral Centre (CEREST) (OR=1.62 – 95%CI 1.02;2.59) or that hosted a CEREST in their territory (OR=4.37 – 95CI% 2.75;6.93), within a shorter distance to the state capital (OR=1.43 – 95%IC 1.06;1.92) and having a high human development index (OR=2.35 – 95%CI 1.16;4.75). Among the municipalities located in a Cerest coverage area, notification was more common when there was a Speech-Language-Hearing professional in the team (OR=1.96 – 95%CI – 1.47;2.63) and a low turnover of professionals (OR=1.88 – 95%CI 1.40;2.52). Conclusion: Contextual factors influence NIHL notification, particularly the existence and qualification of CEREST. Objetivo: Investigar fatores associados à notificação de perda auditiva induzida por ruído (Pair) no Sistema de Informação de Agravos de Notificação no Brasil. Métodos: Estudo ecológico para estimar a proporção de municípios notificantes de Pair. Foram empregados modelos de regressão logística para identificar fatores associados. Resultados: Entre 2013 e 2015, 277 (5,0%) municípios notificaram Pair. A notificação foi mais comum entre municípios com cobertura por Cerest (OR=1,62 – IC95% 1,02;2,59) ou que sediavam unidade de Cerest em seu território (OR=4,37 – IC95% 2,75;6,93), a menor distância da capital do estado (OR=1,43 – IC95% 1,06;1,92) e com alto índice de desenvolvimento humano (OR=2,35 – IC95% 1,16;4,75). Entre os municípios situados em área com cobertura de Cerest, a notificação foi mais comum quando na equipe havia fonoaudiólogo (OR=1,96 – IC95% 1,47;2,63) e era baixa a rotatividade de profissionais (OR=1,88 – IC95% 1,40;2,52). Conclusão: Fatores contextuais influenciam na notificação de Pair, notadamente a existência e qualificação dos Cerest

Ear canal collapse prevalence and associated factors among users of a center of prevention and rehabilitation for disabilities

ABSTRACT Purpose: to investigate the prevalence of the ear canal collapse when using supra-aural earphones and to verify if this event is influenced by sex, age, color of the skin and prominent ear. Methods: the collapse was assessed by a visual inspection after the positioning of a detached cushion, pressured against the external ear. Results: a total of 436 individuals, aged 3 to 97 years, participated in the study. Ear canal collapse was observed in 11.4% of the subjects, being mostly bilateral (90.0%). The prevalence ranged from 6.3% to 36.6% across age groups. Males, aged 65 years or above and presence of prominent ear were independently identified as associated factors for the occurrence of ear canal collapse (p&lt;0.05). Despite a higher prevalence for those self-identified as white skinned when compared to non-whites, the difference was not statistically significant. Conclusion: the ear canal collapse, when supra-aural earphones are used, is more likely to occur in men, in elderly people, and among those with prominent ears. The prevalence of the event in this population raises the necessity of a careful examination, previous to any evaluation using supra-aural earphones.</jats:p

Prevalence and causes of hearing impairment in Fundong Health District, North-West Cameroon.

OBJECTIVE: To estimate the prevalence and causes of hearing impairment in Fundong Health District, North-West Cameroon. METHODS: We selected 51 clusters of 80 people (all ages) through probability proportionate to size sampling. Initial hearing screening was undertaken through an otoacoustic emission (OAE) test. Participants aged 4+ years who failed this test in both ears or for whom an OAE reading could not be taken underwent a manual pure-tone audiometry (PTA) screening. Cases of hearing impairment were defined as those with pure-tone average ≥41 dBHL in adults and ≥35 dBHL in children in the better ear, or children under age 4 who failed the OAE test in both ears. Each case with hearing loss was examined by an ear, nose and throat nurse who indicated the main likely cause. RESULTS: We examined 3567 (86.9%) of 4104 eligible people. The overall prevalence of hearing impairment was 3.6% (95% confidence interval [CI]: 2.8-4.6). The prevalence was low in people aged 0-17 (1.1%, 0.7-1.8%) and 18-49 (1.1%, 0.5-2.6%) and then rose sharply in people aged 50+ (14.8%, 11.7-19.1%). Among cases, the majority were classified as moderate (76%), followed by severe (15%) and profound (9%). More than one-third of cases of hearing impairment were classified as unknown (37%) or conductive (37%) causes, while sensorineural causes were less common (26%). CONCLUSIONS: Prevalence of hearing impairment in North-West Cameroon is in line with the WHO estimate for sub-Saharan Africa. The majority of cases with known causes are treatable, with impacted wax playing a major role

Congenital Zika Syndrome-Assessing the Need for a Family Support Programme in Brazil.

The Zika outbreak in Brazil caused congenital impairments and developmental delays, or Congenital Zika Syndrome (CZS). We sought to ascertain whether a family support programme was needed and, if so, could be adapted from the Getting to Know Cerebral Palsy programme (GTKCP) designed for children with cerebral palsy (CP). We conducted a systematic review of the needs of families of children with CZS or CP in low- and middle-income countries and reviewed the findings of the Social and Economic Impact of Zika study. We undertook a scoping visit to three facilities offering services to children with CZS in Brazil to understand potential utility and adaptability of GTKCP. The literature review showed that caregivers of children with CZS experience challenges in mental health, healthcare access, and quality of life, consistent with the CP literature. The scoping visits demonstrated that most support provided to families was medically orientated and while informal support networks were established, these lacked structure. Caregivers and practitioners expressed an eagerness for more structure community-based family support programmes. A support programme for families of children with CZS in Brazil appeared relevant and needed, and may fill an important gap in the Zika response

Mothers as facilitators for a parent group intervention for children with Congenital Zika Syndrome: Qualitative findings from a feasibility study in Brazil.

BACKGROUND: The Zika virus outbreak in Brazil (2015-2016) affected thousands of children who were born with Congenital Zika Syndrome (CZS). Families play an important role in their care of children with complex needs, yet their knowledge, experience and skills are rarely harnessed in existing interventions to best support these families. OBJECTIVE: This study explores the use of mothers as facilitators for a community-based group intervention for children with CZS and their caregivers in Brazil. METHODS: Four facilitators were trained to deliver the 10-week intervention called "Juntos". Two were mothers of a child with CZS ("expert mothers") and two were therapists (speech therapist and physiotherapist). The intervention was delivered to three groups, generally including 8-10 caregivers. Two researchers, who were psychologists, observed the groups and held focus group discussions at the end of each session. They undertook semi-structured interviews post intervention with a purposive sample of caregivers, and with the facilitators. Observation notes were collated and summarised. Transcripts were transcribed and thematically analysed using five elements to assess feasibility: acceptability, demand, implementation, practicality and adaptation. RESULTS: The use of expert mothers as facilitators was considered to be acceptable and there was demand for their role. Their experiential knowledge was viewed as important for sharing and learning, and supporting and encouraging the group. The intervention was delivered with fidelity by the expert mothers. The practicality of the intervention was facilitated by holding the group sessions in the community, providing transport costs to facilitators and participants, paying expert mothers and therapist facilitators equally and supporting the expert mothers through a mentorship programme. Equal payment with the therapist enabled the expert mothers to better facilitate the groups, through increased confidence in the value of their role. Adaptation of the intervention included development of video resources and mentoring guidelines. CONCLUSION: The use of expert mothers as facilitators of caregiver groups provides a unique approach to harness the knowledge, experience, and skills of families to provide care, and is likely to be feasible in similar contexts