Introdução - A cárie dentária representa, ainda, em termos de saúde bucal, o principal agravo em saúde pública no Brasil. A fluoretação da água de abastecimento público tem participação comprovada na redução dos índices de prevalência, tendo sido considerada uma das dez grandes conquistas da saúde pública do século XX. Regulamentada no país em 1974, a medida teve acentuada expansão nos anos 80, sobretudo nas regiões de maior desenvolvimento sócio-econômico, como o Estado de São Paulo. A ampliação da cobertura da fluoretação aos municípios com sistemas de tratamento de água é uma das prioridades da política nacional de saúde bucal. Objetivos - Identificar, reunir e sistematizar informações disponíveis sobre a cobertura da fluoretação e descrever sua evolução no Estado de São Paulo, no período de 1956 a 2009. Material e Método - Estudo descritivo, com utilização de dados secundários, tendo como unidade de análise os municípios do Estado de São Paulo, descrevendo um histórico da cobertura desde a instituição da medida. A apresentação dos dados é feita por meio de tabelas, gráficos e mapas temáticos, produzidos a partir de sistemas de informações geográficas. Resultados - A cobertura da fluoretação no Estado de São Paulo evoluiu de apenas um para 546 municípios...

Depuração é a atividade responsável pela localização e correção de defeitos gerados durante o desenvolvimento de programas. A depuração ocorre devido à atividade de teste bem-sucedida, na qual falhas no comportamento do programa são reveladas, indicando a existência de defeitos. Diversas técnicas têm sido propostas para automatizar a tarefa de depuração de programas. Algumas delas utilizam heurísticas baseadas em informações de cobertura obtidas da execução de testes. O objetivo é indicar trechos de código do programa mais suspeitos de conter defeitos. As informações de cobertura mais usadas em depuração automatizada são baseadas no teste estrutural de unidade. A cobertura de integração, obtida por meio da comunicação entre as unidades de um programa, pode trazer novas informações sobre o código executado, possibilitando a criação de novas estratégias para a tarefa de localização de defeitos. Este trabalho apresenta uma nova técnica de localização de defeitos chamada Depuração de programas baseada em Cobertura de Integração (DCI). São apresentadas duas coberturas de integração baseadas nas chamadas de métodos de um programa. Essas coberturas são usadas para a proposição de roteiros de busca dos defeitos a partir dos métodos considerados mais suspeitos. As informações de cobertura de unidade são então utilizadas para a localização dos defeitos dentro dos métodos. A DCI também utiliza uma nova heurística para atribuição de valores de suspeição a entidades de integração estática dos programas como pacotes...

Objetivos: Estimar a cobertura vacinal contra a influenza em idosos; identificar os motivos de não adesão da vacina e analisar os fatores associados à adesão à vacinação. Metodologia: Estudo transversal de base populacional, desenvolvido com dados do Projeto Saúde, Bem-Estar e Envelhecimento (SABE). Foram incluídas pessoas de 60 anos e mais, residentes no Município de São Paulo/SP, Brasil. A amostra final foi constituída de 1.399 idosos, de ambos os sexos, selecionados a partir de amostragem probabilística por conglomerados. A análise de dados levou em consideração os pesos de amostragem, propiciando a inferência de representatividade das conclusões. A variável dependente foi o relato de vacinação contra a influenza no ano de 2006. As variáveis independentes incluíram características demográficas, socioeconômicas, comportamentais, condições de saúde autorreferidas e uso e acesso de serviços de saúde. Como medida de efeito e associação entre variáveis, utilizou-se a razão de prevalências e intervalos de confiança de 95 por cento, conforme estimadas diretamente e com ajuste multivariado por meio da regressão de Poisson. Resultados: Registrou-se cobertura vacinal autorreferida de 73,8 por cento. O principal motivo relatado para a não adesão à vacinação foi não acreditar na vacina. Observou-se menor percentual de vacinados entre os idosos na faixa etária de 60 a 69 anos. As variáveis que se mostraram associadas à vacinação e permaneceram no modelo final foram: idade...

Vigilância Epidemiológica, é a forma através do qual o SUS busca produzir impacto em termos de controle, eliminação e até erradicação de um conjunto definido de doenças imunopreveníveis. O PNI tem conseguindo bons resultados em termos de cobertura vacinais e controle de importantes doenças, embora ainda com importantes desigualdades regionais e locais. Este estudo busca conhecer os fatores que determinam a efetividade deste programa no município de São Paulo a partir de uma análise mutinível. MÉTODO: Em 2002 o Depto. de Medicina Social da FCMSCSP realizou o Inquérito de Cobertura Vacinal no primeiro ano de vida para a coorte de nascidos entre 1º de novembro de 1999 e 31 de outubro de 2000 residentes no município de São Paulo. Este inquérito domiciliar se baseou no processo de amostragem por conglomerado preconizado pela OPAS. Em cada um dos 41 Distritos de Saúde (DS) foi calculada uma amostra de 210 crianças, num total de 8610 crianças. A importância de variáveis grupais e individuais em relação a cobertura vacinal para esquema completo em crianças com um ano de idade e a participação no Dia Nacional de Vacinação (25/08/2001) foi investigada através de um modelo multinível logístico. Foram estabelecidos nesta análise três níveis: individual...

This paper presents an empirical comparison of the growth characteristics of four code coverage measures, block, decision, c-use and p-use, as testing is increased. Due to the theoretical foundations underlying the lognormal software reliability growth model, we hypothesize that the growth for each coverage measure is lognormal. Further, since for a given program the breadth and the depth of the different coverage measures are similar, we expect that the parameters of the lognormal coverage growth model for each of the four coverage measures to be similar. We confirm these hypotheses using coverage data generated from extensive testing of an application which has 30 KLOC. We then discuss how the lognormal coverage growth function could be used to control the testing process and to guide decisions about when to stop testing, since it can provide an estimate of the marginal testing effort necessary to achieve a given level of improvement in the coverage.

This paper describes a methodological proposal based on secondary data and the main results of the HIV-Sentinel Study among childbearing women, carried out in Brazil during 2006. A probabilistic sample of childbearing women was selected in two stages. In the first stage, 150 health establishments were selected, stratified by municipality size (<50,000; 50,000-399,999; 400,000+). In the second stage, 100-120 women were selected systematically. Data collection was based on HIV-test results registered in pre-natal cards and in hospital records. The analysis focused on coverage of HIV-testing during pregnancy and HIV prevalence rate. Logistic regression models were used to test inequalities in HIV-testing coverage during pregnancy by macro-region of residence, municipality size, race, educational level and age group. The study included 16,158 women. Results were consistent with previous studies based on primary data collection. Among the women receiving pre-natal care with HIV-test results registered in their pre-natal cards, HIV prevalence was 0.41%. Coverage of HIV-testing during pregnancy was 62.3% in the country as a whole, but ranged from 40.6% in the Northeast to 85.8% in the South. Significant differences according to race, educational level and municipality size were also found. The proposed methodology is low-cost...

The Countdown to 2015 country profiles present, in one place, comprehensive evidence to enable an assessment of a country’s progress in improving reproductive, maternal, newborn and child health. Profiles are available for each of the 75 countries that together account for more than 95% of all maternal and child deaths. The two-page profiles are updated approximately every 2 years with new data and analyses. Profile data include demographics, mortality, nutritional status, coverage of evidence-based interventions, within-countries inequalities in coverage, measures of health system functionality, supportive policies and financing indicators. The main sources of data for the coverage, nutritional status and equity indicators are the US Agency for Internal Development (USAID)-supported demographic and health surveys and the United Nations Children’s Fund (UNICEF)-supported multiple indicator cluster surveys. Data on coverage are first summarized and checked for quality by UNICEF, and data on equity in intervention coverage are summarized and checked by the Federal University of Pelotas. The mortality estimates are developed by the Inter-agency Group for Child Mortality Estimation and the Maternal Mortality Estimation Inter-Agency Group. The financing data are abstracted from datasets maintained by the Organization for Economic Co-operation and Development Assistance Committee...

The GenBank database contains essentially all of the nucleotide sequence data generated for published molecular systematic studies, but for the majority of taxa these data remain sparse. GenBank has value for phylogenetic methods that leverage data–mining and rapidly improving computational methods, but the limits imposed by the sparse structure of the data are not well understood. Here we present a tree representing 13,093 land plant genera—an estimated 80% of extant plant diversity—to illustrate the potential of public sequence data for broad phylogenetic inference in plants, and we explore the limits to inference imposed by the structure of these data using theoretical foundations from phylogenetic data decisiveness. We find that despite very high levels of missing data (over 96%), the present data retain the potential to inform over 86.3% of all possible phylogenetic relationships. Most of these relationships, however, are informed by small amounts of data—approximately half are informed by fewer than four loci, and more than 99% are informed by fewer than fifteen. We also apply an information theoretic measure of branch support to assess the strength of phylogenetic signal in the data, revealing many poorly supported branches concentrated near the tips of the tree...

Objective. To determine the impact of rising health insurance premiums on coverage rates. Data Sources & Study Setting. Our analysis is based on two cohorts of nonelderly Americans residing in 64 large metropolitan statistical areas (MSAs) surveyed in the Current Population Survey in 1989–1991 and 1998–2000. Measures of premiums are based on data from the Health Insurance Association of America and the Kaiser Family Foundation/Health Research and Educational Trust Survey of Employer-Sponsored Health Benefits. Study Design. Probit regression and instrumental variable techniques are used to estimate the association between rising local health insurance costs and the falling propensity for individuals to have any health insurance coverage, controlling for a rich array of economic, demographic, and policy covariates. Principal Findings. More than half of the decline in coverage rates experienced over the 1990s is attributable to the increase in health insurance premiums (2.0 percentage points of the 3.1 percentage point decline). Medicaid expansions led to a 1 percentage point increase in coverage. Changes in economic and demographic factors had little net effect. The number of people uninsured could increase by 1.9–6.3 million in the decade ending 2010 if real...

Mobile phone coverage has expanded considerably throughout the developing world, particularly within sub-Saharan Africa. Existing evidence suggests that increased access to information technology has improved agricultural market efficiency for consumer markets and certain commodities, but there is less evidence of its impact on producer markets. Building on the work of Aker (2010), this paper estimates the impact of mobile phone coverage on producer price dispersion for three commodities in Niger. The results suggest that mobile phone coverage reduces spatial producer price dispersion by 6 percent for cowpea, a semi-perishable commodity. These effects are strongest for remote markets and during certain periods of the year. The introduction of mobile phone coverage has no effect on producer price dispersion for millet and sorghum, two staple grains that are less perishable and are commonly stored by farmers. There are no impacts of mobile phone coverage on traders' gross margins or producer price levels...

The data in this book are based on World Bank's World Development Indicators (WDI) 2011. The data are for 2009 and 2010 or the most recent year unless otherwise noted. Glossary contains definitions of the terms used in the tables.

Immunization against childhood diseases such as diphtheria, pertussis, tetanus, polio and measles is one of the most important means of preventing childhood morbidity and mortality. Despite the low cost of basic childhood immunizations, nearly 3 million children still die each year from vaccine-preventable diseases. Achieving and maintaining high levels of immunization coverage must therefore be a priority for all health systems. In order to monitor progress in achieving this objective, immunization coverage data can serve as an indicator of a health system's capacity to deliver essential services to the most vulnerable members of a population. This note discusses the use of trends in immunization coverage data, and argues that immunization is a health output with a strong impact on child morbidity, child mortality and permanent disability. This note discusses measurement and interpretation issues for coverage data collected through surveys and administrative records.

The group of 20 (G-20) recognizes data and measurement as an essential foundation for advancing financial inclusion at a global level. The data and measurement sub-group, in its first year, was tasked to identify the existing financial inclusion data landscape, to assess the data gaps, to develop key performance indicators, and to lay out the foundations for the framing of financial inclusion target setting approaches. The purpose of this report, prepared for the global partnership for financial inclusion (GPFI), is to highlight the key findings and recommendations of the data and measurement sub-group during its first year, provide input for a roadmap for the GPFI's work plan for the coming year, and to present key policy recommendations for consideration by the G-20 policy makers for the Cannes summit in November 2011. The policy recommendations presented are relevant at the global level, including both G-20 and non-G-20 countries. The GPFI holds the potential for impact on two levels: (i) incorporating guidance on measurement frameworks and prioritizations of targets through GPFI country-level pilots; and (ii) aligning on the roadmap and determining a toolkit for formulating country level targets or goals to help - operationalize GPFI's universal access vision.

Background: Pneumococcal 10-valent conjugate vaccine (PCV10) was introduced to the routine immunization in Brazil in 2010. During PCV10 introduction year three schedules were used: (i) children aged ≤6 months: 3 doses + 1 booster; (ii) children aged 7-11 months: 2 doses + 1 booster (2p + 1), and (iii) children 12-15 months: single dose. The aim of this study was to assess vaccination coverage and compliance with recommended schedules after the introduction of PCV10 and to identify the factors associated with greater coverage and compliance. Methods: A household survey was conducted between December 2010 and February 2011 in Goiania, GO, where the PCV10 vaccination started on June, 2010. Systematic sampling was used to recruit 1,237 children. A sociodemographic questionnaire was applied during the home visits; dates of vaccination were obtained from the vaccination card. The child's age at vaccine introduction was calculated for July 14th, 2010 (30 days after the introduction of the vaccine on routine immunization) and the child was retrospectively classified into one of three age groups: ≤6 months, 7-11 months; 12-15 months. Vaccination coverage (percentage of children who received the number of recommended doses) and compliance with schedules (percentage of children who received all valid doses at the recommended time interval) were calculated for all children and for each of the three age groups; prevalence ratios were compared by chi-square test. Log binomial regression (prevalence ratio / PR) was used to identify variables independently associated with vaccination coverage and compliance with recommended schedules. Results: The overall vaccination coverage was 53.4% (95% CI: 50.8-56.2%)...

One of the inversion schemes most employed in seismic tomography processing is least squares and derived algorithms, using as input data the vector of first arrivals. A division of the whole space between sources and receivers is performed, constructing a pixel model with its elements of the same size. Spatial coverage is defined, then, as the sum of traveled length by all rays through every pixel that conform the medium considered. It is related, therefore, with the source-receiver's distribution and the form of the domain among them. In cross-hole array, rays do not evenly sample the properties of the medium, leading to non-uniform spatial coverage. It is known that this affects the inversion process. The purpose of this paper, then, was to study the problem of spatial coverage uniformity to obtain travel path matrices leading to inversion algorithms with better convergence. The medium was divided in elements of different size but with an even spatial coverage (named as 'ipixels'), and then it was explored how this improved the inversion process. A theoretical model was implemented with added noise to emulate real data; and then the vector of measured times was generated with known velocity distribution. Afterwards an inversion method using minimum length solution was performed to test the two domain divisions. The results showed that the fact of using ipixels not only improved the inversion scheme used in all cases; but in addition allowed to get convergence where it was impossible to do using pixels; particularly through the method considered. This is a direct result of the improvement of condition number of the associated matrices.

Models of weak-scale supersymmetry offer viable dark matter (DM) candidates. Their parameter spaces are however rather large and complex, such that pinning down the actual parameter values from experimental data can depend strongly on the employed statistical framework and scanning algorithm. In frequentist parameter estimation, a central requirement for properly constructed confidence intervals is that they cover true parameter values, preferably at exactly the stated confidence level when experiments are repeated infinitely many times. Since most widely-used scanning techniques are optimised for Bayesian statistics, one needs to assess their abilities in providing correct confidence intervals in terms of the statistical coverage. Here we investigate this for the Constrained Minimal Supersymmetric Standard Model (CMSSM) when only constrained by data from direct searches for dark matter. We construct confidence intervals from one-dimensional profile likelihoods and study the coverage by generating several pseudo-experiments for a few benchmark sets of pseudo-true parameters. We use nested sampling to scan the parameter space and evaluate the coverage for the benchmarks when either flat or logarithmic priors are imposed on gaugino and scalar mass parameters. The sampling algorithm has been used in the configuration usually adopted for exploration of the Bayesian posterior. We observe both under- and over-coverage...

Satellites mapping the spatial variations of the gravitational or magnetic fields of the Earth or other planets ideally fly on polar orbits, uniformly covering the entire globe. Thus, potential fields on the sphere are usually expressed in spherical harmonics, basis functions with global support. For various reasons, however, inclined orbits are favorable. These leave a "polar gap": an antipodal pair of axisymmetric polar caps without any data coverage, typically smaller than 10 degrees in diameter for terrestrial gravitational problems, but 20 degrees or more in some planetary magnetic configurations. The estimation of spherical harmonic field coefficients from an incompletely sampled sphere is prone to error, since the spherical harmonics are not orthogonal over the partial domain of the cut sphere. Although approaches based on wavelets have gained in popularity in the last decade, we present a method for localized spherical analysis that is firmly rooted in spherical harmonics. We construct a basis of bandlimited spherical functions that have the majority of their energy concentrated in a subdomain of the unit sphere by solving Slepian's (1960) concentration problem in spherical geometry, and use them for the geodetic problem at hand. Most of this work has been published by us elsewhere. Here...

The last few years have seen a growing commitment worldwide to universal health coverage (UHC). Yet there is a lack of clarity on how to measure progress towards UHC. This paper proposes a ‘mashup’ index that captures both aspects of UHC: that everyone—irrespective of their ability-to-pay—gets the health services they need; and that nobody suffers undue financial hardship as a result of receiving care. Service coverage is broken down into prevention and treatment, and financial protection into impoverishment and catastrophic spending; nationally representative household survey data are used to adjust population averages to capture inequalities between the poor and better off; nonlinear tradeoffs are allowed between and within the two dimensions of the UHC index; and all indicators are expressed such that scores run from 0 to 100, and higher scores are better. In a sample of 24 countries for which there are detailed information on UHC-inspired reforms, a cluster of high-performing countries emerges with UHC scores of between 79 and 84 (Brazil...

OBJECTIVE: The nominal registration system of Uruguay's national immunization program (NIP) tracks administered vaccines on a paper form filled out after each vaccination and collated into a national database, thus allowing for individual follow-up. This study performed a comprehensive assessment of the quality of Uruguay's immunization data in November 2006 to evaluate the validity of the information and to confirm the high national immunization coverage reported by the program. METHODS: The research team analyzed the concordance of the operational-level numerators (infant immunization data from 18 public and private vaccination centers in six country departments) with department- and national-level data, and compared the national-level (NIP) infant denominators with other official sources. A standardized questionnaire was used to evaluate system performance at the operational (vaccination center), department, and national level. Rapid house-to-house monitoring was conducted to generate additional coverage estimates. RESULTS: Numerator accuracy throughout the data flow was 100%, and national-level denominators appeared to be exhaustive. Overall system performance was excellent (proper archiving and recording of form data, sufficient supply of forms...

OBJECTIVE: To describe an adapted version of the Pan American Health Organization (PAHO) methodology for rapid monitoring of vaccination coverage and its use as a supervisory tool to guide decision-making and strategies for end-stage vaccination activities ("mopup" operations) following a six-week national rubella elimination campaign in Brazil. METHODS: Vaccination coverage assessments modeled on a variation of PAHO's rapid house-to-house coverage monitoring methodology were conducted by Brazilian municipalities following mass immunization of adults and adolescents from August to December 2008. Results of monitoring assessments conducted in 3 658 (65.7%) of 5 564 municipalities were reported to Brazil's National Immunization Program. RESULTS: Information on vaccination against rubella was obtained from more than 1.5 million Brazilians (2.1% of the 70.1 million people targeted for immunization) during vaccination coverage monitoring. According to the assessment data, vaccination targets of 95% coverage were reached in 2 175 (59.5%) of the 3 658 municipalities that reported results. The percentage of municipalities that reached coverage targets was lower than administrative coverage estimates (number of vaccine doses administered divided by the immunization target population). These results informed targeted "mop-up" campaigns to reach unvaccinated populations. CONCLUSIONS: Rapid coverage monitoring implemented at the local level proved useful for deciding when to conclude vaccination activities and where to focus additional efforts to achieve desired coverage.