A regionalização como instrumento de governança pública em saúde no estado do Paraná: análise dos vazios assistenciais como subsídio à ação do estado

Everyone has a right to health and the State’s duty is to provide it. SUS (unified health system) main principles are universalization, integrality and equality which are based on the decentralization, regionalization and hierarchization directives and shows the importance of a territorial perspective for planning healthcare actions. Decentralization was the strategy chosen to implant SUS, since municipalities were in charge of providing and organizing the municipal healthcare services. Nevertheless regionalization, that’s to say service, institution and practice integration, was not performed satisfactorily, thus jeopardizing the health system decision making process and causing disputes between municipalities over financial resources instead of developing an interdependent and cooperative net. This way, it is important to analyze if health regionalization has a good potential for being used as public governance tool. The present study aims at giving answers to the following research problem: What are the contributions of regionalism to the State of Paraná public governance applied to health? Besides that, it also aims at assessing the State of Parana health regionalization to identify healthcare gaps and help the State actions through public governance principles applied to healthcare. Therefore, the study used a quantitative-qualitative, exploratory and descriptive research, plus secondary data concerning bibliographic and documental research. The present study analyzed the current hospital bed distribution by compared to the ideal distribution allowing the identification of healthcare gaps in the regional healthcare centers, besides considering medical specialties in the State of Paraná. The study conclusion is that health regionalization is an important tool for reducing healthcare gaps concerning hospital beds permitting the use of seven to ten public governance principles applied to healthcare, as established in the present study, and shows health regionalization is an important pubic governance tool.

Avaliação do potencial de Tillandsia recurvata (L.) L., Bromeliaceae, como bioindicadora da poluição atmosférica urbana

Air pollution can threat the environment and public health, and is assess by pollutant ́s concentration measurements in order to verify whether the limits set by environmental agencies are being respected. However, these measures do not indicate immediately the impacts to living beings. To faced this problem, plants are been investigated as potential bioindicators of air pollution and, among them, stand out bromeliads Tillandsia genus which colonize various substrates,. obtaining water and nutrients from the atmosphere directly. In this context, this research assessed the potential of epiphytic bromeliad Tillandsia recurvata (L.) L. found in urbanized areas of the city of Curitiba - PR as a bioindicator of urban air pollution. According to vehicle traffic, five sample points were selected and classified. Points P1 and P2 were classified as high-traffic vehicle due presenting trucks and urban transport; point P3 was classified as moderate traffic due the predominance of private vehicles and urban transport; and points P4 and P5 were classified as low-traffic, presenting circulation of private vehicles only. There were analyzed the abundance of T. recurvata, morphophysiological parameters (leaf area, leaf specific area, sclerophylly index, percentage dry weight / fresh weight, chlorophyll (a + b), analysis of structural mesophyll organization) and the heavy metals accumulation (Fe, Cd, Cr, Cu, Pb and Zn). The abundance analysis and the results obtained for metals analysis were correlated with the intensity of vehicular traffic, directing the sampling points P1 > P2 = P3 > P4 = P5. This result demonstrate that the abundance of T. recurvata is greater in urban air pollution impacted areas, thus indicating that T. recurvata absorbs and accumulates metals and can be used in biomonitoring of urban air pollution in areas impacted by vehicular traffic. Morphophysiological parameters analyzed shows that the internal plant ́s structure is not significantly impacted by urban air pollution due plant ́s adptations. The presence of absorbing scales, the CAM metabolism pathway and it ́s store water ability, among other features, demonstrate their potential as bio-indicator in urban areas, especially regarding heavy metals accumulation .