Local Knowedge and Citizenship: the communitarian health agents

Discussions about the new meaning of citizenship, valuing differences and respecting knowledge diversity bring the question of how public policies can be locally rooted to ensure access to diversity. This is evident when we deal with health policies, where the interaction between implementers and beneficiaries is essential to understand the results of the policy. The Family Health Program (FHP) has tried to change the relationship between state and society, bringing health professionals with the daily experienced by the users where there is (re) production of the components that lead to insecurity, poor health and disease. To analyse this kind of policy we must take into account the interaction processes and the practices of the actors involved in the FHP implementation. This article aims to analyze the role of Health Communitarian Agents (HCA) as FHP implementers. Through ethnographic research followed the practices of ACS in different cities, we seek to understand how they deal with their different knowledge, enable and disable referrals and adapt action to enact the program. We want to understand how they use mediations and interactions in their practices and built policies locally rooted, constructing alternative ways to implement these policies.

Local Injections of Adipose-Derived Mesenchymal Stem Cells Modulate Inflammation and Increase Angiogenesis Ameliorating the Dystrophic Phenotype in Dystrophin-Deficient Skeletal Muscle

The effects of adipose-derived mesenchymal stem cells (ADMSC) transplantation on degeneration, regeneration and skeletal muscle function were investigated in dystrophin-deficient mice (24-week-old). ADMSC transplantation improved muscle strength and, resistance to fatigue. An increase in fiber cross-sectional area and in the number of fibers with centralized nuclei and augment of myogenin content were observed. In ADMSC-treated muscles a decrease in muscle content of TNF-alpha, IL-6 and oxidative stress measured by Amplex(A (R)) reagent were observed. The level of TGF-beta 1 was lowered whereas that of VEGF, IL-10 and IL-4 were increased by ADMSC treatment. An increase in markers of macrophage M1 (CD11 and F4-80) and a decrease in T lymphocyte marker (CD3) and arginase-1 were also observed in ADMSCs-treated dystrophic muscle. No change was observed in iNOS expression. Increased phosphorylation of Akt, p70S6k and 4E-BP1 was found in dystrophic muscles treated with ADMSC. These results suggest that ADMSC transplantation modulates inflammation and improves muscle tissue regeneration, ameliorating the dystrophic phenotype in dystrophin-deficient mice.

Early transplantation of human immature dental pulp stem cells from baby teeth to golden retriever muscular dystrophy (GRMD) dogs: Local or systemic?

Background:The golden retriever muscular dystrophy (GRMD) dogs represent the best available animal model for therapeutic trials aiming at the future treatment of human Duchenne muscular dystrophy (DMD). We have obtained a rare litter of six GRMD dogs (3 males and 3 females) born from an affected male and a carrier female which were submitted to a therapeutic trial with adult human stem cells to investigate their capacity to engraft into dogs muscles by local as compared to systemic injection without any immunosuppression. Methods Human Immature Dental Pulp Stem Cells (hIDPSC) were transplanted into 4 littermate dogs aged 28 to 40 days by either arterial or muscular injections. Two non-injected dogs were kept as controls. Clinical translation effects were analyzed since immune reactions by blood exams and physical scores capacity of each dog. Samples from biopsies were checked by immunohistochemistry (dystrophin markers) and FISH for human probes. Results and Discussion We analyzed the cells' ability in respect to migrate, engraftment, and myogenic potential, and the expression of human dystrophin in affected muscles. Additionally, the efficiency of single and consecutive early transplantation was compared. Chimeric muscle fibers were detected by immunofluorescence and fluorescent in situ hybridisation (FISH) using human antibodies and X and Y DNA probes. No signs of immune rejection were observed and these results suggested that hIDPSC cell transplantation may be done without immunosuppression. We showed that hIDPSC presented significant engraftment in GRMD dog muscles, although human dystrophin expression was modest and limited to several muscle fibers. Better clinical condition was also observed in the dog, which received monthly arterial injections and is still clinically stable at 25 months of age. Conclusion Our data suggested that systemic multiple deliveries seemed more effective than local injections. These findings open important avenues for further researches.

The immediate effects of local and adjacent acupuncture on the tibialis anterior muscle: a human study

Abstract Background This study compares the immediate effects of local and adjacent acupuncture on the tibialis anterior muscle and the amount of force generated or strength in Kilogram Force (KGF) evaluated by a surface electromyography. Methods The study consisted of a single blinded trial of 30 subjects assigned to two groups: local acupoint (ST36) and adjacent acupoint (SP9). Bipolar surface electrodes were placed on the tibialis anterior muscle, while a force transducer was attached to the foot of the subject and to the floor. An electromyograph (EMG) connected to a computer registered the KGF and root mean square (RMS) before and after acupuncture at maximum isometric contraction. The RMS values and surface electrodes were analyzed with Student's t-test. Results Thirty subjects were selected from a total of 56 volunteers according to specific inclusion and exclusion criteria and were assigned to one of the two groups for acupuncture. A significant decrease in the RMS values was observed in both ST36 (t = -3.80, P = 0,001) and SP9 (t = 6.24, P = 0.001) groups after acupuncture. There was a decrease in force in the ST36 group after acupuncture (t = -2.98, P = 0.006). The RMS values did not have a significant difference (t = 0.36, P = 0.71); however, there was a significant decrease in strength after acupuncture in the ST36 group compared to the SP9 group (t = 2.51, P = 0.01). No adverse events were found. Conclusion Acupuncture at the local acupoint ST36 or adjacent acupoints SP9 reduced the tibialis anterior electromyography muscle activity. However, acupuncture at SP9 did not decrease muscle strength while acupuncture at ST36 did.

A Atuação de conselhos do meio ambiente na gestão ambiental local

A complexidade do desenvolvimento sustentável configura um paradigma em que são necessárias ações efetivas de gestão ambiental que, em última instância, têm relação com a formulação e a implementação de políticas públicas. Para que haja uma efetiva gestão ambiental no âmbito municipal é necessária a participação da sociedade nos processos de gestão. Logo, os conselhos municipais do meio ambiente são peças fundamentais na promoção da gestão ambiental local com vistas a uma melhor qualidade de vida. A literatura enfatiza que a efetividade dessas instâncias está ligada, principalmente, à sua estrutura e funcionamento. Assim sendo, essa pesquisa objetivou a identificação de oportunidades de melhoria na estrutura e no funcionamento do Conselho Municipal de Gestão e Saneamento Ambiental de Santo André (COMUGESAN) como uma contribuição para sua atuação na gestão ambiental. Para tanto, utilizou-se a pesquisa bibliográfica, documental e qualitativa, no ano de 2008, caracterizando-se como estudo de caso exploratório no Município de Santo André, SP. Observou-se que a atuação de Conselhos Municipais do Meio Ambiente na gestão ambiental transcende as ações de tomada de decisão, formulação e implementação das políticas locais, constituindo-se, sobretudo, como espaço educativo e de construção da cidadania. Como oportunidades de melhoria, identificaram-se seis aspectos primordiais a serem fortalecidos em sua atuação: estrutura; composição e representatividade; capacitação; educação em meio ambiente; informação; avaliação constante. Com os resultados obtidos, sugere-se que o COMUGESAN adote atividades de capacitação para aperfeiçoar a representatividade, instituindo cursos de formação de conselheiros e atividades em educação continuada, bem como a realização de diagnósticos internos.

The nature of extremely red galaxies in the local universe

We investigate the nature of extremely red galaxies (ERGs), objects whose colours are redder than those found in the red sequence present in colour–magnitude diagrams of galaxies. We selected from the Sloan Digital Sky Survey Data Release 7 a volume-limited sample of such galaxies in the redshift interval 0.010 < z < 0.030, brighter than Mr = −17.8 (magnitudes dereddened, corrected for the Milky Way extinction) and with (g − r) colours larger than those of galaxies in the red sequence. This sample contains 416 ERGs, which were classified visually. Our classification was cross-checked with other classifications available in the literature. We found from our visual classification that the majority of objects in our sample are edge-on spirals (73 per cent). Other spirals correspond to 13 per cent, whereas elliptical galaxies comprise only 11 per cent of the objects. After comparing the morphological mix and the distributions of Hα/Hβ and axial ratios of ERGs and objects in the red sequence, we suggest that dust, more than stellar population effects, is the driver of the red colours found in these extremely red galaxies.