O difícil acesso a serviços de média complexidade do SUS: o caso da cidade de São Paulo, Brasil

O acesso aos serviços de média complexidade tem sido apontado, por gestores e pesquisadores, como um dos entraves para a efetivação da integralidade do SUS. Este artigo teve o objetivo de avaliar mecanismos utilizados pela gestão do SUS, no município de São Paulo, para garantir acesso à assistência de média complexidade, durante o período de 2005 a 2008. Optou-se pela estratégia de estudo de caso, utilizando as seguintes fontes de evidência: entrevistas com gestores; grupo focal com usuários e observação participante. Utilizouas técnica de análise temática, a partir do referencial teórico da integralidade da assistência, na dimensão da organização de serviços. Buscou-se descrever os caminhos percorridos pelos usuários para acessar os serviços da média complexidade, a partir da visão dos gestores e dos próprios usuários. A média complexidade foi identificada, pelos gestores, como o "gargalo" do SUS e um dos principais obstáculos para a construção da integralidade. Para enfrentar essa situação, o gestor municipal investiu na informatização dos serviços, como medida isolada e, ainda, sem considerar a necessidade dos usuários. Sendo assim, essa incorporação tecnológica teve pouco impacto na melhoria do acesso, o que se confirmou no relato dos usuários. Discute-se que para o enfrentamento de um problema tão complexo são necessárias ações articuladas, tanto no âmbito da política de saúde, quanto da organização dos serviços, bem como a (re)organização do processo de trabalho em todos os níveis do sistema de saúde.

Associação entre prática de atividade física, escolaridade e perfil alimentar de motoristas de caminhão

A demanda da sociedade moderna intensificou o trabalho ininterrupto em diversas profissões. Além disso, o modo de organização da sociedade, com atividades predominantemente mecanizadas, tem contribuído para a prevalência de hábitos de vida não saudáveis, como a inatividade física. Este estudo objetiva verificar se fatores ocupacionais, sociodemográficos, antropométricos e alimentares estão associados à prática de atividade física insuficiente e se há diferenças nessa associação entre motoristas de caminhão que trabalham de dia ou à noite. Participaram da pesquisa 470 motoristas de caminhão, que responderam a questionários de dados sociodemográficos, atividade física e frequência alimentar. Foi realizada uma regressão logística univariada para verificar a associação entre atividade física insuficiente e as demais variáveis. Além disso, a regressão logística múltipla foi testada para obter modelos que mostrem a associação de conjuntos de variáveis relacionados à atividade física insuficiente. Os resultados indicaram que a prática de atividade física está associada ao maior nível de escolaridade (OR = 1,84; IC = 1,22-2,76) e menor consumo de bebidas alcoólicas (OR = 1,59; IC = 1,04-2,45). Maior ingestão de cereais integrais (OR = 1,63; IC = 1,08-2,46) foi associada à prática regular de atividade física. Entre os trabalhadores noturnos, foi encontrada associação entre a prática regular de atividade física, maior consumo de cereais integrais (OR = 2,02; IC =1,13-3,60) e menor consumo de carboidratos simples (OR = 1,91; IC = 1,08-3,37).

Neurotoxicity and aggressiveness triggered by low-level lead in children: a review

Lead-induced neurotoxicity acquired by low-level long-term exposure has special relevance for children. A plethora of recent reports has demonstrated a direct link between low-level lead exposure and deficits in the neurobehavioral-cognitive performance manifested from childhood through adolescence. In many studies, aggressiveness and delinquency have also been suggested as symptoms of lead poisoning. Several environmental, occupational and domestic sources of contaminant lead and consequent health risks are largely identified and understood, but the occurrences of lead poisoning remain numerous. There is an urgent need for public health policies to prevent lead poisoning so as to reduce individual and societal damages and losses. In this paper we describe unsuspected sources of contaminant lead, discuss the economic losses and urban violence possibly associated with lead contamination and review the molecular basis of lead-induced neurotoxicity, emphasizing its effects on the social behavior, delinquency and IQ of children and adolescents

O difícil acesso a serviços de média complexidade do SUS

O acesso aos serviços de média complexidade tem sido apontado, por gestores e pesquisadores, como um dos entraves para a efetivação da integralidade do SUS. Este artigo teve o objetivo de avaliar mecanismos utilizados pela gestão do SUS, no município de São Paulo, para garantir acesso à assistência de média complexidade, durante o período de 2005 a 2008. Optou-se pela estratégia de estudo de caso, utilizando as seguintes fontes de evidência: entrevistas com gestores; grupo focal com usuários e observação participante. Utilizouas técnica de análise temática, a partir do referencial teórico da integralidade da assistência, na dimensão da organização de serviços. Buscou-se descrever os caminhos percorridos pelos usuários para acessar os serviços da média complexidade, a partir da visão dos gestores e dos próprios usuários. A média complexidade foi identificada, pelos gestores, como o "gargalo" do SUS e um dos principais obstáculos para a construção da integralidade. Para enfrentar essa situação, o gestor municipal investiu na informatização dos serviços, como medida isolada e, ainda, sem considerar a necessidade dos usuários. Sendo assim, essa incorporação tecnológica teve pouco impacto na melhoria do acesso, o que se confirmou no relato dos usuários. Discute-se que para o enfrentamento de um problema tão complexo são necessárias ações articuladas, tanto no âmbito da política de saúde, quanto da organização dos serviços, bem como a (re)organização do processo de trabalho em todos os níveis do sistema de saúde

Circulation of antibodies against yellow fever virus in a simian population in the area of Porto Primavera hydroeletric plant, São Paulo, Brazil

A febre amarela (FA) é doença infecciosa aguda de origem viral transmitida por mosquitos. No ciclo silvestre, o vírus é mantido por meio da infecção de macacos e da transmissão transovariana nos vetores. A vigilância sobre populações de primatas não humanos torna-se necessária para detectar a circulação viral, quando ainda está restrito a epizootias, e para determinar sua presença em regiões indenes ou de transição para a doença. Padronizou-se a técnica ELISA (Enzyme Linked Immunosorbent Assay) para determinar a prevalência de anticorpos da classe IgG contra o vírus da FA em soros de bugios (Alouatta caraya) da região do reservatório da Usina Hidrelétrica de Porto Primavera, SP. Foram testados soros de 570 macacos sendo que nenhuma amostra mostrou-se reativa para a presença de anticorpos contra o vírus da FA. Os resultados são coerentes com a epidemiologia da FA na região. Mesmo sendo área de transição, não se conhece, até o momento, ocorrência de epizootia ou surto de FA em humanos e investigações entomológicas não apontaram a presença de vetores para esta arbovirose. A técnica mostrou-se sensível, rápida e útil à vigilância epidemiológica como instrumento de busca ativa permitindo desencadear ações preventivas, como vacinação, antes mesmo do surgimento de epizootias

Deep plant-derived carbon storage in Amazonian podzols

Equatorial podzols are soils characterized by thick sandy horizons overlying more clayey horizons. Organic matter produced in the topsoil is transferred in depth through the sandy horizons and accumulate at the transition, at a depth varying from 1 to more than 3 m, forming deep horizons rich in organic matter (Bh horizons). Although they cover great surfaces in the equatorial zone, these soils are still poorly known. Studying podzols from Amazonia, we found out that the deep Bh horizons in poorly drained podzol areas have a thickness higher than 1m and store unexpected amounts of carbon. The average for the studied area was 66.7 +/- 5.8 kgCm(-2) for the deep Bh and 86.8 +/- 7.1 kgCm(-2) for the whole profile. Extrapolating to the podzol areas of the whole Amazonian basin has been possible thanks to digital maps, giving an order of magnitude around 13.6 +/- 1.1 PgC, at least 12.3 PgC higher than previous estimates. This assessment should be refined by additional investigations, not only in Amazonia but in all equatorial areas where podzols have been identified. Because of the lack of knowledge on the quality and behaviour of the podzol organic matter, the question of the feedback between the climate and the equatorial podzol carbon cycle is open.

DESCRIPTION OF THE IMMATURES OF WORKERS OF THE ANT CAMPONOTUS VITTATUS (HYMENOPTERA: FORMICIDAE)

Camponotus vittatus Forel is a poorly studied Neotropical ant, which is very common in Brazil. Larval descriptions are useful to systematics, as larval characters aid with genus-level differentiation, and ant larvae lie at the basis of ant social organization. This study presents the first description of the immatures of C. vittatus with the aid of light and scanning electron microscopy. There are three instars based on the frequency distribution of larval head widths. The larvae had some characteristics typical of Camponotus, specifically, a 'pogono-myrmecoid' body shape, 10 pairs of spiracles, antennae with 3 sensilla, mature larvae with pronounced labial pseudopalps, and conspicuous 'chiloscleres' on the labrum. Unique characteristics found would include the greatest diversity of body hair types recorded in an ant larva and 'camponotoid' mandibles with 6 medial denticles over the blade. The number of antennal sensilla proved variable.

Practice of walking and its association with perceived environment among elderly Brazilians living in a region of low socioeconomic level

Background: The aim of this study was analyze associations between the practice of walking and environmental perception among elderly Brazilians in a region of low socioeconomic level. Methods: A cross-sectional study was conducted among 385 elderly people aged 60 years and over. To evaluate walking, the International Physical Activity Questionnaire (IPAQ), long version (leisure and transport modules) was used. The environment was evaluated by means of the Neighborhood Environmental Walkability Scale (NEWS) (adapted Brazilian version). For the statistical analysis, multiple logistic regression models were created separately for men and women. The practice of at least 150 minutes a week of walking was the dependent variable, and the variables of environmental perception were the independent variables. All the models were controlled for schooling level and age. Results: The proportion of elderly people active in walking was 56.9% for the men and 26.4% for the women. The perception of the presence of soccer fields (OR = 4.12) and their proximity, within ten minutes' walk from home (OR = 3.43), were associated with the practice of walking among the men. The perception of the presence of public squares (OR = 4.70) and the proximity of primary healthcare units, within ten minutes' walk from home (OR = 3.71), were associated with the practice of walking among the women. An association with adequate perception of vehicle traffic remained at the threshold of significance for the women. Conclusion: Accessibility of leisure structures such as football fields and public squares and of health services such as primary healthcare units were important environmental variables associated with the practice of walking among elderly people living in a region of low socioeconomic level in Brazil. These variables need to be taken into consideration when aiming to promote the practice of walking among elderly people living in similar regions.

Convergence of developmental mutants into a single tomato model system: 'Micro-Tom' as an effective toolkit for plant development research

Background: The tomato (Solanum lycopersicum L.) plant is both an economically important food crop and an ideal dicot model to investigate various physiological phenomena not possible in Arabidopsis thaliana. Due to the great diversity of tomato cultivars used by the research community, it is often difficult to reliably compare phenotypes. The lack of tomato developmental mutants in a single genetic background prevents the stacking of mutations to facilitate analysis of double and multiple mutants, often required for elucidating developmental pathways. Results: We took advantage of the small size and rapid life cycle of the tomato cultivar Micro-Tom (MT) to create near-isogenic lines (NILs) by introgressing a suite of hormonal and photomorphogenetic mutations (altered sensitivity or endogenous levels of auxin, ethylene, abscisic acid, gibberellin, brassinosteroid, and light response) into this genetic background. To demonstrate the usefulness of this collection, we compared developmental traits between the produced NILs. All expected mutant phenotypes were expressed in the NILs. We also created NILs harboring the wild type alleles for dwarf, self-pruning and uniform fruit, which are mutations characteristic of MT. This amplified both the applications of the mutant collection presented here and of MT as a genetic model system. Conclusions: The community resource presented here is a useful toolkit for plant research, particularly for future studies in plant development, which will require the simultaneous observation of the effect of various hormones, signaling pathways and crosstalk.

Gene expression profile of the plant pathogen Fusarium graminearum under the antagonistic effect of Pantoea agglomerans

The pathogenic fungus Fusarium graminearum is an ongoing threat to agriculture, causing losses in grain yield and quality in diverse crops. Substantial progress has been made in the identification of genes involved in the suppression of phytopathogens by antagonistic microorganisms; however, limited information regarding responses of plant pathogens to these biocontrol agents is available. Gene expression analysis was used to identify differentially expressed transcripts of the fungal plant pathogen F. graminearum under antagonistic effect of the bacterium Pantoea agglomerans. A macroarray was constructed, using 1014 transcripts from an F. graminearum cDNA library. Probes consisted of the cDNA of F. graminearum grown in the presence and in the absence of P. agglomerans. Twenty-nine genes were either up (19) or down (10) regulated during interaction with the antagonist bacterium. Genes encoding proteins associated with fungal defense and/or virulence or with nutritional and oxidative stress responses were induced. The repressed genes coded for a zinc finger protein associated with cell division, proteins containing cellular signaling domains, respiratory chain proteins, and chaperone-type proteins. These data give molecular and biochemical evidence of response of F. graminearum to an antagonist and could help develop effective biocontrol procedures for pathogenic plant fungi.

In silico analysis of Simple Sequence Repeats from chloroplast genomes of Solanaceae species

The availaibilty of chloroplast genome (cpDNA) sequences of Atropa belladonna, Nicotiana sylvestris, N tabacum, N tomentosiformis, Solanum bulbocastanum, S lycopersicum and S tuberosum, which are Solanaceae species, allowed us to analyze the organization of cpSSRs in their genic and intergenic regions In general, the number of cpSSRs in cpDNA ranged from 161 in S tuberosum to 226 in N tabacum, and the number of intergenic cpSSRs was higher than genic cpSSRs The mononucleotide repeats were the most frequent in studied species, but we also identified di-, tri-, tetra-, penta- and hexanucleotide repeats Multiple alignments of all cpSSRs sequence from Solanaceae species made the identification of nucleotide variability possible and the phylogeny was estimated by maximum parsimony Our study showed that the plastome database can be exploited for phylogenetic analyses and biotechnological approaches

AtPIN: Arabidopsis thaliana Protein Interaction Network

Background: Protein-protein interactions (PPIs) constitute one of the most crucial conditions to sustain life in living organisms. To study PPI in Arabidopsis thaliana we have developed AtPIN, a database and web interface for searching and building interaction networks based on publicly available protein-protein interaction datasets. Description: All interactions were divided into experimentally demonstrated or predicted. The PPIs in the AtPIN database present a cellular compartment classification (C(3)) which divides the PPI into 4 classes according to its interaction evidence and subcellular localization. It has been shown in the literature that a pair of genuine interacting proteins are generally expected to have a common cellular role and proteins that have common interaction partners have a high chance of sharing a common function. In AtPIN, due to its integrative profile, the reliability index for a reported PPI can be postulated in terms of the proportion of interaction partners that two proteins have in common. For this, we implement the Functional Similarity Weight (FSW) calculation for all first level interactions present in AtPIN database. In order to identify target proteins of cytosolic glutamyl-tRNA synthetase (Cyt-gluRS) (AT5G26710) we combined two approaches, AtPIN search and yeast two-hybrid screening. Interestingly, the proteins glutamine synthetase (AT5G35630), a disease resistance protein (AT3G50950) and a zinc finger protein (AT5G24930), which has been predicted as target proteins for Cyt-gluRS by AtPIN, were also detected in the experimental screening. Conclusions: AtPIN is a friendly and easy-to-use tool that aggregates information on Arabidopsis thaliana PPIs, ontology, and sub-cellular localization, and might be a useful and reliable strategy to map protein-protein interactions in Arabidopsis. AtPIN can be accessed at http://bioinfo.esalq.usp.br/atpin.

CHARACTERIZATION OF MICROSATELLITE LOCI IN HIMATANTHUS DRASTICUS (APOCYNACEAE), A MEDICINAL PLANT FROM THE BRAZILIAN SAVANNA

Premise of the study: We developed a new set of microsatellite markers for studying the genome of the janaguba tree, Himatanthus drasticus (Mart.) Plumel, which is used in folk medicine in northeastern Brazil. These novel markers are being used to evaluate the effect of harvesting on the genetic structure and diversity of natural populations of this species. Methods and Results: Microsatellite loci were isolated from an enriched H. drasticus genomic library. Nine primer pairs successfully amplified polymorphic microsatellite regions, with an average of 8.5 alleles per locus. The average values of observed and expected heterozygosity were 0.456 and 0.601, respectively. Conclusions: The microsatellite markers described here are valuable tools for population genetics studies of H. drasticus. The majority of the primers also amplified sequences in the genome of another species of the same genus. This new set of markers may be useful in designing a genetic conservation strategy and a sustainable management plan for the species.

Coleópteros coletados com armadilhas luminosas e etanólicas em plantio de Eucalyptus spp. no sul do Rio Grande do Sul

The objective of this study was to collect, identify and study population fluctuation of Coleoptera species in a forest of Eucalyptus spp., on a farm in the municipality of Pinheiro Machado, Rio Grande do Sul State. Insects were collected with light traps and ethanol traps, once every fifteen days, in the period of February 2006 to October 2007. The insects, after selection procedures, were identified based on entomological collections and specialized literature. A total of 6172 individuals were collected and distributed among 40 families and 249 species, of which 130 were identified at the species level and 119 at the family level, representing 4498 and 1674 of total individuals collected, respectively. Cyclocephala sp. 1, Cyclocephala sp. 2, Dyscinetus sp. 1, Euetheola humilis (Scarabaeidae) and Neoclytus curvatus (Cerambycidae) were the most abundant species, representing 49.28% of the individuals identified in genus and/or species. Scarabaeidae presented the highest number of individuals (2588), distributed in 37 species. The families Cerambycidae (47) and Scolytidae (40) presented the largest number of species. Individuals of Coleoptera were trapped at all collections but the largest number of individuals was trapped in December 2006 and March 2007.