Avaliação do cuidado na estratégia saúde da família em metrópoles do nordeste brasileiro

Objective: To evaluate the implementation of the Family Health Strategy (FHS) in Brazilian cities of the Northeast, expanding coverage, analyzing the progress, challenges and innovations. Methods: Multicentric Evaluation Research, Studies Baselines in urban centers, using as a case study method. Selected cases of Aracaju, being capital, advanced coverage with extended team, and Fortaleza, capital coverage incipient and minimal staff. In Fortaleza, purposive sample of 11 Units Primary (APS), 03 managers, 53 professionals and 109 users. In Aracaju, 09 units of APS, 02 managers, 36 professionals, and 90 users. Structured interviews for managers, and structured to professionals and users. Descriptive analysis focusing on the political and institutional dimensions, organization and comprehensive care. Results: There was consensus that the ESF is the preferred port users and acts as inducing changes in care. In the case of Fortaleza, the specificities were: care protocols and community activities aimed at chronic conditions (100%) , with greater participation of doctors and nurses (93%) ; conjunction with more complex services, but the teams reported difficulties with the examination center and experts, the long waits and poor access to local services were the main difficulties reported by users., As innovative practice, the therapeutic group of elderly caregivers mentioned by respondents; There was intersectoral initiatives and teams 87 % of users have participated in meetings about health problems. In the case of Aracaju, care protocols were directed to the lines of care and formulated locally, 85 % coverage of the population with FHS counterpart local financing; employees hired by public tender; 70 % of teams with expertise in public health center for continuing education acting; democratization in management; access technologies, welcoming and computerization in different integrated networks, and evaluation matrix. Conclusions: The ESF has promoted access to health care and inclusion of disadvantaged populations. Different perceptions and practices in the organization of care, with distinct trajectories of reorganization. In the case of Fortaleza, predominance of model programs valuing older, with evidence of advances in care practices and teamwork, but restricted to primary care practices and incipient in public policy perspective. In Aracaju, had network integration with technologies related to the family, in which the ESF is consolidated as public policy. It can be argued that the XII APS expanding coverage, exhibited efficacy, despite the challenges inherent to the different degrees of implementation

Estrutura genética populacional de Lutjanus analis cioba e Lutjanus jocu dentão (Lutjanidae) ao longo do litoral brasileiro

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Comportamento adaptativo de Lutzomyia longipalpis (Diptera: Psychodidae) às áreas urbanas da cidade de Teresina-PI.

The sand fly Lutzomyia longipalpis (Diptera: Psychodidae) is currently appointed as the main vector of visceral leishmaniasis in the Americas. The growth of cities in areas originally endemics to American Visceral Leishmaniasis (AVL) resulted in the spread of the disease at the same time that observed the adaptation of this species to the urban environment.Changes in behavior of L.longipalpis that enabled the adapt to increasing losings of biodiversity, as well as the frequent exposure of the vector to insecticides evident in urban areas, could justify the increasing population of the species and consequently the spread of disease for these environments .Thus, we selected sixty houses spread among three areas with increasing stages of occupation of an area endemic for AVL in Teresina-PI. We evaluated the correlation between the density of L.longipalpis captured and different aspects, such as population density of animals, vegetation cover and socio-economic aspects in each house. In addition to the correlations, the feeding preference of the vector between the predominant plant species in the neighborhoods, as well as the presence of metabolic mechanisms of resistance among the captured insects were tested. The results showed that over the growing occupations, represented by three areas, L.longipalpis demonstrate its adaptive nature through an apparent opportunistic behavior in relation to sources of carbohydrates and blood. On the evolutionary point of view, this behavior may have favored its vector competence in urban areas among the limited presence of food sources, as well as in various environments encountered.

Níveis de homocisteína e desempenho cognitivo em uma amostra populacional de idosos da cidade do Natal-RN

The imprecision of the frontier that separates those cognitive deficits inherent to the human physiological aging process from those which represent the early signs of nervous system degenerative pathologies ,very prevalent among the elderly, has brought attention to the need of studies aiming to establish clinical and/or laboratorial criteria to allow this differentiation. Elderly people living in poor and developing countries are frequently exposed to precarious socioeconomic conditions which facilitate the development of an array of pathologies which have metabolic and nutritional dysfunctions as the established or proposed etiological agents. The levels of certain micronutrients, such as the vitamins B12 and B9 (folic acid), and of some intermediary metabolites, such as homocysteine are being thought of as etiological factors and/or as biological markers of a group of alterations which affect the normal functioning of the nervous system with important reflexes upon cognitive performance. This study aims to investigate the influence of homocysteine, B12 vitamin and folic acid levels on the cognitive performance of the low income elderly population. This transversal study took place in Natal, Rio Grande do Norte State, Brazil, and involved 205 dwelling elderly people, users of the Programa de Saúde da Família, a public healthcare program, maintained by the city s health authorities. A multidimensional questionnaire was used to assess the socio-demographic aspects and the overall health and nutrition conditions. The cognitive performance was measured by the use of the Portuguese version of the Mini Mental State Exam (MMSE). The serum levels of homocysteine, B12 vitamin and folic acid were determined by chemiluminescence. The association between the socio-demographic and serum levels of Hcy, B12 vitamin and folic acid was determined by multiple linear regression. Serum levels higher than 13.5 μmol/l, indicative of hyperhomocysteinemia (HHcy), were found on 25.4% of the sample, being more prevalent in men (p<0.05). Deficitary levels of folic acid (<5ng/mol) and of B12 vitamin (<193 pg/ml) were found on 3.9% and 10.2% of the sample respectively. A negative correlation was found between cognitive performance with both age and HHcy and a positive correlation was found between cognitive performance and schooling. The isolated HHcy R2 values were an explanation to only 4% of the variance of the MMSE scores. However, when associated with schooling and age, this model explains about 25% of this association

Prevalência e fatores associados da síndrome de Osgood-Schlatter em uma amostra populacional de adolescentes brasileiros

Osgood-Schlatter (O-S) syndrome, a pathology of the musculoskeletal system, exhibits high incidence in adolescence, a phase of accelerated bone growth. Detection of physiopathological mechanisms that may cause disorders and dysfunctions in bone growth must be taken into account when planning physical activities, in order to promote normal physiological growth patterns. The aim of this epidemiological investigation was to identify and analyze the relationships between sociodemographic, anthropometric and clinical aspects and O-S. A cross-sectional design was used, with a representative sample of 956 subjects: 474 (49.6%) males and 482 (50.4%) females. Age range varied between 12 and 15 years (mean = 13.7±1.04). We used a battery of tests, previously applied in a pilot study, which met the aims of the investigation. Descriptive statistics (frequency, mean and standard deviation) were used and the odds ratio was calculated from bivariate and multivariate logistic regression (p<0.05). A prevalence of 9.8% was found (n = 94 cases): 11% males and 8.3% females. Hierarchized multivariate analysis showed a significant association between regular physical activities (OR= 1.94; CI 95%, 1.22-3.10) and shortening of the rectus femoris muscle (OR= 7.15; CI 95%, 2.86-17.86). The results may serve as a basis for therapeutic and prophylactic measures, in addition to increasing our knowledge of this syndrome in Brazilian adolescents. This investigation used a multidisciplinary approach, involving elements of anatomy, nutrition, physical education and physical therapy to elucidate the object under study related to Osgood-Schlatter syndrome

Rastreamento populacional para Doença de Gaucher em Tabuleiro do Norte-CE

Background. Gaucher Disease (GD) is a hereditary lysosomal storage disorder characterized by the accumulation of glucosylceramide, mainly in the cells of the reticuloendothelial system, due to a deficiency of the enzyme acid β-glucosidase (GBA). Diagnosis is usually based on measurement of GBA activity in peripheral leukocytes. The purpose of this study was to evaluate the ability of screening for GBA and chitotriosidase activity using Dried Blood Spots on Filter Paper (DBS-FP) to identify individuals at high risk for GD in high-risk populations such as that of Tabuleiro do Norte, a small town in Northeastern Brazil. Methods. Between June 1, 2007 and May 31, 2008, 740 consented residents and descendants of traditional families from Tabuleiro do Norte were submitted to screening with DBS-FP. Subjects with GBA activity <2.19 nmol/h/mL were referred to analysis of GBA and chitotriosidase activity in peripheral leukocytes and in plasma, respectively. Subjects at highest risk for GD (GBA activity in peripheral leukocytes <5.6 nmol/h/mg protein) were submitted to molecular analysis to confirm diagnosis. Results. Screening with DBS-FP identified 135 subjects (18.2%) with GBA activity <2.19 nmol/h/mL, 131 of whom remained in the study. In 10 of these (7.6%), GBA activity in leukocytes was 2.6 5.5 nmol/h/mg protein. Subsequent molecular analysis confirmed 6 cases of heterozygosity and 4 normals for GD. Conclusion. DBS-FP assay was shown to be an effective initial GD screening strategy for high-prevalence populations in developing regions. Diagnosis could not be established from GBA activity in leukocytes alone, but required confirmation with molecular analysis

Impacto da atividade física na qualidade de vida em mulheres de meia idade: estudo de base populacional

Conselho Nacional de Desenvolvimento Científico e Tecnológico

A mídia impressa sergipana nas eleições para governador em 2006: cobertura do Cinform, correio de Sergipe e jornal da cidade

The elections for governor in 2006 with its victory Marcelo Déda Workers Party (PT), were a landmark in the state of Sergipe, for the first time, called progressive fronts (an alliance of parties formed mostly by origin of the left) broke the hegemony of two political groups, Franco and the Alves, whose direction was in force for over 30 years. This study proceeds on the assumption that the print media has certain standards of conduct in covering the election period. Therefore, this study seeks to quantify, classify and compare data from three newspapers more representative of the State of Sergipe (Cinform, Cidade Journal and Correio de Sergipe) to analyze the behavior of these journals, such as private apparatus of hegemony in election coverage 2006. It also uses the concept of hegemony Gramsci and theories of journalism framing (Entman and Porto) and agenda setting (McCombs and Shaw) to identify these patterns

A guerra midiática contra a Venezuela de Hugo Chavez: a cobertura da revista veja (1998-2002)

A pretensão deste trabalho foi o de analisar o discurso da revista semanal Veja sobre o governo de Hugo Chávez Frías, atual presidente da República Bolivariana da Venezuela. Através da leitura das reportagens, procuramos apresentar o comportamento da revista em relação ao se governo e a forma que sua política é classificada, representada. Reunimos edições da revista, entre 1998 a 2002, início do seu governo - eleito em dezembro de 1998, toma posse no início de 1999, período da tentativa de golpe (frustrada) em abril de 2002. O trabalho procura mostrar como as matérias não são isentas e que há um claro posicionamento ideológico da revista, que se insere no conjunto mais geral da mídia conservadora e anti-Chávez. O presidente, eleito e reeleito democraticamente, aparece sempre nas diversas reportagens da revista caracterizado como golpista, ditador, populista, fanfarrão. O nosso objetivo é o de revelar como Veja criou uma imagem negativa do presidente da Venezuela, coerente com os princípios neoliberais defendidos pela revista. A Venezuela com Hugo Chávez, com a chamada Revolução Bolivariana , realiza uma experiência singular de governo num país de larga tradição antidemocrática e afirma caminhar na contracorrente do pensamento hegemônico neoliberal. Em contrapartida, a revista Veja se apresenta com um representante da burguesia financeira e importante sujeito na construção e continuidade do neoliberalismo

Envelhecimento populacional: um diagnóstico dos idosos institucionalizados, em Natal/RN

The aging process lived by the Brazilian population concurred to the transformation in the family models, causing difficulties related to the elderly care on the Family environment, a fact that is one of the main reasons for their institutionalization. Facing this scenario, the need of investigating how the elderly lives on the long-term facilities (ILPI) has aroused. In this study, it has been conducted an analysis of the populational aging process, contrasting the Rio Grande do Norte to Brazil and the Northeast Region, between 1980 to 2010. Faced with the realization of this process, and the rising number of long-term facilities for the elderly (ILPI), it was needed to make a rescue of the abiding laws regarding elderly institutionalization, on the scope of Natal, which surged after the 1988 Federal Constitution, checking what were the impacts on the assistance of the institutionalized elderly. Lastly, it were investigated the possible determinants associated with the institutionalization, in Natal-RN, considering the aspects of the family structure, family relationship, economic, health and well being of the elderly. The results showed that Rio Grande do Norte, particularly Natal, follows the national scene, since between 1980 and 2000 its population passed the intermediate level in the process of population aging for, in 2010, to be considered elderly. Throughout this process, it was observed that Natal has been adapting to the federal legislation, through the creation of the municipal policy, City Council and other relevant standards for the elderly, promoting significant changes in ILPI.However, philanthropic institutions needs better resources for their maintenance. In research with the elderly, it was found that although the majority of the elderly have declared themselves satisfied with life, they had indicators of impairment of functional capacity and cognitive, isolated social behavior and depression, affecting the life quality of these elderly. These results reflect the need for greater investment of public power in the drafting, implementation and monitoring of public policies aimed at promoting changes that raise the level of life quality of this segment of the population

Estrutura genética populacional de Heliconius erato e Heliconius melpomene (Lepidoptera: Nymphalidae) em fragmentos de Mata Atlântica do Rio Grande do Norte

Extensive studies using molecular markers on butterflies have shown how a highly fragmented landscape may result in the reduction of gene flow among patches of habitat and, consequently, increase genetic differentiation among populations. However, little is known about Heliconius geographical structure and the effects of fragmentation on the connectivity of populations. Furthermore, findings on the effects of the population structure on the dynamics of mimicry evolution in Heliconius butterflies need to be tested in H. erato and H. melpomene specimens found in other locations other than Central and northern South Americas. For the present study, we had two motivations: (1) compare the population structure of H. erato and H. melpomene given the highly fragmented Brazil s Atlantic Forest habitat; and (2) studying population structure of co-mimics could give us insights into the dynamics of mimicry evolution. For this, we analysed the spatial structure and connectivity of eight populations of Heliconius butterflies, in a total of 137 H. erato specimens and 145 H. melpomene specimens, using nine microsatellites loci, 1144 AFLPs markers and 282 mitochondrial DNA sequences. In general, both species exhibited evidence of population subdivision but no isolation by distance indicating some extent of genetic differentiation among populations. Contrary to Kronforst & Gilbert s (2008) Costa Rican Heliconius, H. melpomene exhibited more genetic differentiation than H. erato based on nuclear markers. However, for mitochondrial DNA, H. erato populations showed more genetic differentiation than H. melpomene. Our results corroborate to other studies on Heliconius butterflies concerning the pronounced population subdivision and local genetic drift found in this genus. Nevertheless, the pattern of this differentiation varies significantly from the pattern found in studies conducted in Central America, where H. erato is generally more differentiated and structured than H. melpomene, based on nuclear markers. This different pattern may reflect different evolutionary histories of Heliconius species in Northeastern Brazil s Atlantic Forest

Biologia populacional comparada de duas espécies de heliconius (Lepidoptera: Nymphalidae) em um ambiente sazonal de floresta atlântica do nordeste brasileiro

Tropical environments often face strong seasonal variations in climate, such as alternate periods of dry and rain, that may often be important influence in the annual X the organisms lives. Here we assess how population dynamics of two butterfly species (Heliconius erato and Heliconius mepomene) respond to environmental and seasonal variations. A mark-release-recapture study carried out in an Atlantic forest reserve, 15 Km from Natal, Rio Grande do Norte, Brazil, for 3 years, during the dry and rainy season, with three visits weekly done. Information such as species, wing lenght, site of capture, pollen load and phenotype (number of spots) (in H. erato only) were noted for each capture. Seasonal variation exists in capture rates of the two species, with great capture rates during the rainy season. Despite finding differences in the mean density of individuals of the two species among the different collection areas, this difference was only significant between floodplain and central areas, and no influence of seasonality was observed in the mean density between the areas. Seasonality in wing size was only observed for H. erato, with larger wings during the rainy season. Females carried larger pollen loads than males both species, but species were similar. Only males differed seasonally, with larger pollen loads during the rainy season. The distribution of the number of wing spots did not vary between the dry and rainy seasons, and the number of spots in males and females was similar. Therefore, we conclude that there was a strong influence of seasonal variation in the population dynamic of the two Heliconius species, as well as in several aspects of their biology

Estrutura populacional e aspectos reprodutivos do Octopus insularis Cephalopodas: Octopodidae: implicações para o manejo da pesca de polvo no município de Rio de Fogo-RN

In northeastern Brazil, Octopus insularis is the most commercially important cephalopod species and its capture has been performed for several years by the lobster fishermen in the region. In order to obtain information about the reproductive biology, 1108 specimens were collected between November 2009 and September 2011 in the landings and fish markets of Rio do Fogo (RN). For each specimen the mantle length (CM) and total fresh weight (PT) were recorded. Gonads of 264 males and 295 females were examined macroscopically and histologically to assess sexual maturation and determine reproductive indices. Four reproductive stages were determined for males (immature, maturing, mature and post-mature) and females (immature, early maturing, late maturing and mature). The average of eggs recorded in the female s gonads was 93.820 and 39 was the average of spermatophores found in male Needham s complex. Spermathecae with sperm were found in females with 69 mm CM (immature). Males and females become sexually mature at 64.41 and 98.50 mm of CM, respectively. The weight at sexual maturity was 270 g for males and 630 g for females. The values of the size and weight at sexual maturity found in this study show that males mature at smaller sizes than females. For both sexes the maturation peaks occurred in February and November 2010 and also in September 2011. The periods of maximum reproductive activity lasted about 3 months and it seems to occur every 7 10 months. Only one spent female (stage V) was found and the number of mature females was low. Presumably, mature females migrate to deep waters with complex habitat to protect the offspring, indicating that fishery by snorkeling with maximum depth of 15 meters is not reaches this part of the stock. Finally, it is noticeable the importance of the establishment of management strategies for the exploitation of O. insularis different of the ones used for O. vulgaris, once the species have distinct biological features

Avaliação da cobertura e monitoramento do branqueamento de corais nos

Coral bleaching has been increasingly the focus of research around the world since the early 1980s, when it was verified to be increasing in frequency, intensity and amount of areas affected. The phenomenon has been recorded since 1993, associated with elevation of the sea surface temperature due to El Niños and water thermal anomalies, according to most reports around the world. On the coast of Rio Grande do Norte, Brazil, a mass coral bleaching event was recorded in the Environmental Protection Area of Coral Reefs (APARC) during March and April 2010, when the water temperature reached 34°C for several days. About 80% of the corals in Maracajaú reef-complex exhibited partial or total bleaching. The aims of this study were to verify representativeness of coral coverage and how the bleaching dynamic has developed among different species. Coral coverage was estimated according to Reef Check Brazil protocol associated with quadrant method, and bleaching was evaluated from biweekly visual surveys in 80 colonies of Favia gravida, Porites astreoides, Siderastrea stellata and Millepora alcicornis. At the same time temperature, pH, salinity and horizontal transparency, as well as mortality and disease occurrence were monitored. Analysis of variance and Multiple Regression from the perspective of time lag concept were used to evaluate the bleaching dynamics among species and the relationship between variation of means of bleaching and variations of abiotic parameters, respectively. Species showed significant differences among themselves as to variation of means of bleaching over time, but the dynamic of variation exhibited similar patterns

Sobrevivência e tamanho populacional do Tiê-preto Tachyphonus Rufus (aves: thraupidae) em fragmento de restinga no extremo Norte da Mata Atlântica

For a long time, we believed in the pattern that tropical and south hemisphere species have high survival. Nowadays results began to contradict this pattern, indicating the need for further studies. Despite the advanced state of the study of bird population parameters, little is known about their variation throughout the year and the factors affecting them. Reproduction, for example, is one factor that may alter adult survival rates, because during this process the breeding pair allocates resources to maintain itself to maintain offspring, making itself more susceptible to diseases and predation. The aim of this study was to estimate survival and population size of a Central and South America passerine, Tachyphonus rufus (Boddaert, 1783), testing hypotheses about the factors that define these parameters. We performed data collection between Nov/2010 and ago/2012 in 12 ha plot, in a fragment of Atlantic Forest in northeastern Brazil. We used capture-mark-recapture methods to generate estimates using Closed Design Robust model in the program MARK. We generated Multi-state models to test some assumptions inherent to Closed Robust Design. The influence of co-variables (time, rain and reproductive cycle) and the effect of transient individuals were measured. Capture, recapture and apparent survival parameters were defined by reproductive cycle, while temporary dispersal was influence by rain. The estimates showed a higher apparent survival during the non-breeding period (92% ± 1%) than during breeding (40% ± 9%), revealing a cost of reproduction and suggesting a trade-off between surviving and reproducing. The low annual survival observed (34%) did not corroborate the pattern of high rates expected for a tropical bird. The largest population size was estimated to be 56 individuals in Nov/11, explained by high recruitment of juveniles, while the lowest observed in May/12: 10 individuals, probably as a result of massive influx of competitor species. Results from this study add to the growing literature on life history of Neotropical species. We encourage studies like this especially in Brazil, where there are few information, and suggest that covariates related to habitat quality and environmental changes should be tested, so that we can generate increasingly reliable models