Interdependência entre os níveis de atenção do Sistema Único de Saúde (SUS): significado de integralidade apresentado por trabalhadores da Atenção Primária

Integrality constitutes an important principle of the SUS, achieved through the struggles of the Brazilian health movement. It represents an expansion of the concepts of health and illness, to include the social determinants of healthcare needs. Intending to investigate the meanings of integrality reported by primary care workers, a study was developed in a medium-sized municipality in the state of São Paulo, concerning distinct technological work organization models in primary healthcare units. Among the results, the dimension of system integrality appeared with greatest frequency, according to analysis on focus groups. The workers pointed out difficulties in integration and communication between the healthcare levels, determined by selective social policies and medium/high-technology services delegated to the private market. The theoretical-philosophical framework of this study was based on cultural-historical psychology, taking into consideration the categories of work/activity, consciousness, mediation and totality.

Relationship between bone ageand pubertal breast stage to bone biomarkers and bone mineral density in healthy brazilian female adolescents

Background and Aims Bone metabolism involves understanding many factors, especially during puberty, when bone turnover is significant and the bone mass peak must be achieved as a protective factor of future bone health. The objective was to evaluate the behavior of formation and resorption bone biomarkers (BB) in function of biological maturation in female adolescents.Methods Evaluation of formation and resorption BB, osteocalcin (OC), bone alkaline phosphatase (BAP) and carboxyterminal telopeptide (S-CTx) by correlating them with bone mineralization, bone age and pubertal development in healthy female adolescents. Seventy-two volunteers were subdivided into groups according to chronological age/bone age (BA): 10 11 years (n=12), 12 13 years (n=16), 14 15 years (n=15) and 16 19 years (n=29). The following were evaluated: weight (kg), height (m), BMI (kg/m2), calcium intake (3-day 24h food recalls (mg/day), puberty events (Tanner stages), serum OC (ng/mL), BAP (U/L), S-CTx (ng/mL) and bone mineral density (BMD) as calculated by DXA (g/cm2) in the spine (L1-L4), proximal femur and whole body. The project was approved by the UNESP Ethics Committee.Results BB showed similar behaviors, with higher mean values for 10 12 years and when adolescents were in the B2-B3 Pubertal Maturation Stage (B2: BAP=110.16 U/L, OC=33.81ng/mL, S-CTx=1.66 ng/mL and B3: BAP=136.50 U/L, OC=39.15ng/mL and S-CTx=1.88 ng/mL; p<0.001). Mean BB values decreased with advancing BA and pubertal maturity.Conclusions BB values showed parallelism with peak height velocity and significant negative correlation with BMD in the different evaluated sites, with chronological and BA ; higher BMD values correlated with lower bone biomarker values.

Análise do conflito do uso e ocupação da terra em área de preservação permanente através do SIG

This study aimed to map the classes of use and occupation and their conflicts in Areas of Permanent Preservation (APPs) in the basin of Ribeirão São Pedro - Botucatu (SP) with the use of remote sensing techniques - image obtained by satellite 2011 - and the use of GIS. For this, we used the GIS techniques, and the integration of information held in the Geographic Information System (GIS) - IDRISI, coupled with the use of digital maps, published by the Brazilian Institute of Geography and Statistics - IBGE, scale 1: 50,000 and satellite images LANDSAT - 5 (2011) sensor TM (Thematic Mapper) with spatial resolution of 30 x 30 meters, provided by the National Institute for Space Research (INPE) .The Geographic Information System (GIS) was used IDRISI Selva and software, CartaLinx. This work had as legal support environmental legislation, specifically, the Federal Law 12.651 / 12. Thus, the study of the watershed becomes an important tool to understand its dynamics in relation to the use and occupation of their area and to characterize their environmental problems and taking as legal counsel to the preservation and conservation of the land to support environmental legislation.

Acessibilidade e resolutividade em assistência oftalmológica para o SUS

Pós-graduação em Bases Gerais da Cirurgia - FMB