Avaliação da qualidade da assistência no programa de AIDS: questões para a investigação em serviços de saúde no Brasil

O artigo mostra o desenvolvimento de uma pesquisa que objetivou avaliar a qualidade da assistência ambulatorial do Programa Brasileiro de DST/ AIDS. A investigação, realizada entre 2001-2003, envolveu três projetos: uma análise do padrão tecnológico da assistência realizada em cinco serviços, uma avaliação qualitativa em 27 serviços e, finalmente, uma avaliação estruturada de 322 serviços de sete estados brasileiros. Mediante a descrição de todas as etapas dos projetos, as autoras discutem questões teóricas e metodológicas envolvidas na avaliação da assistência em programas de saúde. Discutem ainda algumas questões relacionadas à aplicabilidade e ao impacto das avaliações em serviços de saúde.

Distribuição do caranguejo Hepatus pudibundus (Herbst, 1785) (Crustacea, Decapoda, Brachyura) na Enseada da Fortaleza, Ubatuba (SP), Brasil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação da estrutura organizacional da assistência ambulatorial em HIV/Aids no Brasil

OBJETIVO: No contexto de acesso universal à terapia antiretroviral, os resultados do Programa de Aids dependem da qualidade do cuidado prestado. O objetivo do estudo foi avaliar a qualidade do cuidado dos serviços ambulatoriais que assistem pacientes de Aids. MÉTODOS: Estudo realizado em sete Estados brasileiros, em 2001 e 2002. Foi avaliada a qualidade do atendimento a pacientes com Aids quanto à disponibilidade de recursos e a organização do trabalho de assistência. Um questionário com 112 questões estruturadas abordando esses aspectos, foi enviado a 336 serviços. RESULTADOS: A taxa de resposta foi de 95,8% (322). Os indicadores de disponibilidade de recursos mostram uma adequação maior do que os indicadores de organização do trabalho. Não faltam antiretrovirais em 95,5% dos serviços, os exames de CD4 e Carga Viral estão disponíveis em quantidade adequada em 59 e 41% dos serviços, respectivamente. em 90,4% dos serviços há pelo menos um profissional não médico (psicólogo, enfermeiro ou assistente social). Quanto à organização, 80% não agendavam consulta médica com hora marcada; 40,4% agendavam mais que 10 consultas médicas por período; 17% não possuíam gerentes exclusivos na assistência e 68,6% não realizavam reuniões sistemáticas de trabalho com a equipe. CONCLUSÕES: Os resultados apontam que além de garantir a distribuição mais homogênea de recursos, o programa precisa investir no treinamento e disseminação do manejo do cuidado, conforme evidenciado nos resultados da organização de trabalho.

Distribuição do macrozoobentos na coluna vertical dos sedimentos da região estuarina de Cananéia (SP), Brasil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

O Programa UNI no Brasil: uma avaliação da coerência no seu processo de formulação e implementação

O estudo avaliou a coerência do ideário do Programa UNI, em três projetos no Brasil, analisando a relação entre Propósitos, Métodos e Organização, à luz do Postulado de Coerência de Mario Testa. Bibliografia sobre o Programa UNI e entrevistas com doze atores do seu processo, agrupados como Formuladores do Programa UNI, Diretores de Projetos UNI e Avaliadores, compuseram o material empírico. Este foi recortado, sistematizado e analisado segundo categorias analíticas de determinação, condicionamento, sujeito coletivo e paradigma e segundo categorias empíricas de propósito, método e organização. Evidenciou-se uma formulação idealizada do espaço real de operacionalização dos Projetos e a presença de linhas de determinação e condicionamento construídas, dialeticamente, no espaço concreto de atuação dos atores e na relação entre sujeito e objeto, algumas vezes, em sentido contrário ao que previamente se supôs na formulação do Programa. A investigação conseguiu identificar movimentos de mudanças nas realidades dos Projetos UNI, tanto na universidade, como nos serviços de saúde e comunidade. As limitações presentes no referencial teórico funcionalista, adotado na formulação inicial do Programa e na pouca valorização dada às linhas de condicionamento ou determinação que partem das organizações podem ser apontadas como explicações para o não alcance de sua eficácia plena.

Oferta e distribuição de estágio supervisionado em cursos de odontologia do estado de Minas Gerais, Brasil

Since 2002, which are in effect the Curriculum Guidelines for National Graduate courses in dentistry. The adequacy of the education needs of the Unified Health System is one of its main goals. As guidance, a way of achieving this goal is through supervised, which are presented as a tool for improving the academic scientific and technical, providing you know the reality of health and society in which to work. This study aims to examine the supply and distribution of supervised in graduate programs in dentistry in the state of Minas Gerais - Brazil. The material for analysis was obtained by sending letters to courses and consulting to its sites on the Internet. Were part of the study, 15 of the 23 courses in the state. It appeared that the load-hours of supervised showed variations between 315 and 975 hours, with only 20% of courses devoted 20% of the total working hours of supervised practice. There was no correlation between the total working hours of the course and working hours of supervised practice. The courses in which the supervised activities were represented only by extra muros showed a lower percentage of working hours in relation to total working hours of the course.

Variação espaço-temporal na distribuição e abundância de Moenkhausia sanctaefilomenae (Characiformes: Characidae) em lagoas da planície de inundação do rio Cuiabá, Pantanal, Brasil

Identifying the biotic and abiotic factors that determine the variation in the distribution and abundance of populations has become a great challenge for the field of ecology in recent years. Thus, in this study we evaluated the effect of abiotic variables and the abundance of predators on the abundance of Moenkhausia sanctaefilomenae, the variation in the average length of the individuals between lakes and periods, and the effect of the abiotic variables and abundance of predators on the structure in length of that species. Sixteen lakes of the Cuiaba river flood plain were sampled in June (drying period), September (dry period) and December (flooding period) 2005 and March (flood period) 2006. For M. sanctaefilomenae, the distribution is ampler and the abundance is greater at the end of the drying period, beginning of dry season, reducing gradually over the periods of dry, drying and flood season. Additionally, the period affects the structure in size of the populations that are spatially homogeneous. Smaller individuals were captured at the end of the drying period and the larger individuals at the start of flooding. During the end of the drying period and in the beginning of the dry season, the spatial variation in the abundance of the population was positively related with pH, dissolved oxygen and macrophyte cover and area of the lake, but not with the local abundance of predators in the littoral zone of the lakes.

Desenvolvimento inicial e distribuição temporal de larvas e juvenis de Bryconamericus stramineus Eigenmann, 1908 (Osteichthyes, Characidae) na planície alagável do alto rio Paraná, Brasil

The aim of this paper was to analyze initial development and temporal distribution of larvae and juveniles of Bryconamericus stramineus and their relationship with some environmental variables of Ressaco do Leopoldo in the Upper Paraná River floodplain. The samples were taken from February 1991 to February 1992. The larvae and the juveniles were identified and described according to the with its morphologic and meristic characteristics. The larvae presented scarce pigmentation, subterminal mouth, medium anal opening and myomeres varying 35-40 (16-21 pre and IT-22 postanal). The greater densities of larvae and juveniles were verified in December 1991 and November 1991, respectively, mainly during the night. The larvae density was only correlated with precipitation.

Habitat, distribuição e aspectos adaptativos de peixes da microbacia do ribeirão Grande, Estado de São Paulo, Brasil

The ichthyofauna of ribeirão Grande microbasin that runs through one of the few remaining fragments of Atlantic Forest (in Mantiqueira mountain range, Valley of Paraíba) was studied. Fish samples were obtained with an electric fishing powered by a maximum capacity generator of 155 V and 60-Hz alterning current, gill-nets and traps. In three collecting days, during July/2001, October/2001, January/2002 and April/2002, 2865 fishes were sampled. These fishes belonged to 12 families, 23 genera and 37 species. The species were more abundant between the piedmont and the plain of the Valley of Paraíba. The Characidium, Trichomycterus genera and the Imparfinis minutus species presented only one ovary or testis and no swim bladder. The ecological significance of morphological features in stream mountain fishes was used to predict the niche adaptation for those conditions, towards K-strategy.

Distribuição sazonal de parasitos branquiasis em diferentes especies de piexes em pesque-pague do municipio de Guariba-SP, Brasil.

This study was accomplished with the objective of knowing the seasonal distribution of the main species of parasites causes of branchial damages to the fish from fee-fishing at Guariba, State of São Paulo. This city is situated at 21 degrees 15'22'' S, 48 degrees 18'58'' W, in altitude 595 meters. This research was conducted between April, 1997 to March, 1999. From 408 fishes examined, 29.1% of them were infested by the protozoans e metazoans. Leporinus macrocephalus showed the highest parasitism by Trichodina sp., although Piaractus mesopotamicus and Cyprinus carpio were also parasited. Piscinoodinium pillulare infestation were found in L. macrocephalus, P. mesopotamicus, C. carpio e Colossoma macropomum. Monogenetics metazoan have largely been observed in L. macrocephalus, P. mesopotamicus, C. carpio, C. macropomum e cross-bred tambacu. The incidence of this parasite was elevated in the summer for L. macrocephalus, spring for P. mesopotamicus and C. macropomum, and both seasons for cross-bred tambacu. Lernaea cyprinacea copepodes were observed in L. macrocephalus, P. mesopotamicus, C. carpio and cross- breeding tambacu, in spite of the fact that C. carpio has demonstrated high parasitism of adult form. The fish L. macrocephalus, P. mesopotamicus and C. carpio were sponged intensely by Dolops carvalhoi, in situation of high population density. Piaractus mesopotamicus was considered the species more parasited by myxosporídeos, that were also observed in L. macrocephalus and cross-breeding tambacu.

Distribuição de cladóceros planctônicos (Crustacea: Branchiopoda) em um reservatório eutrófico raso (Paraná, Brasil)

This study focused the spatial and temporal distribution of the composition, abundance, and diversity of planktonic cladocerans from eutrophic, Iraí Reservoir, as well as their relationships with some biotic and abiotic variables. The tested hypothesis was that cladocerans present higher variation in a temporal than in a spatial scale. The samples were taken monthly in 6 stations, from March/02 to July/03. Twenty-four taxa were identified, distributed in 7 families, the richest families being Daphniidae (6 spp.), Chydoridae (6 spp.), and Bosminidae (5 spp.). The most frequent and abundant species were Bosmina hagmanni, Moina minuta, and Ceriodaphnia cornuta. The highest abundances were found in September/2002. Temporally, rainfall influenced organism's distribution, while spatially cladocerans were more affected by reservoir hydrodynamics and wind action. The low species richness could be a reflection of the trophic state of the reservoir, in which a dominance of Cyanobacteria was observed during that study period. Both scales showed high variation, but only the temporal scale showed significant difference to richness and abundance. Nearby the end of this study, higher stable values of species richness were recorded, which could suggest an increase in the water quality due to des-pollutions actions.

Ampliação da distribuição geográfica de três caranguejos majóideos (Crustacea, Decapoda, Brachyura) na costa do Estado de São Paulo, Brasil

This study reports range extensions of three species of crabs to the northern coast of the state of São Paulo. The species obtained were Inachoides forceps, Microphrys antillensis and Mithraculus sculptus. Recent new records of marine species in Brazilian waters illustrate the importance of continuous investigations on the biodiversity of subtidal rocky bottoms.

Gestión del conocimiento en la educación ambiental : Estudio de casoen el programa de educación ambiental de la universidad de São Paulo Brasil

The objective of this study was to analyze and to describe the process of knowledge creation in an environmental education program. The research can be defined as a case study, because a thorough study of the characteristics of an environmental education program at a public university in Brazil was carried out. The study had a descriptive character; it observed, ordered and recorded data and behavior, explaining and interpreting facts without manipulating them, using a method of qualitative data collection, the interview. The method of data analysis used was content analysis. At the end good practices for environmental education programs are suggested.

Diversidade e distribuição dos lagartos de uma área de ecótono entre Cerrado e Mata Atlântica, no sudeste do Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)