23 resultados para Health administration and planning

em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"


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Pós-graduação em Odontologia Preventiva e Social - FOA

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Transition to diets that are high in saturated fat and sugar has caused a global public health concern as the pattern of food consumption is a mayor modifiable risk factor for chronic non-communicable diseases Although agri food systems are intimately associated with this transition, agriculture and health sectors are largely disconnected in their priorities policy, and analysis with neither side considering the complex inter relation between agri trade patterns of food consumption health, and development We show the importance of connection of these perspectives through estimation of the effect of adopting a healthy diet on population health, agricultural production trade the economy and livelihoods, with a computable general equilibrium approach on the basis of case studies from the UK and Brazil we suggest that benefits of a healthy diet policy will vary substantially between different populations, not only because of population dietary intake but also because of agricultural production trade and other economic factors

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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The human buccal micronucleus cytome assay (BMCyt) is one of the most widely used techniques to measure genetic damage in human population studies. Reducing protocol variability, assessing the role of confounders, and estimating a range of reference values are research priorities that will be addressed by the HUMNXL, collaborative study. The HUMNXL, project evaluates the impact of host factors, occupation, life-style, disease status, and protocol features on the occurrence of MN in exfoliated buccal cells. In addition, the study will provide a range of reference values for all cytome endpoints. A database of 5424 subjects with buccal MN values obtained from 30 laboratories worldwide was compiled and analyzed to investigate the influence of several conditions affecting MN frequency. Random effects models were mostly used to investigate MN predictors. The estimated spontaneous MN frequency was 0.74 parts per thousand (95% CI 0.52-1.05). Only staining among technical features influenced MN frequency, with an abnormal increase for non-DNA-specific stains. No effect of gender was evident, while the trend for age was highly significant (p < 0.001). Most occupational exposures and a diagnosis of cancer significantly increased MN and other endpoints frequencies. MN frequency increased in heavy smoking (>= 40 cig/day. FR = 1.37:95% CI 1.03-.82) and decreased with daily fruit consumption (FR = 0.68; 95% CI 0.50-0.91). The results of the HUMNXL, project identified priorities for validation studies, increased the basic knowledge of the assay, and contributed to the creation of a laboratory network which in perspective may allow the evaluation of disease risk associated with MN frequency. (C) 2011 Elsevier B.V. All rights reserved.

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Descreve-se a inovação pedagógica de dois casos na graduação médica: uma matéria denominada Saúde Coletiva III, com (Administração, Ciências Sociais, Epidemiologia, Ética e Nutrição em Saúde Publica) e a disciplina de Semiologia Pediátrica. Para descrição e avaliação dos casos, utilizaram-se métodos qualitativos. A Saúde Coletiva III foi organizada por núcleos temáticos: Problemas em Saúde Publica; Nutrição em Saúde Publica; Planejamento em Saúde. O modelo de ensino centrou-se na problematização de situações vivenciadas na prática da Saúde Publica, trabalhando-se em centros, serviços e organizações de saúde. A Semiologia Pediátrica privilegiou a atenção integral à saúde da criança. O modelo de ensino centrou-se na aprendizagem baseada em problemas e no aprendizado prático da semiologia pediátrica em diferentes cenários, enfatizando-se o ensino ambulatorial. Privilegiou-se o trabalho em pequenos grupos, com a orientação docente. A principal missão voltou-se à utilização de estratégias que valorizassem o ensino centrado no estudante e sua capacidade de construir conhecimento com autonomia. No caso da Pediatria, avançou-se rumo a Medicina Integral, com enfoque amplo do modelo de atenção à criança. A Saúde Coletiva aproximou-se da Medicina Comunitária problematizando situações concretas no SUS e na atenção primária. O estudo mostra a possibilidade de inovação no ensino, e podendo contribuir para a mudança institucional.

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Objectives. To describe the changes in the use of maternal and child health care services by residents of three municipalities-Embu, Itapecerica da Serra, and Taboao da Serra-in the São Paulo metropolitan area, 12 years after the implementation of the Unified Health System (SUS) in Brazil, and to analyze the potential of population-based health care surveys as sources of data to evaluate these changes.Methods. Two population-based, cross-sectional surveys were carried out in 1990 and 2002 in municipalities located within the São Paulo metropolitan area. For children under 1 year of age, the two periods were compared in terms of outpatient services utilization and hospital admission; for the mothers, the periods were compared in terms of prenatal care and deliveries. In both surveys, stratified and multiple-stage conglomerate sampling was employed, with standardization of interview questions.Results. The most important changes observed were regarding the location of services used for prenatal care, deliveries, and hospitalization of children less than 1 year of age. There was a significant increase in the use of services in the surrounding region or hometown, and decrease in the utilization of services in the city of São Paulo (in 1990, 80% of deliveries and almost all admissions for children less than 1 year versus 32% and 46%, respectively, in 2002). The use of primary care units and 24-hour walk-in clinics also increased. All these changes reflect care provided by public resources. In the private sector, there was a decrease in direct payments and payments through company-paid health insurance and an increase in payments through self-paid health insurance.Conclusions. The major changes observed in the second survey occurred simultaneous to the changes that resulted from the implementation of the SUS. Population-based health surveys are adequate for analyzing and comparing the utilization of health care services at different times.

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The relative condition factor (Kn), gonadosomatic index (GSI), selected hematological variables and gill morphology of the fish Astyanax fasciatus were analyzed in two sites (site I was unpolluted and site 2 was polluted with untreated domestic sewage) of a tropical river (Camanducaia river, São Paulo State, Brazil). The relationship between the body mass (M-B) and the standard length (L-S) of A. fasciatus from both sites was M-B = 0.00799 L-S(3.51843). Tyhe Kn values from both the males and females were significantly higher in site 2. The mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration were higher in females from site 2. Gill tissue anomalies and gill parasites were rare in fish from both sites; however, the number of chloride cells was significantly higher in fish from site 1. A. fasciatus presents high capacity to live in ion-poor and soft water and is able to compensate for environmental changes caused by untreated domestic sewage discharges. (c) 2004 Elsevier B.V. All rights reserved.

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Interest in the measurement of salivary cortisol has increased recently because saliva can be easily collected before and after an imposed stress. This study evaluated the relationship between plasma and salivary concentrations of cortisol following ACTH administration in calves ( experiment 1) and machine milking of adult cows ( experiment 2). A catheter was inserted into the jugular vein of all animals 72 h before the beginning of experiments. Blood and saliva samples were collected before and after ACTH administration (0.6 IU/kg BW) in calves or before and after machine milking of cows. Using a cotton swab, each saliva sample was taken immediately following the blood sample. In general, cortisol profiles were similar in plasma and saliva and correlated in both experiments; however, plasma concentrations were significantly higher than salivary concentrations. In addition, the differences between cortisol concentrations measured in saliva and plasma within each experiment varied substantially between animals and samples. Furthermore, in experiment 2, nearly 10% of salivary samples were below limits of detection. The sharp peaks in cortisol after ACTH administration in both the plasma and saliva were reflected adrenal stimulation. In addition, increases in cortisol in response to milking in both the plasma and saliva suggest that salivary sampling is a reliable option when studying cortisol responses to normal physiological events.

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This paper offers a geographical perspective on the way in which health regions have been defined and established in São Paulo as part of overall Brazilian health policy. To accomplish this, I first situate the Brazilian case in the international debate over the regionalization of health services. Second, I examine health regionalization in the case of São Paulo and show how the process is dynamic and complex, involving geographical scales that go well beyond the administrative boundaries of Brazilian municipalities.

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Nowadays, power system operation becomes more complex because of the critical operating conditions resulting from the requirements of a market-driven operation. In this context, efficient methods for optimisation of power system operation and planning become critical to satisfy the operational (technical), financial and economic demands. Therefore, the detailed analysis of modern optimisation techniques as well as their application to the power system problems represent a relevant issue from the scientific and technological points of view. This paper presents a brief overview of the developments on modern mathematical optimisation methods applied to power system operation and planning. Copyright © 2007 Inderscience Enterprises Ltd.

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Objective: The aim of this study was to analyse associations between self-perception of oral health and relevant clinical, personal and socio-demographic factors in a Brazilian community. Material And Methods: Urban adults living in a city in southern Brazil were interviewerd and examined. Individuals with acute pain and who needed multiple extractions of teeth were excluded. Self-perception and the Oral Health Impact Profile (OHIP-14) were applied to measure the impact of oral conditions on the quality of life. Socio-demographic and clinical indicators were also analysed. Results: The clinical examination revealed a high dental caries experience (DMFT = 18.9) and a high prevalence of periodontal disease. Oral condition was considered normal by 42% of respondents. The variables associated with the OHIP-14 were: education, age, self-assessment, dental caries and the DMFT index. Conclusions: Self-perception of oral health was associated with OHIP-14 and the clinical indicators had low influence in the self-perception. Therefore, the development of educational initiatives and preventive strategies for the adult population is recommended. © BASCD 2011.

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Currently, there is worldwide interest in the technological use of agro-industrial residues as a renewable source of food and biofuels. Lignocellulosic materials (LCMs) are a rich source of cellulose and hemicellulose. Hemicellulose is rich in xylan, a polysaccharide used to develop technology for producing alcohol, xylose, xylitol and xylo-oligosaccharides (XOSs). The XOSs are unusual oligosaccharides whose main constituent is xylose linked by β 1-4 bonds. The XOS applications described in this paper highlight that they are considered soluble dietary fibers that have prebiotic activity, favoring the improvement of bowel functions and immune function and having antimicrobial and other health benefits. These effects open a new perspective on potential applications for animal production and human consumption. The raw materials that are rich in hemicellulose include sugar cane bagasse, corncobs, rice husks, olive pits, barley straw, tobacco stalk, cotton stalk, sunflower stalk and wheat straw. The XOS-yielding treatments that have been studied include acid hydrolysis, alkaline hydrolysis, auto-hydrolysis and enzymatic hydrolysis, but the breaking of bonds present in these compounds is relatively difficult and costly, thus limiting the production of XOS. To obviate this limitation, a thorough evaluation of the most convenient methods and the opportunities for innovation in this area is needed. Another challenge is the screening and taxonomy of microorganisms that produce the xylanolytic complex and enzymes and reaction mechanisms involved. Among the standing out microorganisms involved in lignocellulose degradation are Trichoderma harzianum, Cellulosimicrobium cellulans, Penicillium janczewskii, Penicillium echinulatu, Trichoderma reesei and Aspergillus awamori. The enzyme complex predominantly comprises endoxylanase and enzymes that remove hemicellulose side groups such as the acetyl group. The complex has low β-xylosidase activities because β-xylosidase stimulates the production of xylose instead of XOS; xylose, in turn, inhibits the enzymes that produce XOS. The enzymatic conversion of xylan in XOS is the preferred route for the food industries because of problems associated with chemical technologies (e.g., acid hydrolysis) due to the release of toxic and undesired products, such as furfural. The improvement of the bioprocess for XOS production and its benefits for several applications are discussed in this study. © 2012 Elsevier Ltd.

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The aimed of this article is to measure risk factors on health and milk production on organic and conventional dairy goats in Brazil. Two experimental groups (organic and conventional) were evaluated simultaneously. The study design was completely randomized. The organic herd consisted of 25 goats and 15 kids. In the conventional production system, a dairy herd comprising 40 goats and 20 kids participated in the study. Data on milk production and health management were available from January 2007 to December 2009. The abortion rate in the conventional system was 5% (2/40) whereas in organic system no abortion was diagnosed (0/25). The mortality rate at weaning in the conventional system was 5% (2/40) and in the organic system was 8% (2/25). Milk production was lower (2.20 kg/day) in organic than conventional system (2.66 kg/day). Goats and kids in organic farm had a higher FEC (386±104 and 900±204, respectively) (p<0.05) than those in conventional farm (245±132 and 634±212, respectively). In addition, Saanen kids had higher FEC (p<0.001) than goats. Treatment with antiparasitic drugs was higher in conventional system (50%) than organic system (1.3%).