Regionalization of health in Brazil: an analytical perspective

This article aims to contribute to the debate on the SUS regionalization policy and the establishment of health regions in Brazil. Understanding them require to recognize the dichotomy between public health and individual health - which marks the history of Brazilian public health - and identify the different rationalities that lead this process. Such rationalities allow not only to consider the legacy of municipalization in the current regionalization process, as well as to establish links between the two fields of fundamental knowledge to the debate, epidemiology and geography. Clinical epidemiology, privileging individual health, gives basis to a healthcare model that prioritizes the optimization of resources. The recognition of health in its broader concept, in the social epidemiology, bases an attention model aimed at social determinants. With geography, functional regions can be formulated, based on Christaller's theory, or lablachianas regions which recognize the social loco / regional structure, allowing intervention in determining or conditioning the way of illness and death of populations.

Are supplier selection criteria going green? Case studies of companies in Brazil

Purpose - The purpose of this paper is to verify if Brazilian companies are adopting environmental requirements in the supplier selection process. Further, this paper intends to analyze whether there is a relation between the level of environmental management maturity and the inclusion of environmental criteria in the companies' selection of suppliers.Design/methodology/approach - A review of mainstream literature on environmental management, traditional criteria in the supplier selection process and the incorporation of environmental requirements in this context. The empirical study's strategy is based on five Brazilian case studies with industrial companies. Face-to-face interviews and informal conversations are to be held, explanations made by e-mail with representatives from the purchasing, environmental management, logistics and other areas, and observation and the collection of company documents are also employed.Findings - Based on the cases, it is concluded that companies still use traditional criteria to select suppliers, such as quality and cost, and do not adopt environmental requirements in the supplier selection process in a uniform manner. Evidence found shows that the level of environmental management maturity influences the depth with which companies adopt environmental criteria when selecting suppliers. Thus, a company with more advanced environmental management adopts more formal procedures for selecting environmentally appropriate suppliers than others.Originality/value - This is the first known study to verify if Brazilian companies are adopting environmental requirements in the supplier selection process.

Molecular detection of enterotoxins E, G, H and I in Staphylococcus aureus and coagulase-negative staphylococci isolated from clinical samples of newborns in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Detection of hybrids and genetic introgression in wild stocks of two catfish species (Siluriformes: Pimelodidae): The impact of hatcheries in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Detection and partial characterization of a carlavirus causing stem necrosis of soybean in Brazil

No ano agrícola de 2000/2001, ocorreu um surto de nanismo e necrose da haste em soja (Glycine max) plantada em duas áreas do Brasil Central e na safra seguinte, esta anomalia foi constatada em outras regiões produtoras, mesmo distantes mais de 2.000 km de onde fora inicialmente constatada. Estudos envolvendo ensaios de transmissão (enxertia, mecânica e insetos vetores), microscopia eletrônica, purificação, sorologia e ensaios moleculares indicaram que a enfermidade foi causada por um carlavirus transmitido por mosca branca, possivelmente relacionado ao Cowpea mild mottle virus (CpMMV).

Pathogenic variation in Colletotrichum gloeosporioides infecting Stylosanthes spp. in a center of diversity in Brazil

Pathogenic variation in Colletotrichum gloeosporioides infecting species of the tropical pasture legume Stylosanthes at its center of diversity was determined from 296 isolates collected from wild host population and selected germ plasm of S. capitata, S. guianensis, S. scabra, and S. macrocephala in Brazil. A putative host differential set comprising 11 accessions was selected from a bioassay of 18 isolates on 19 host accessions using principal component analysis. A similar analysis of anthracnose severity data for a subset of 195 isolates on the 11 differentials indicated that an adequate summary of pathogenic variation could be obtained using only five of these differentials. of the five differentials, S. seabrana 'Primar' was resistant and S. scabra 'Fitzroy' was susceptible to most isolates. A cluster analysis was used to determine eight natural race clusters using the 195 isolates. Linear discriminant functions were developed for eight race clusters using the 195 isolates as the training data set, and these were applied to classify a test data set of the remaining 101 isolates. All except 11 isolates of the test data set were classified into one of the eight race clusters. Over 10% of the 296 isolates were weakly pathogenic to all five differentials and another 40% were virulent on just one differential. The unclassified isolates represent six new races with unique virulence combinations, of which one isolate is virulent on all five differentials. The majority of isolates came from six field sites, and Shannon's index of diversity indicated considerable variation between sites. Pathogenic diversity was extensive at three sites where selected germ plasm were under evaluation, and complex race clusters and unclassified isolates representing new races were more prevalent at these sites compared with sites containing wild Stylosanthes populations.

Comparative efficacy evaluation of moxidectin gel and ivermectin paste against internal parasites of equines in Brazil

A total of 24 male and female equines of mixed breed, 10-20 months of age and naturally infected with internal parasites was utilized in a controlled test to evaluate the efficacy of a moxidectin 2% gel formulation at the dosage of 0.4 mg moxidectin per kg of live weight and an ivermectin 1.87% commercial paste formulation at the dosage 0.2 mg ivermectin per kg applied orally Animals were allocated into three groups of eight horses each based on pre-treatment eggs per gram (EPG) counts and treatments were randomized among the groups. One group was kept as untreated controls. One animal in the moxidectin-treated group died before the end of the trial from a cause unrelated to treatment leaving a total of seven animals in this group. Fecal egg counts were performed three times post-treatment and the number of parasites remaining in each animal was determined. Statistical analyses using geometric means were performed at the 1% level of significance. Both moxidectin and ivermectin preparations reduced initial EPG from a mean of 1600 to 0 on Days 5, 7 and at the end of the trial on Day 14. Efficacy percentages of moxidectin and ivermectin against immature and adult nematodes were as follows: Trichostrongylus axel, Parascaris equorum, Strongylus edentatus, S. vulgaris, Triodontophorus spp. and Gyalocephalus capitatus, 100% for both products; Habronema muscae 99.5 and 99.6%, respectively, Strongyloides westeri, 100 and 99.2%, respectively; Oxyuris equi, 99.6 and 100%, respectively; small strongyles, 99.7% for both products. of the latter, the most numerous were: Cylicocyclus insigne, Cylicostephanus longibursatus and Cyathostomum catinatum. No Gasterophilus nasalis were found in horses from either treated group, while two of eight control horses had infections with this parasite. Moxidectin showed greater efficacy (84.9%) than ivermectin (67.8%) against Strongylus vulgaris larvae found in the mesenteric artery aneurisms, but the difference was not statistically significant. Total parasite counts for both treated groups were significantly lower (p<0.01) than in the non-treated group. No significant differences were noted between moxidectin and ivermectin. Efficacy against the 30 nematode species found in this study was very evident for both products. As expected, neither moxidectin nor ivermectin was effective in controlling the tapeworm Anoplocephala perfoliata. No adverse reactions were observed during the experimental period. (C) 1998 Elsevier B.V. B.V. All rights reserved.

Genetic and phenotypic trends for growth traits of buffaloes in Brazil

The objectives this paper were to estimate genetic parameters and genetic and phenotypic trends of birth weight (BWT) and weights adjusted to 205 (WT205), 365 (WT365) and 550 (P550) days of age of beef buffaloes born from 1985 to 2003 in Brazil. For BWT and WT205 the model included direct and maternal genetic and maternal environment as random effects and contemporary and genetic groups as fixed effects. For WT365 and WT550 the same model was used except without direct maternal and maternal environmental effects. The genetic and phenotypic trends were estimated by regression of means of dependent variables on birth year of animals Regressions were obtained by using two methodologies: 1) linear regression; and 2) non-parametric splined regression. The direct heritability estimates were 0.09, 0.45, 0.46 and 0.58 for BWT, WT205, WT365 and WT550, respectively. The direct genetic trends from linear regression were 0.01, 0.23, 0.58 and 1.40 kg per year for PN, WT205, VVT365 and WT550, respectively (P<0.001 for all). Phenotypic trends were strongly positive while genetic trends were consistently positive but small. Genetic parameters indicate potential for increased rate of genetic change with full implementation of genetic improvement programs.

EPIZOOTIC BOTULISM OF CATTLE IN BRAZIL

The first diagnosis of botulism in cattle in Brazil and it's epizootiology are reviewed. The high prevalence of the disease raised on phosphorus deficient pastures in Savanna regions has caused severe economic losses in the past.The temperature induced microcomplement fixation test (TIMCF) confirmed the clinical-pathological diagnosis in all of the 24 cases studied by this method.The most important reason why botulism has not been controlled satisfactorily in Brazil is the lack of an available effective vaccine (type C and D). Additional prophylactic measures are phosphorus supplementation and removal of carcasses from the pasture.

Design and ergonomics of package inserts of drugs in Brazil: a reality in construction

This research deals with the design of leaflets of medicines, evidencing the problems resulting from the lack of Brazilian normalization to promote the use of the graphical representation of instructional texts warnings. It approaches studies related to the effectiveness and efficiency of information systems, highlighting the semiotics and the cultural and informational ergonomics. The analysis of the context uses as method, an analytical study on selected warnings of thirty leaflets of medicines, followed by interviews lead with the public managers involved with the regulation of the pharmaceutical companies, and two experiments with users performed in city of Recife, in State of Pernambuco: one aiming at to identify how they interact with the leaflets of medicines, and the second one testing their understanding concerning standardized illustrations in the United States and the South Africa. The results show the need for improvements in presentation and graphic representation of leaflets of medicines, powering them to the role of communication, to ensure the consumption of medicine safely by its users. The conclusion congregates parameters and recommendations for the graphic representation of warnings in leaflets of medicines in Brazil.

Epidemiology of neurocysticercosis in Brazil

A revision of literature was done with the objective of tracing an epidemiologic profile of neurocysticercosis (NCC) in Brazil. The prevalence was 0.12-9% in autopsies. The frequency was 0.03-7.5% in clinical series and 0.68-5.2% in seroepidemiological studies. The disease corresponds to 0.08-2.5% of admissions to general hospitals. Patient origin was rural in 30 63% of cases. The most involved age range (64-100%) was 11 to 60 years, with a predominance (22-67%) between 21 and 40 years. The male sex was the most affected (51-80%). In the severe forms there was a predominance of urban origin (53-62%) and of the female sex (53-75%). The period of hospitalization ranges from 1 to 254 days and 33 to 50% of patients suffer 1.7 ± 1.4 admissions. The clinical picture was variable, with a predominance of epileptic syndrome (22-92%) and intracranial hypertension (19-89%). Psychiatric manifestations were associated in 9-23% of patients. Lethality was 0.29% in terms of all diseases in general and 4.8-25.9% in terms of neurologic diseases. The asymptomatic form was detected in 6% of patients in clinical serie and in 48.5% of case from autopsies The racemose form and ventricular localization also was observed as asymptomatic form. Among the patients with cutaneous cysticercosis 65% of them showed neurologic manifestations.

Nutrients foliar content for high productivity cultivars of guava in Brazil

Commonly grown in tropical and sub-tropical regions, guava (Psidium guajava L.) is an important fruit crop of Brazil. It is cultivated on a large scale in São Paulo state, and covers about 6,500 hectares. As a result of the guava selection program developed at FCAV/UNESP, two new cultivars were created: 'Rica' and 'Paluma' with a high productivity, and also with higher nutritional requirement. Leaves analysis has become a powerful tool in mineral-nutrition research with fruit crops, not only to determine response to different nutrients, but also for diagnostic techniques in making fertilizer recommendations and assessing deficiency symptoms. Nutrient composition of the leaves varies depending on the leaf maturity, tree age, variety and nutrient supply. For the interpretation of analytical values, selection of the index tissue is important. The results of experiments conducted in the field during 1989-2000 were studied. The nutritional status was evaluated by annual leaf sampling, carried out at full bloom. Recent fully developed leaves, corresponding to the third pair (with the petiole) were collected, starting at the end of the branch, all around the tree, at a height of 1.5 m from the soil, with a total of 30 leaf pairs per sample. The yield was evaluated by weighing all the fruits in the useful area of each lot. Foliar chemical analysis showed excellent correlation with the fruit production. Through the results it was verified that the maximum yield was associated to the following levels: N = 22-26; P = 1.5-1.9; K = 17-20; Ca = 11-15; Mg = 2.5-3.5; S = 3.0-3.5 g kg -1; B = 20-25; Cu = 10-40; Fe = 50-150; Mn = 180-250; Zn = 25-35 mg kg-1 DW in the leaves of the 'Rica' guava and to N = 20-23; P = 1.4-1.8; K = 14-17; Ca = 7-11; Mg = 3.4-4.0; S = 2.5-3.5 g kg-1; B = 20-25; Cu = 20-40; Fe = 60-90; Mn = 40-80; Zn = 25-35 mg kg-1 DW in the leaves of the 'Paluma' guava.

Coordinated, network-based research as a strategic component of science in Brazil

Scientific research plays a fundamental role in the health and development of any society, since all technological advances depend ultimately on scientific discovery and the generation of wealth is intricately dependent on technological advance. Due to their importance, science and technology generally occupy important places in the hierarchical structure of developed societies, and they receive considerable public and private investment. Publicly funded science is almost entirely devoted to discovery, and it is administered and structured in a very similar way throughout the world. Particularly in the biological sciences, this structure, which is very much centered on the individual scientist and his own hypothesis-based investigations, may not be the best suited for either discovery in the context of complex biological systems, or for the efficient advancement of fundamental knowledge into practical utility. The adoption of other organizational paradigms, which permit a more coordinated and interactive research structure, may provide important opportunities to accelerate the scientific process and further enhance its relevance and contribution to society. The key alternative is a structure that incorporates larger organizational units to tackle larger and more complex problems. One example of such a unit is the research network. Brazil has utilized such networks to great effect in genome sequencing projects, demonstrating their relevance to the Brazilian research community and opening the possibility of their wider utility in the future.

Evaluation of systems for timing of fungicide sprays for control of postbloom fruit drop of citrus in Brazil

Postbloom fruit drop (PFD) of citrus, caused by Colletotrichum acutatum, infects petals of citrus flowers and produces orange-brown lesions that induce the abscission of young fruitlets and the retention of calyces. Proper timing of fungicide applications is essential for good disease control. Different systems for timing of fungicide applications for control of PFD in a major citrus-growing region in southern São Paulo state in Brazil were evaluated from 1999 to 2002. The following programs were compared to an unsprayed control using counts of diseased flowers, persistent calyces, or fruit: (i) a phenology-based program currently recommended in Brazil with one application at early and another at peak bloom; (ii) the Florida PFD model; (iii) the postbloom fruit drop-fungicide application decision system (PFD-FAD), a new computer-assisted decision method; and (iv) grower's choice. In 1999, no disease developed, sprays applied with the phenology-based program had no effect, and the Florida PFD model saved two sprays compared with the phenology-based program. In 2000, PFD was moderate and the phenology-based and growers' choice treatments had a significantly lower number of persistent calyces and higher fruit numbers than the control, but no differences were found between those treatments and the PFD model. In 2001, PFD was severe with considerable yield loss. The PFD model, the phenology-based program, and the grower's choice reduced flower blight and the number of persistent calyces, and improved fruit yields with two to three applications, but the PFD-FAD achieved comparable yields with only one spray. In 2002, the disease was mild, with no yield loss, and the Florida PFD model and the PFD-FAD saved one spray compared with the other systems. The PFD model and the PFD-FAD were equally effective for timing fungicide applications to control PFD in Brazil. Scouting of trees is simpler with PFD-FAD; therefore, this system is recommended and should eliminate unnecessary sprays and reduce costs for growers.