32 resultados para county health department

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


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Pós-graduação em Geografia - IGCE

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Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, a coccidian protozoan of worldwide distribution. The seroprevalence in canine population can be an alternative for measuring T. gondii urban spreading. A total of 780 blood samples from dogs were collected, during the yearly anti-rabies campaign, carried out by the Department of Veterinary Hygiene and Public Health, School of Veterinary Medicine and Animal Husbandry (FMVZ), São Paulo State University, UNESP, together with the county health authorities, in August 1999. Using Indirect Fluorescent Antibody Test (IFAT) for detecting antibodies anti-T. gondii in the sera samples, we observed that 258 dogs (33.1%) were positive. The associations between the serological results and the epidemiological variables were studied. Statistically significant differences were not found regarding sex (32.2% male and 34.3% female reactors). Dogs without a defined breed showed seropositivity statistically higher than the pedigreed group. The occurrence of infection was considered higher with age.

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OBJETIVO: Avaliar os indicadores de aleitamento materno em consultórios particulares e centros de saúde no município de Lins, SP, e comparar a prevalência de aleitamento materno exclusivo dessa região com a encontrada em outras pesquisas. MÉTODOS: Estudo de corte transversal com amostra aleatória de 255 crianças de quatro a doze meses de idade, estratificada por sexo, condição socioeconômica e escolaridade dos pais. Foram avaliados os indicadores de aleitamento materno em dois grupos de crianças: as acompanhadas em consultórios particulares e as acompanhadas em centros de saúde. Foram utilizados questionários respondidos pelos responsáveis. Os dados desta pesquisa foram comparados aos de outros estudos. RESULTADOS: Apesar de haver diferenças significativas nas condições de renda, estrato social e escolaridade dos pais, não houve diferença significativa nos índices de aleitamento materno entre os dois grupos. No grupo total, a prevalência de aleitamento materno exclusivo aos quatro meses foi de 61,1% e a mediana de aleitamento materno exclusivo foi de 120 dias. Os resultados foram superiores aos dos demais estudos consultados. CONCLUSÃO: Os resultados mostraram diferenças relacionadas às condições socioeconômicas, porém, os índices de aleitamento materno foram semelhantes entre os dois grupos. Os resultados de aleitamento materno exclusivo foram superiores aos das demais pesquisas.

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Este artigo apresenta o desenvolvimento, validação e utilização de uma metodologia de avaliação da qualidade dos serviços de atenção primária do Sistema Único de Saúde (SUS), o Questionário de Avaliação da Qualidade de Serviços de Atenção Básica (QualiAB). Destina-se aos serviços de atenção básica, organizados segundo diferentes modelos de atenção, incluindo a Saúde da Família. Contém 50 indicadores sobre oferta e organização do trabalho assistencial e programático e 15 sobre gerenciamento, na forma de questões de múltipla escolha, autorespondidas via web pela equipe local do serviço. Confere a cada resposta valor zero, um ou dois; a média geral atribui ao serviço um grau de qualidade expresso pela distância do melhor padrão correspondente à média dois. Foi construído por processo de consenso interativo, que incluiu metodologias qualitativas, teste-piloto, aplicação em 127 serviços, validação de construto e confiabilidade. Respondido, em 2007, por 598 (92%) dos serviços de 115 municípios paulistas, mostrou bom poder para discriminar níveis de qualidade. Adotado em 2010 como parte de um programa de apoio à Atenção Básica da Secretaria de Estado da Saúde de São Paulo, foi respondido por 95% (2.735) dos serviços de 586 municípios (90,8% do Estado). Os resultados foram encaminhados aos municípios. O QualiAB fornece uma avaliação válida, simples e com a possibilidade de retorno imediato para gerentes e profissionais. Mostrou factibilidade, aceitabilidade, bom poder de discriminação e utilidade para auxiliar a gestão da rede de atenção básica do SUS em São Paulo. A experiência indica aplicabilidade nas redes de atenção básica do Brasil.

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Com os processos de regionalização no final dos anos 1990, os estados iniciam um resgate de seu papel político para enfrentamento da fragmentação do sistema público de saúde. Nesse processo, as secretarias estaduais de saúde, representadas pelo Conselho Nacional de Secretários de Saúde, passam a redefinir as funções do Estado junto à Atenção Básica. Na histórica atuação da Secretária de Estado da Saúde de São Paulo (SES-SP) na atenção primária, uma das marcas refere-se à expertise profissional nesse campo, que com o processo de municipalização migrou para os municípios, especialmente os de maior porte, ou redefiniu suas áreas de atuação no interior da própria SES-SP, em áreas como a vigilância epidemiológica e sanitária, a de avaliação e controle, entre outras. Esse capital humano foi em parte resgatado a partir de 2009, com o Programa Articuladores de Atenção Básica. O Programa representa uma política de apoio da SES-SP para os municípios, priorizando aqueles com população inferior a 100 mil habitantes, com o objetivo de auxiliar os gestores municipais na qualificação dos serviços de Atenção Básica e fortalecer esse nível de atenção no sistema público de saúde. Toma como objeto de trabalho o reconhecimento de prioridades de saúde locais e dos obstáculos para a melhoria da atenção à saúde, na construção conjunta de estratégias e alternativas de enfrentamento dos problemas identificados. Este artigo apresenta o processo de implantação desse Programa, bem como alguns resultados referentes às principais frentes de atuação desses profissionais na busca da qualificação da atenção básica no estado.

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A method has been developed for the direct and simultaneous determination of As, Cu, Mn, Sb, and Se in drinking water by electrothermal atomic absorption spectrometry (ETAAS) using a transversely heated graphite tube atomizer (THGA) with longitudinal Zeeman-effect back- ground correction. The thermal behavior of analytes during the pyrolysis and atomization stages was investigated in 0.028 mol L-1 HNO3, 0.14 mol L-1 HNO3 and 1 + 1 (v/v) diluted water using mixtures of Pd(NO3)(2) + Mg(NO3)(2) as the chemical modifier, With 5 mug Pd + 3 mug Mg as the modifier, the pyrolysis and atomization temperatures of the heating program of the atomizer were fixed at 1400degreesC and 2100degreesC, respectively, and 20 muL of the water sample (sample + 0.28 mol L-1 HNO3, 1 + 1, v/v), dispensed into the graphite tube, analytical curves were established ranging from 5.00 - 50.0 mug L-1 for As, Sb, Se; 10.0 - 100 mug L-1 for Cu; and 20.0 - 200 mug L-1 for Mn. The characteristic masses were around 39 pg As, 17 pg Cu, 60 pg Mn, 43 pg Sb, and 45 pg Se, and the lifetime of the tube was around 500 firings. The limits of detection (LOD) based on integrated absorbance (0.7 mug L-1 As, 0.2 mug L-1 Cu, 0.6 mug L-1 Mn, 0.3 mug L-1 Sb, 0.9 mug L-1 Se) exceeded the requirements of the Brazilian Food Regulations (decree # 310-ANVS from the Health Department), which established the maximum permissible level for As, Cu, Mn, Sb, and Se at 50 mug L-1, 1000 mug L-1, 2000 mug L-1, 5 mug L-1, and 50 mug L-1, respectively. The relative standard deviations (n = 12) were typically < 5.3% for As, < 0.5% for Cu, < 2.1% for Mn, < 11.7% for Sb, and < 9.2% for Se. The recoveries of As, Cu, Mn, Sb, and Se added to the mineral water samples varied from 102-111%, 91-107%, 92-109%, 89-97%, and 101-109%, respectively. Accuracy for the determination of As, Cu, Mu Sb and Se was checked using standard reference materials NIST SRM 1640 - Trace Elements in Natural Water, NIST SRM 1643d - Trace Elements in Water, and 10 mineral water samples. A paired t-test showed that the results were in agreement with the certified values of the standard reference materials at the 95% confidence level.

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A method has been developed for the direct simultaneous determination of Cd and Pb in white and red wine by electrothermal atomic absorption spectrometry (ET-AAS) using a transversely heated graphite tube atomizer (THGA) with longitudinal Zeeman-effect background correction. The thermal behavior of both analytes during pyrolysis and atomization stages were investigated in 0.028 mol l(-1) HNO3 and in 1 + 1 v/v diluted wine using mixtures of Pd(NO3)(2) + Mg(NO3)(2) and NH4H2PO4 + Mg(NO3)(2) as chemical modifiers. With 5 mug Pd + 3 mug Mg as the modifiers and a two-step pyrolysis (10 s at 400 degreesC and 10 s at 600 degreesC), the formation of carbonaceous residues inside the atomizer was avoided. For 20 mul of sample (wine + 0.056 mol l(-1) HNO3, 1 + 1, v/v) dispensed into the graphite tube, analytical curves in the 0.10-1.0 mug l(-1) Cd and 5.0-50 mug l(-1) Pb ranges were established. The characteristic mass was approximately 0.6 pg for Cd and 33 pg for Pb, and the lifetime of the tube was approximately 400 firings. The limits of detection (LOD) based on integrated absorbance (0.03 mug l(-1) for Cd, 0.8 mug l(-1) for Pb) exceeded the requirements of Brazilian Food Regulations (decree #55871 from Health Department), which establish the maximum permissible level for Cd at 200 mug l(-1) and for Pb at 500 mug l(-1). The relative standard deviations (n = 12) were typically < 8% for Cd and < 6% for Pb. The recoveries of Cd and Pb added to wine samples varied from 88 to 107% and 93 to 103%, respectively. The accuracy of the direct determination of Cd and Ph was checked for 10 table wines by comparing the results with those obtained for digested wine using single-element ET-AAS, which were in agreement at the 95% confidence level. (C) 2001 Elsevier B.V. B.V. All rights reserved.

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A method has been developed for the direct and simultaneous determination of As, Cu, Mn, Sb, and Se in drinking water by electrothermal atomic absorption spectrometry (ETAAS) using a transversely heated graphite tube atomizer (THGA) with longitudinal Zeeman-effect background correction. The thermal behavior of analytes during the pyrolysis and atomization stages was investigated in 0.028 mol L-1 HNO3, 0.14 mol L-1 HNO3 and 1 + 1 (v/v) diluted water using mixtures of Pd(NO3)2 + Mg(NO3)2 as the chemical modifier. With 5 μg Pd + 3 μg Mg as the modifier, the pyrolysis and atomization temperatures of the heating program of the atomizer were fixed at 1400°C and 2100°C, respectively, and 20 μL of the water sample (sample + 0.28 mol L-1 HNO3, 1 + 1, v/v), dispensed into the graphite tube, analytical curves were established ranging from 5.00 -50.0 μg L-1 for As, Sb, Se; 10.0 - 100 μg L-1 for Cu; and 20.0 - 200 μg L-1 for Mn. The characteristic masses were around 39 pg As, 17 pg Cu, 60 pg Mn, 43 pg Sb, and 45 pg Se, and the lifetime of the tube was around 500 firings. The limits of detection (LOD) based on integrated absorbance (0.7 μg L-1 As, 0.2 μg L-1 Cu, 0.6 μg L-1 Mn, 0.3 μg L-1 Sb, 0.9 μg L-1 Se) exceeded the requirements of the Brazilian Food Regulations (decree # 310-ANVS from the Health Department), which established the maximum permissible level for As, Cu, Mn, Sb, and Se at 50 μg L-1, 1000 μg L-1, 2000 μg L-1, 5 μg L-1, and 50 μg L-1, respectively. The relative standard deviations (n = 12) were typically < 5.3% for As, < 0.5% for Cu, < 2.1% for Mn, < 11.7% for Sb, and < 9.2% for Se. The recoveries of As, Cu, Mn, Sb, and Se added to the mineral water samples varied from 102-111%, 91-107%, 92-109%, 89-97%, and 101-109%, respectively. Accuracy for the determination of As, Cu, Mn, Sb, and Se was checked using standard reference materials NIST SRM 1640 - Trace Elements in Natural Water, NIST SRM 1643d - Trace Elements in Water, and 10 mineral water samples. A paired t-test showed that the results were in agreement with the certified values of the standard reference materials at the 95% confidence level.

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Objectives: to evaluate the structure and process of the prenatal and puerperal care given by Direção Regional de Saúde (DIR) XI, at the city of Botucatu, State of São Paulo, Brazil. Methods: an evaluation of resources and activities developed during prenatal and puerperal care in twenty municipalities comprising DIR XI which had adhered the Prenatal and Birth Humanization Program until 2003. Interviews with city managers and analysis of 385 sampled patient charts taking into account recommendations by the Health Department. Results: structure analysis showed that caregiving was centered on medical work; basic equipment and instruments were available; 85.2% of patients began prenatal care with up to 120 days of pregnancy, and 75.9% had at least six prenatal consultations. The active search for absentees and strategies for early prenatal care initiation were observed in 30% and 50% of the municipalities, respectively. Process indicators showed that 3.6% of women had six prenatal consultations, one puerperal consultation, all basic exams and tetanus immunization. Recording of gestational age, arterial blood pressure and weight was of approximately 90%; 58.7% of the women underwent childbirth review and 31.5% were vaccinated. Conclusions: the performance of the set of activities is a challenge to prenatal care at DIR XI.

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In Brazil, the rates of mother-to-child-transmission (MTCT) of human immunodeficiency virus (HIV) decreased from 20% to 1-2% in some regions. However, the country contains 90% of individuals infected with visceral leishmaniasis (VL) in Latin America, and the west region of São Paulo state faces an alarming expansion of the disease. We describe the epidemiological aspects of the expanding infection of VL and a case report of an HIV-VL-co-infected child from the west region of São Paulo state. The patient was an AIDS-C3 with low levels of CD4, high viral load, severe diarrhea, oral and perineal candidiasis, severe thrombocytopenia, and protein-caloric malnourishment. She evolved with sepsis, renal and cardiac failure. An rK rapid diagnosis test, indirect fluorescent antibody test (IFAT), and bone marrow aspirate were performed for VL. Her symptoms improved significantly after liposomal amphotericin B administration. From the 45 municipalities that compose the Regional Health Department of Presidente Prudente, Lutzomyia longipalpis vectors were found in 58% of them. VL infected dogs were found in 33% of those municipalities, infected dogs and humans were found in 29%, 20% are starting and 33% of the municipalities are preparing VL investigation. It is likely, in this patient, that VL advanced the clinical progression of the HIV disease and the development of AIDS severity. Supported by favorable conditions, the region becomes a new frontier of VL in Brazil. © 2013.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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