Gestão do trabalho na Estratégia Saúde da Família em municípios do Estado do Rio de Janeiro com mais de 500 mil habitantes: o caso do Rio de Janeiro e Duque de Caxias

Não obstante ao aumento do número de equipes de Saúde da Família no território brasileiro há disparidade na implantação da Estratégia Saúde da Família (ESF) em municípios de grande porte. Outras dificuldades enfrentadas referem-se aos recursos humanos em saúde (RHS). Nesse sentido, esta pesquisa objetivou analisar o cenário atual da gestão do trabalho na ESF nos municípios do Rio de Janeiro e Duque de Caxias. Metodologia: Estudo exploratório, de investigação narrativa, bibliográfica e documental, de abordagem qualitativa. A coleta de dados se deu em duas fases: pesquisa de material bibliográfico nas bases: LILACS, PAHO e WHOLIS, e de editais de processos seletivos e concursos públicos dos anos 2000, com vistas à contratação de profissionais de saúde para a ESF e; entrevistas semiestruturadas com gestores da ESF. O período de coleta perdurou entre agosto de 2010 e dezembro de 2011. Os documentos foram analisados à luz da estatística descritiva e as entrevistas submetidas à análise de conteúdo. Resultados: Escassez de literatura sobre a ESF nos municípios de Duque de Caxias e Rio de Janeiro. As contratações no Rio de Janeiro obedeceram a dois momentos: prefeitura e Organizações Sociais (OS) como contratantes. Em Duque de Caxias a contratação foi exclusividade da Prefeitura. No Rio de Janeiro os salários dos profissionais variaram entre R$ 728,59 (Agentes Comunitários de Saúde - ACS) e R$ 7.773,69 (médicos), contrastando com a isonomia salarial adotada em Duque de Caxias, com vencimentos ao redor de R$ 700,00 para os ACS, R$ 800,00 para nível técnico e; aproximadamente R$ 5.000,00 aos profissionais de nível superior. Os gestores sugerem que a maior rotatividade entre os médicos é motivada por carga horária excessiva; más condições de trabalho e, localização da unidade em áreas de risco social. As estratégias para atração e fixação profissional incluem: processos seletivos; garantia dos direitos trabalhistas e; abonos salariais, no caso do Rio de Janeiro e; flexibilização de carga horária, melhorias em infraestrutura e estratégias de qualificação, em Duque de Caxias. Entrevistas revelaram as maiores dificuldades na gestão da ESF: alta rotatividade, formação médica destoante com o SUS e, infraestrutura precária. Acrescenta-se o baixo salário para médicos em Duque de Caxias e, vínculos e salários distintos entre profissionais que exercem mesma função no Rio de Janeiro. Conclusões: A expansão da ESF nos grandes centros urbanos encontra obstáculos relacionados à gestão do trabalho que fragilizam sua consolidação. O Rio de Janeiro mostra-se mais atraente para os profissionais da ESF. O único diferencial de Duque de Caxias, sobretudo para odontólogos e enfermeiros, refere-se à contratação direta pela Prefeitura com vinculação estatutária, ainda que, eventual aumento salarial esteja atrelado ao de todos os servidores municipais. No Rio de Janeiro, a contratação sob regime da Consolidação das Leis do Trabalho revela-se uma proteção, posto que diante da possibilidade de perda de profissionais as OS elevam seus salários. Dentre as recomendações para fixação profissional incluem-se: incentivos salariais para atuação em regiões vulneráveis, melhorias em infraestrutura e, acoplação entre Instituições de Ensino Superior e rede de saúde.

Investigação de alterações em genes de microRNAs expressos no cérebro como causa de deficiência intelectual ligada ao cromossomo X

A Deficiência Intelectual (DI) é uma condição definida como um funcionamento intelectual significativamente prejudicado, expresso juntamente com limitações em pelo menos duas áreas do comportamento adaptativo que se manifestam antes dos 18 anos de idade. A prevalência estimada da DI na população em geral é de 2-3% e um número expressivo de casos permanece sem um diagnóstico definitivo. Há um consenso geral de que a DI é mais comum em indivíduos do sexo masculino em relação aos do sexo feminino. Entre as explicações para este excesso está a concentração de genes específicos para a habilidade cognitiva no cromossomo X. MicroRNAs (miRNAs) são pequenas moléculas de RNA não codificador que modulam a expressão gênica pós-transcricional de RNAs mensageiros alvo. Recentemente, estudos têm demonstrado a importância essencial dos miRNAs para o desenvolvimento e funcionamento cerebrais e sabe-se que o cromossomo X tem uma alta densidade de genes de miRNAs. Neste contexto, os miRNAs são candidatos potenciais como fatores genéticos envolvidos na Deficiência Intelectual Ligada ao X (DILX). Neste estudo, foram analisadas as regiões genômicas de 17 genes de miRNAs expressos no cérebro localizados no cromossomo X, com o objetivo de investigar o possível envolvimento de variantes na sequência destes miRNAs na DILX. Para este fim, selecionamos amostras de DNA genômico (sangue periférico) de 135 indivíduos do sexo masculino portadores de DI sugestiva de DILX de um grupo de mais de 1.100 pacientes com DI encaminhados ao Serviço de Genética Humana da UERJ. O critério de inclusão para este estudo era de que os probandos apresentassem um ou mais parentes do sexo masculino afetados pela DI que fossem interligados por via materna. As amostras de DNA dos pacientes foram amplificadas utilizando a técnica de reação em cadeia da polimerase, seguida por purificação e sequenciamento direto pelo método de Sanger dos fragmentos amplificados. Para avaliar a conservação dos 17 miRNAs foi realizada uma análise filogenética in silico incluindo sequências dos miRNAs selecionados de humanos e de outras 8 espécies de primatas estreitamente relacionadas. Não foram encontradas alterações nas sequências nos genes de 17 miRNAs analisados, mesmo diante do padrão genético altamente heterogêneo da população brasileira. Adicionalmente, a análise filogenética destes miRNAs revelou uma alta conservação entre as espécies comparadas. Considerando o papel dos miRNAs como reguladores da expressão gênica, a ausência de alterações e a alta conservação entre primatas sugerem uma forte pressão seletiva sobre estas moléculas, reforçando a sua importância funcional para o organismo em geral. Apesar de não termos encontrado variantes de sequência nos miRNAs estudados, o envolvimento de miRNAs na DI não pode ser completamente descartado. Alterações fora da molécula de miRNA precursor, nos fatores de processamento, nos sítios alvo e variações no número de cópias de genes de miRNAs podem implicar em alteração na expressão dos miRNAs e, consequentemente, na funcionalidade do miRNA maduro. Sendo assim, uma análise sistemática da expressão de miRNAs em pacientes com DILX é urgentemente necessária, a fim de desvendar novos genes/mecanismos moleculares relacionados a esta condição.

Cold-gas chemical vapor deposition to identify the key precursor for rapidly growing vertically-aligned single-wall and few-wall carbon nanotubes from pyrolyzed ethanol

Vertically-aligned carbon nanotubes (VA-CNTs) were rapidly grown from ethanol and their chemistry has been studied using a "cold-gas" chemical vapor deposition (CVD) method. Ethanol vapor was preheated in a furnace, cooled down and then flowed over cobalt catalysts upon ribbon-shaped substrates at 800 °C, while keeping the gas unheated. CNTs were obtained from ethanol on a sub-micrometer scale without preheating, but on a millimeter scale with preheating at 1000 °C. Acetylene was predicted to be the direct precursor by gas chromatography and gas-phase kinetic simulation, and actually led to millimeter-tall VA-CNTs without preheating when fed with hydrogen and water. There was, however a difference in CNT structure, i.e. mainly few-wall tubes from pyrolyzed ethanol and mainly single-wall tubes for unheated acetylene, and the by-products from ethanol pyrolysis possibly caused this difference. The "cold-gas" CVD, in which the gas-phase and catalytic reactions are separately controlled, allowed us to further understand CNT growth. © 2012 Elsevier Ltd. All rights reserved.

Effects of CO2 enrichment on microstructure and ultrastructure of two species of freshwater green algae

order to investigate the morphological response of freshwater green algae to elevated CO2 concentration, Chlamydomonas reinhardtii Dang and Scenedesmus obliquus Kutz were cultured with enriched CO2, and their microstructure and ultrastructure were examined by microscopy and electron microscopy. The effect of CO2 enrichment to 186 mumol/L, was insignificant on the shape and size of C. reinhardtii, but significant in reducing the volume of S. obliquus. High-CO2 increased the amount of chloroplast. The pyrenoids occurred in low-CO2-grown cells but not in high-CO2-grown ones and more starch granules were observed in the former.

Stochastic resonance in quantum-well semiconductor lasers

The quantum well (QW) semiconductor lasers have become main optical sources for optical fibre communication systems because of their higher modulation speed, broader modulation bandwidth and better temperature characteristics. In order to improve the quality of direct-modulation by means of the stochastic resonance (SR) mechanism in QW semiconductor lasers, we investigate the behaviour of the SR in direct-modulated QW semiconductor laser systems. Considering the cross-correlated carrier noise and photon noise, we calculate the power spectrum of the photon density and the signal-to-noise ratio (SNR) of the direct-modulated laser system by using the linear approximation method. The results indicate that the SR always appears in the dependence of the SNR on the bias current density, and is strongly affected by the cross-correlation coefficient of the carrier and photon noises, the frequency of modulation signal, and the photon lifetime in the laser cavity.

Influence of 3A molecular sieve to tetrahydrofuran(THF) hydrate formation

Visual observation of the THF hydrate formation process in the presence of a 3A molecular sieve has been made at normal atmosphere and below a temperature of zero by microscopy. The results indicate that a 3A molecular sieve can induce the nucleation of the THF hydrate and promote the THF hydrate growth. With the existence of a 3A molecular sieve, the growth rate of THF hydrate is between 0.01 and 0.05 mu m/s. In comparison with the system without any 3A molecular sieve, the growth rate increases about 4 nm/s. After the THF hydrate grows into megacryst, the crystals will recombine and partially change under the same condition.

The phase inversion and morphology of nylon 1010 polypropylene blends

Noncompatibilized and compatibilized blends of nylon 1010/PP blends having five different viscosity ratios were prepared by melt extrusion. Glycidyl methacrylate-grafted-polypropylene (PP-g-GMA) was used as the compatibilizer to enbance the adhesion between the two polymers and to stabilize the blend morphology. The effect of the viscosity ratio on the morphology of nylon 1010/polypropylene blends was investigated, with primary attention to the phase-inversion behavior and the average particle size of the dispersed phase. The relationship between the mechanical properties and the phase-inversion composition was investigated as well. Investigation of the morphology of the blends by microscopy indicated that the smaller the viscosity ratio (eta(PP)/eta(PA)) the smaller was the polypropylene concentration at which the phase inversion took place and polypropylene became the continuous phase. The compatibilizer induced a sharp reduction of particle size, but did not have a major effect on the phase-inversion point. An improvement :in the mechanical properties was found when nylon 1010 provided the matrix phase. (C) 1996 John Wiley & Sons, Inc.

Anglo-Irish relations in the framework of the EEC and Northern Ireland, 1969-1975

This thesis will analyse Anglo-Irish relations between 1969 and 1975, when two topics dominated the relationship: Northern Ireland and the entry of Britain and Ireland into the European Economic Community (hereafter EEC). In 1969 entry to the EEC was still only a possibility and awaited political developments, while the Northern Ireland problem had yet to escalate. 1975 on the other hand confirmed that Ireland would remain in the EEC even if Britain left while Direct Rule for Northern Ireland was confirmed as the British policy for the foreseeable future. These dates are significant because they encompass firstly pre and post entry to the EEC and how this transformed Anglo-Irish relations. Secondly they contain the commencement and then deterioration of the Northern Ireland problem and the attempts to resolve it that finally led to direct rule by Westminster. The study will examine the fluctuating nature of the relationship between Britain and Ireland. Special regard will be devoted to the demands of internal British politics and how such demands affected the relationship. Overall, the study will demonstrate how the bilateral relationship evolved under the pressure of events in Northern Ireland and adapted to the multilateral context of the EEC. It will compare the dynamics of the states’ interactions in two extremely different areas. The thesis will demonstrate how entry to the EEC transformed the unequal Anglo-Irish economic relationship and created one of partners within the EEC. It will also analyse how the developing Northern Ireland problem caused changes to British policy. In particular, it will examine how the British Government came to recognise the beneficial role that the Republic of Ireland might play in resolving the Troubles in Northern Ireland.

Trophic role of small cetaceans and seals in Irish waters

Understanding the role of marine mammals in specific ecosystems and their interactions with fisheries involves, inter alia, an understanding of their diet and dietary requirements. In this thesis, the foraging ecology of seven marine mammal species that regularly occur in Irish waters was investigated by reconstructing diet using hard parts from digestive tracts and scats. Of the species examined, two (striped and Atlantic white-sided dolphin) can be considered offshore species or species inhabiting neritic waters, while five others usually inhabit more coastal areas (white-beaked dolphin, harbour porpoise, harbour seal and grey seal); the last species studied was the bottlenose dolphin whose population structure is more complex, with coastal and offshore populations. A total of 13,028 prey items from at least 81 different species (62 fish species, 14 cephalopods, four crustaceans, and a tunicate) were identified. 28% of the fish species were identified using bones other than otoliths, highlighting the importance of using all identifiable structures to reconstruct diet. Individually, each species of marine mammal presented a high diversity of prey taxa, but the locally abundant Trisopterus spp. were found to be the most important prey item for all species, indicating that Trisopterus spp. is probably a key species in understanding the role of these predators in Irish waters. In the coastal marine mammals, other Gadiformes species (haddock, pollack, saithe, whiting) also contributed substantially to the diet; in contrast, in pelagic or less coastal marine mammals, prey was largely comprised of planktivorous fish, such as Atlantic mackerel, horse mackerel, blue whiting, and mesopelagic prey. Striped dolphins and Atlantic white-sided dolphins are offshore small cetaceans foraging in neritic waters. Differences between the diet of striped dolphins collected in drift nets targeting tuna and stranded on Irish coasts showed a complex foraging behaviour; the diet information shows that although this dolphin forages mainly in oceanic waters it may occasionally forage on the continental shelf, feeding on available prey. The Atlantic white-sided dolphin diet showed that this species prefers to feed over the continental edge, where planktivorous fish are abundant. Some resource partitioning was found in bottlenose dolphins in Irish waters consistent with previous genetic and stable isotope analysis studies. Bottlenose dolphins in Irish waters appears to be generalist feeders consuming more than 30 prey species, however most of the diet comprised a few locally abundant species, especially gadoid fish including haddock/pollack/saithe group and Trisopterus spp., but the contribution of Atlantic hake, conger eels and the pelagic planktivorous horse mackerel were also important. Stomach content information suggests that three different feeding behaviours might occur in bottlenose dolphin populations in Irish waters; firstly a coastal behaviour, with animals feeding on prey that mainly inhabit areas close to the coast; secondly an offshore behaviour where dolphins feed on offshore species such as squid or mesopelagic fish; and a third more complex behaviour that involves movements over the continental shelf and close to the shelf edge. The other three coastal marine mammal species (harbour porpoise, harbour seal and grey seal) were found to be feeding on similar prey and competition for food resources among these sympatric species might occur. Both species of seals were found to have a high overlap (more than 80%) in their diet composition, but while grey seals feed on large fish (>110mm), harbour seals feed mostly on smaller fish (<110mm), suggesting some spatial segregation in foraging. Harbour porpoises and grey seals are potentially competing for the same food resource but some differences in prey species were found and some habitat partitioning might occur. Direct interaction (by catch) between dolphins and fisheries was detected in all species. Most of the prey found in the stomach contents from both stranded and by catch dolphins were smaller sizes than those targeted by commercial fisheries. In fact, the total annual food consumption of the species studied was found to be very small (225,160 tonnes) in comparison to fishery landings for the same area (~2 million tonnes). However, marine mammal species might be indirectly interacting with fisheries, removing forage fish. Incorporating the dietary information obtained from the four coastal species, an ECOPATH food web model was established for the Irish Sea, based on data from 2004. Five trophic levels were found, with bottlenose dolphins and grey and harbour seals occurring at the highest trophic level. A comparison with a previous model based on 1973 data suggests that while the overall Irish Sea ecosystem appears to be “maturing”, some indices indicate that the 2004 fishery was less efficient and was targeting fish at higher trophic levels than in 1973, which is reflected in the mean trophic level of the catch. Depletion or substantial decrease of some of the Irish Sea fish stocks has resulted in a significant decline in landings in this area. The integration of diet information in mass-balance models to construct ecosystem food-webs will help to understand the trophic role of these apex predators within the ecosystem.

Coccolithophore species as indicators of surface oceanographic conditions in the vicinity of Azores islands

During summer 2008 and spring 2009, surface oceanographic surveys were carried out around three islands of the Azores archipelago (Terceira, Sao Miguel and Santa Maria) to assess the phytoplankton distribution and associated physico-chemical processes. The Azores archipelago is a major feature in the biogeochemical North Atlantic Subtropical Gyre (NAST) province although its influence on the productivity of the surrounding ocean is poorly known. Surface phytoplankton was studied by microscopy and HPLC (High Precision Liquid Chromatography). The mean values for biomass proxy Chlorophyll a (Chla) ranged from 0.04 to 0.55 mu g L-1 (Chla maximum = 0.86 mu g L-1) and coccolithophores were the most abundant group, followed by small flagellates, Cyanobacteria, diatoms and dinoflagellates being the least abundant group. The distribution of phytoplankton and coccolithophore species in particular presented seasonal differences and was consistent with the nearshore influence of warm subtropical waters from the south Azores current and colder subpolar waters from the north. The satellite-derived circulation patterns showed southward cold water intrusions off Terceira and northward warm water intrusions off Santa Maria. The warmer waters signal was confirmed by the subtropical coccolithophore assemblage, being Discosphaera tubifera a constant presence under these conditions. The regions of enhanced biomass, either resulting from northern cooler waters or from island induced processes, were characterized by the presence of Emiliania huxleyi. Diatoms and dinoflagellates indicated coastal and regional processes of nutrient enrichment and areas of physical stability, respectively.

Next Generation Sequencing Reveals the Hidden Diversity of Zooplankton Assemblages

Zooplankton play an important role in our oceans, in biogeochemical cycling and providing a food source for commercially important fish larvae. However, difficulties in correctly identifying zooplankton hinder our understanding of their roles in marine ecosystem functioning, and can prevent detection of long term changes in their community structure. The advent of massively parallel next generation sequencing technology allows DNA sequence data to be recovered directly from whole community samples. Here we assess the ability of such sequencing to quantify richness and diversity of a mixed zooplankton assemblage from a productive time series site in the Western English Channel. Methodology/Principle Findings Plankton net hauls (200 µm) were taken at the Western Channel Observatory station L4 in September 2010 and January 2011. These samples were analysed by microscopy and metagenetic analysis of the 18S nuclear small subunit ribosomal RNA gene using the 454 pyrosequencing platform. Following quality control a total of 419,041 sequences were obtained for all samples. The sequences clustered into 205 operational taxonomic units using a 97% similarity cut-off. Allocation of taxonomy by comparison with the National Centre for Biotechnology Information database identified 135 OTUs to species level, 11 to genus level and 1 to order, <2.5% of sequences were classified as unknowns. By comparison a skilled microscopic analyst was able to routinely enumerate only 58 taxonomic groups. Conclusions Metagenetics reveals a previously hidden taxonomic richness, especially for Copepoda and hard-to-identify meroplankton such as Bivalvia, Gastropoda and Polychaeta. It also reveals rare species and parasites. We conclude that Next Generation Sequencing of 18S amplicons is a powerful tool for elucidating the true diversity and species richness of zooplankton communities. While this approach allows for broad diversity assessments of plankton it may become increasingly attractive in future if sequence reference libraries of accurately identified individuals are better populated.

Electromigration of vacancies in copper

The total current-induced force on atoms in a Cu wire containing a vacancy are calculated using the self consistent one-electron density matrix in the presence of an electric current, without separation into electron-wind and direct forces. By integrating the total current-induced force, the change in vacancy migration energy due to the current is calculated. We use the change in migration energy with current to infer an effective electromigration driving force F-e. Finally, we calculate the proportionality constant rho* between F-e and the current density in the wire.

Schistosoma mansoni cercariae experience influx of macromolecules during skin penetration

We have observed that when cercariae penetrate the skin of mice, there is influx into their tissues of Lucifer Yellow and certain labelled molecules of up to 20 kDa molecular weight. This observation was made using a variety of fluorescent membrane-impermeant compounds injected into the skin before the application of cercariae. This unexpected phenomenon was investigated further by transforming cercariae in vitro in the presence of the membrane-impermeant compounds and examining the distribution by microscopy. In schistosomula derived from this procedure, the nephridiopore and surface membrane were labelled while the pre- and post-acetabular glands were not labelled. The region associated with the oesophagus within the pharyngeal muscle clearly contained the fluorescent molecules, as did the region adjacent to the excretory tubules and the germinal mass. We used cercariae stained with carmine to aid identification of regions labelled with Lucifer Yellow. Although the mechanism of this influx is unclear, the observation is significant. From it, we can suggest an hypothesis that, during skin penetration, exposure of internal tissues of the parasite to external macromolecules represents a novel host-parasite interface.

The carbenoid approach to peptide synthesis

A different approach to the synthesis of dipeptides is described based on the formation of the (NHCHRCONH)-C-1-(CHRCO)-C-2 bond by carbenoid N-H insertion, rather than the formation of the peptide bond itself. Thus decomposition of triethyl diazophosphonoacetate catalysed by rhodium(Ii) acetate in the presence of N-protected amino acid amides 8 gives the phosphonates 9, Subsequent Wadsworth-Emmons reaction of 9 with aldehydes in the presence of DBU gives dehydro dipeptides 10. The reaction has been extended to a simple two-step procedure, without the isolation of the intermediate phosphonate. for conversion of a range of amino acid amides 11 into dehydro dipepides 12 and to an N-methylamide 11h, and for conversion of a dipeptide: to tripeptide (13-14). Direct conversion, by using methyl diazophenylacetate, of amino acid amides to phenylglycine-containing dipeptides 19 proceeds in good chemical yield, but with poor diastereoselectivity.

Global mitochondrial DNA phylogeography and population structure of the silky shark, Carcharhinus falciformis

Globally, sharks are under enormous pressure from fishing efforts. One such species is the silky shark, Carcharhinus falciformis, which occurs in all the Earth’s tropical oceans and is captured in large numbers in pelagic fisheries. Regionally, the silky shark is listed as Vulnerable to Near Threatened by the International Union for the Conservation of Nature due to high levels of direct and by catch exploitation. Despite major conservation concerns about this species, little is known about its genetic status and level of demographic or evolutionary connectivity among its regional distributions. We report a genetic assessment of silky sharks sampled across a major portion of the species’ global range. We sequenced the complete mitochondrial DNA control region from 276 individuals taken from the western Atlantic and Indo-Pacific Oceans and the Red Sea. Overall, haplotype and nucleotide diversities were relatively large (0.93 ± 0.01 and 0.61 ± 0.32 %, respectively). Nucleotide diversity in Indo-Pacific sharks, however, was significantly lower and about half that in Atlantic sharks. Strong phylogeographic partitioning occurred between ocean basins. Furthermore, shallow but significant pairwise statistical differentiation occurred among most regional samples within the Indo-Pacific, but not the western Atlantic. Overall, at least five mitochondrial DNA populations of silky sharks were identified globally. Despite historically large population sizes, silky sharks appear to be isolated on relatively small spatial scales, at least in the Indo-Pacific, indicating that conservation and management efforts will need to be exerted at relatively small scales in a pelagic and highly vagile species.