Cooperação e apoio técnico entre estado e municípios: a experiência do programa articuladores da atenção básica em São Paulo

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.

História da saúde mental infantil: a criança brasileira da Colônia à República Velha

Este texto descreve a trajetória da Saúde Mental e dos cuidados à infância no Brasil da Colônia à República Velha. No período colonial não havia cuidados especiais à criança. O que temos para compreender a criança colonial são relatos descritos em documentos, tratados e cartas da época, e em descrições de viajantes que aqui aportaram para conhecer o Novo Mundo. Depois do século XVIII a urbanização das cidades requer a intervenção médica nas questões de higiene e saúde, e gradativamente muda a concepção de criança, primeiro na Europa, depois no Brasil, chegando o século XIX com médicos preocupados com a questão da mortalidade infantil e com os cuidados que se deveria ter com a criança, negligenciada até então. É no século XIX que se inicia a institucionalização dos saberes médicos e psicológicos aplicados à infância e é quando podemos obter mais registros sobre que cuidados eram reservados à criança.

Planejamento urbano e geração de empregos: A cidade de São Paulo (Brasil) nos anos 90

This paper attempts to show the convergence of principles between labor market politics and urban management, emphasizing it relationship with pro-market theories. Limits and possibilities of the application of this theoretical frame were investigated by examining the changes in both composition and stock of labor in three important business spaces in São Paulo: Central Area, Paulista Avenue and the new expansion front near Luiz Carlos Berrini and Águas Epraiadas avenues. Despite the claims of pro-market theoreticians, information provided by Labor Ministry showed that between 1996 and 2000, a re-arrangemenet of the workers contingent among the investigated areas occurred, instead of the expected growth. The favorable behavior registered in Berrini/ Águas Espraiadas, because of the bulky volume of investments, took place at the same time that a decrease of labor in the Downtown; meanwhile, in Paulista, a growth of the number of employees was observed, in spite of the landing less elevated of investments.

Avaliação da dinâmica dos processos erosivos lineares e sua relação com a evolução do uso da terra

The development of linear erosion processes is directly related with the environment natural characteristics or with modifications that have occurred on them by the anthropic action. In this context, the present article has as a general objective to evaluate the dynamic of the linear erosion processes and their relations with the evolution of the land use and with the lito-pedologic characteristics of the Cavalheiro hydrographic basin - Analândia, SP. In order to reach such objective, maps of erosive features and land use of several settings were elaborated, besides cartographic representations of the geological and pedological data of the study area. The obtained data were analyzed starting from the principles that concern to the General Systems Theory. Such analysis evidenced the intrinsic bond of the development of linear erosion processes with the several forms of land use and with the natural attributes of the studied area. Therefore, the methodological procedure adopted in this research has been considered as fundamental tool to understand the linear erosion processes dynamic, making it possible to take data of extreme relevance for the planning of the use and occupation of the land.

Design and validity of a questionnaire to assess sexuality in pregnant women

Background. A review of validated methods for assessing female sexual dysfunction and a review of male and female sexual dysfunction did not refer to any specific questionnaire for evaluating sexuality during pregnancy. A study was performed at the Obstetrics and Gynecology Department of Botucatu Medical School, São Paulo State University, Brazil to design and validate a pregnancy sexuality questionnaire, the Pregnancy Sexual Response Inventory (PSRI). Methods. Women with a singleton pregnancy between 10 and 35 weeks of gestation were randomly recruited. There were five phases in the development of the PSRI: (1) item selection; (2) item development; (3) determination of internal consistency, reliability and convergence; (4) content validity; and (5) determination of inter-interviewer reliability. Internal consistency and reliability were evaluated using Cronbach's alpha. Inter-interviewer reliability was assessed by evaluating the responses of 18 academics at various institutions, using Kappa Index and Student t test. Results. Good internal consistency and reliability were obtained (Cronbach's alpha coefficient = 0.79). Among the 18 academics, 13 totally agreed (K = 1.0), three partially agreed (K = 0.67) and two disagreed (K = 0.33) with the proposed questions. Comparisons of the mean PSRI domain scores made between the primary investigators and the other interviewers showed no significant differences in all domains (p > 0.05). Conclusion. PSRI is a new validated instrument for evaluating sexuality and sexual activity and related health concerns during pregnancy. © 2009 Rudge et al; licensee BioMed Central Ltd.

Zoneamento do parque ecológico de ourinhos SP

The aim of this study was to carry out a zoning in the municipal ecological park of Ourinhos, SP, located southwest of São Paulo State, aiming to subsidize the planning and management of this area. With this purpose it was made an inventory of the landscape resources of this park with hypsometry, declivity, use of soil and zoning mappings. From this zoning, we analyzed the possibilities of implementing purposes of use, with the objective of preserving this area, minimizing the negative environmental impacts. Thus, this research was of extreme importance, since it allowed to identify and rank, in the territory, areas or sectors that are priority to the development of activities, as well as contribute to the conservation of natural and socio-cultural heritage.

Mineral water: A microbiological approach

The microbiological quality of bottled mineral water of various domestic brands sold in Brazil was investigated, with particular focus on the heterotrophic plate count (HPC). Neither total coliforms nor Escherichia coli were found in any 1.5 L bottle samples. Total coliforms were found in 2.9% of the small bottles, while in 20 L bottles the presence of total coliforms and E. coli was demonstrated in 15.5 and 2.4% of samples, respectively. Pseudomonas aeruginosa was detected in 4.3, 4.5 and 9.5% of small, 1.5 and 20 L bottles, respectively. In 36.4% of the samples of 1.5 L bottles, the HPC was above 500 cfu/mL. This percentage of samples with an HPC above 500 cfu/mL increased to 52.0 and 61.9% in small and 20 L bottles, respectively. Higher contamination by total coliforms, E. coli, P. aeruginosa and HPCs occurred in 20 L bottles. In conclusion, several samples in this study were outside the international quality standard for mineral water and the large number of samples with high HPCs shows that more work must be done on the use of HPC in mineral water and the damaging effects that these microorganisms may cause to humans. The bottled mineral water was confirmed as a particularly important public health problem, due to the poor microbiological quality of the products that are marketed. © IWA Publishing 2012.

Plano municipal de saúde: Análise do instrumento de gestão

Among planning instruments used by manager instances of Brazilian Health System it pointed the Health Municipal Plan (PMS) that should be built collectively showing political intentions, directresses, priorities, objectives, goals framework, estimative of resources and need costs to get the goals of the health sector. The aim of this work was to analyze the plans in relation to attendance of legal requirements which manage the Brazilian Health System, its constitution and showing of essential items. The study included three municipalities form São Paulo State. It was used the documental analysis as research technique. Near all plans showed an analysis of situation with detailed descriptions of general situation of municipality, and only one of them realized critical analysis of their epidemiological data; the financial income applied on health was decrypted by only one municipality. About programming, all municipalities described the main problems and its solutions. Although they had goals framework, the question about cost estimative to get the goals was not approached. Any municipality showed an annual review, being one of them delayed over than two years. It was observed no participation of Municipal Health Council on elaboration and review of plans. It was concluded that there was a deficiency in the plans analyzed. It's necessary to execute continuing education with managers in relation to importance of systematic elaboration of plans and to incentive the promotion of active participation of Municipal Health Council promotion of aiming to became true the social control of health actions.

Estrutura populacional de Lutzomya longipalpis através da amplificação e sequenciamento do segmento ribossomal 12S de DNA mitocondrial

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

A saúde em pauta: análise de enquadramento de matérias sobre saúde pública de dois telejornais

Pós-graduação em Comunicação - FAAC

A odontologia nos planos municipais de saúde: análise dos municípios pertencentes à 8ª Regional de Saúde do Estado do Paraná

Pós-graduação em Odontologia Preventiva e Social - FOA

Acidentes rábicos em município do norte do Paraná: uma análise do perfil, conduta e sistema de notificação

Pós-graduação em Saúde Coletiva - FMB

Seleção de indicadores para a gestão de saúde no município

Pós-graduação em Saúde Coletiva - FMB

Avaliação das pressões respiratórias máximas e expansibilidade pulmonar em pacientes portadoras de câncer de mama e submetidas a tratamento cirúrgico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Pesquisa de Micobacterium Leprae e outras microbactérias em Tatus Selvagens

Pós-graduação em Doenças Tropicais - FMB