A política de formação dos Agentes Comunitários de Saúde: memória de uma formulação em disputa nos anos 2003-2005

Este estudo trata da formulação da política de formação do agente comunitário de saúde (ACS), buscando compreender as disputas que então se travaram, a partir dos processos políticos relativos à gestão da educação e do trabalho do ACS, implementados no período compreendido entre o início de 2003 e meados de 2005. Para tal fim, foram analisados os documentos debatidos nessa formulação, no intervalo de tempo compreendido entre março de 2003 e julho de 2004, o qual se revelou um período intenso de produção conceitual em torno dessa política. Nos documentos analisados, revelaram-se posições acerca do perfil social do ACS e do trabalho que este deve realizar, articuladas a concepções de ensino e formação em saúde, que disputaram o conteúdo e a forma que a política de formação desses trabalhadores deveria assumir. Tais disputas guardam relação também com o modo como esta função se instituiu no SUS e as contradições geradas desde então; ao mesmo tempo, as posições conflitantes apontam para distintos projetos de saúde, educação e trabalho. Esse processo resultou na publicação do Referencial Curricular para Curso Técnico de Agente Comunitário de Saúde, que consolidou a proposta de formação técnica, mas cuja implementação não tem se dado integralmente, configurando a prevalência de uma qualificação inicial, conforme determina a legislação que orienta o exercício da profissão de ACS. Entretanto, a dissertação indica que o processo não se esgotou, sendo a atual política de formação dos ACS objeto de disputas e demandas, tanto pela sua conservação, quanto pela sua transformação.

A New theory for evaluating the number density of inclusions in films

A new formulation derived from thermal characters of inclusions and host films for estimating laser induced damage threshold has been deduced. This formulation is applicable for dielectric films when they are irradiated by laser beam with pulse width longer than tens picoseconds. This formulation can interpret the relationship between pulse-width and damage threshold energy density of laser pulse obtained experimentally. Using this formulation, we can analyze which kind of inclusion is the most harmful inclusion. Combining it with fractal distribution of inclusions, we have obtained an equation which describes relationship between number density of inclusions and damage probability. Using this equation, according to damage probability and corresponding laser energy density, we can evaluate the number density and distribution in size dimension of the most harmful inclusions. (c) 2005 Elsevier B.V. All rights reserved.

Effects of CO2 laser conditioning of the antireflection Y2O3/SiO2 coatings at 351 nm

Y2O3/SiO2 coatings were deposited on fused silica by electron beam evaporation. A continuous wave CO2 laser was used to condition parts of the prepared samples at different scanning speeds in the air. LAMBDA 900 spectrometer was used to investigate the changes of the transmittance and residual reflection spectrum. A Nomarski microscope under dark field was used to examine the changes of the micro defect density. The changes of the surface roughness and the microstructure of the film before and after conditioning were investigated by AFM and X-ray diffraction, respectively. We found that laser-induced damage threshold (LIDT) of the films conditioning at 30 mm/s scanning speed was increased by more than a factor of 3 over the thresholds of the as-deposited films. The conditioning effect was correlated with an irradiation-induced decrease of the defect density and absorption of the films. (c) 2005 Elsevier B.V. All rights reserved.

Influence of buffer layer thickness on the structure and optical properties of ZnO thin films

A series of ZnO thin films were deposited on ZnO buffer layers by DC reactive magnetron sputtering. The buffer layer thickness determination of microstructure and optical properties of ZnO films was investigated by X-ray diffraction (XRD), photoluminescence (PL), optical transmittance and absorption measurements. XRD results revealed that the stress of ZnO thin films varied with the buffer layer thickness. With the increase of buffer layer thickness, the band gap edge shifted toward longer wavelength. The near-band-edge (NBE) emission intensity of ZnO films deposited on ZnO buffer layer also varied with the increase of thickness due to the spatial confinement increasing the Coulomb interaction between electrons and holes. The PL measurement showed that the optimum thickness of the ZnO buffer layer was around 12 nm. (c) 2005 Elsevier B.V. All rights reserved.

Overcoat dependence of laser-induced damage threshold of 355 nm HR coatings

A series of HR coatings, with and without overcoat, were prepared by electron beam evaporation using the same deposition process. The laser-induced damage threshold (LIDT) was measured by a 355 nm Nd:YAG laser with a pulse width of 8 ns. Damage morphologies of samples were observed by Leica-DMRXE Microscope. The stress was measured by viewing the substrate deformation before and after coatings deposition using an optical interferometer. Reflectance of the samples was measured by Lambda 900 Spectrometer. The theoretical results of electric field distributions of the samples were calculate by thin film design software (TFCalc). It was found that SiO2 overcoat had improved the LIDT greatly, while MgF2 overcoat had little effect on the LIDT because of its high stress in the HR coatings. The damage morphologies were different among HR coatings with and without overcoats. (c) 2005 Elsevier B.V. All rights reserved.

Structure and optical properties of ZnS thin films grown by glancing angle deposition

The glancing angle deposition (GLAD) technique was used to deposit ZnS films by electron beam evaporation method. The cross sectional scanning electron microscopy (SEM) image illustrated a highly orientated microstructure composed of slanted column. The atomic force microscopy (APM) analysis indicated that incident flux angle had significant effects on the nodule size and surface roughness. Under identical nominal thickness, the actual thickness of the GLAD films is related to the incident flux angle. The refractive index and in-plane birefringence of the GLAD ZnS films were discussed, and the maximum bireffingence Delta n = 0.036 was obtained at incident flux angle of alpha = 80 degrees. Therefore, the glancing angle deposition technique is a promising way to create a columnar structure with enhanced birefringent property. (c) 2005 Elsevier B.V. All rights reserved.

Theoretical analysis of optical properties of dielectric coatings dependence on substrate subsurface defects

A model for refractive index of stratified dielectric substrate was put forward according to theories of inhomogeneous coatings. The substrate was divided into surface layer, subsurface layer and bulk layer along the normal direction of its surface. Both the surface layer (separated into N-1 sublayers of uniform thickness) and subsurface layer (separated into N-2 sublayers of uniform thickness), whose refractive indices have different statistical distributions, are equivalent to inhomogeneous coatings, respectively. And theoretical deduction was carried Out by employing characteristic matrix method of optical coatings. An example of mathematical calculation for optical properties of dielectric coatings had been presented. The computing results indicate that substrate subsurface defects can bring about additional bulk scattering and change propagation characteristic in thin film and Substrate. Therefore, reflectance, reflective phase shift and phase difference of an assembly of coatings and substrate deviate from ideal conditions. The model will provide some beneficial theory directions for improving optical properties of dielectric coatings via substrate surface modification. (c) 2005 Elsevier B.V. All rights reserved.

Práticas dos enfermeiros na estratégia de saúde da família sob a ótica do agente comunitário de saúde

Esta pesquisa provém da dissertação de mestrado do Programa de Pós-Graduação em Enfermagem da Universidade do Estado do Rio de Janeiro (ENF/UERJ) e apresenta como objeto de estudo as práticas dos enfermeiros na Estratégia de Saúde da Família (ESF) sob a ótica do Agente Comunitário de Saúde (ACS). Este estudo está vinculado às pesquisas Práticas de cuidado no SUS: o papel do enfermeiro na Atenção Básica e Abordagem interdisciplinar das novas relações e processos de trabalho em saúde: o caso dos agentes comunitários de saúde. O interesse em estudar tais práticas decorreu da vivência como enfermeira de família, atuando com a assistência aos usuários e como chefe de equipe, surgindo reflexões e inquietações em torno das práticas de saúde realizadas pelo enfermeiro e como estas são vistas pelo agente de saúde. Sendo assim, surge o questionamento: Qual a visão dos agentes comunitários de saúde em relação às praticas de saúde desenvolvidas por enfermeiros na Estratégia de Saúde da Família? A fim de responder esta questão, definiu-se como objetivo geral: analisar as práticas dos enfermeiros da Estratégia Saúde-Família do município do Rio de Janeiro, sob a ótica dos Agentes Comunitários de Saúde e objetivos específicos: identificar as práticas de saúde desenvolvidas por enfermeiros na perspectiva do Agente Comunitário de saúde e conhecer os fatores determinantes destas práticas e sua correlação com o trabalho na Estratégia de Saúde da Família. Trata-se de um estudo descritivo com abordagem qualitativa, tendo sido realizado no município do Rio de Janeiro, de 2008 a 2010. A fonte dados foi um conjunto de narrativas de ACS do estudo Abordagem Interdisciplinar dos Novos Processos e Condições de Trabalho em Saúde: o Caso dos Agentes Comunitários de Saúde do Rio de Janeiro. A seleção dos sujeitos foi realizada a partir de uma varredura do banco de narrativas, selecionando aquelas nas quais os ACS discorrem sobre as práticas dos enfermeiros. De um total de 60 ACS, foram selecionados 7 agentes. As narrativas analisadas formaram tres categorias: cuidados do enfermeiro na ESF; práticas do enfermeiro na ESF; fatores que influenciam a prática do enfermeiro na ESF. Com a análise foi possível identificar que o ACS enxerga o enfermeiro como cuidador, através do acolhimento, resolução de problemas e consultas de enfermagem. A prática do enfermeiro é vista pelo agente de saúde através da supervisão, como educador em saúde e através das visitas domiciliares. Entretanto, tais práticas são determinadas por fatores que as facilitam ou a dificultam. As facilidades de atuação do enfermeiro estão em gostar da profissão, a criação do vínculo entre o profissional e o usuário e a presença de uma equipe completa na ESF. Já as dificuldades são encontradas quando o enfermeiro não tem a equipe completa, falta de infraestrutura e recursos materiais no serviço. Ao olhar as práticas de saúde dos enfermeiros na ESF foi possível identificar como elas são desenvolvidas na visão de outros membros da equipe, neste caso os ACS, contribuindo na compreensão de como obter uma melhoria do cuidado à família, de forma qualitativa e humanizada.

Celiac disease in the Mediterranean area

Background: The World Gastroenterology Organization recommends developing national guidelines for the diagnosis of Celiac Disease (CD): hence a profile of the diagnosis of CD in each country is required. We aim to describe a cross-sectional picture of the clinical features and diagnostic facilities in 16 countries of the Mediterranean basin. Since a new ESPGHAN diagnostic protocol was recently published, our secondary aim is to estimate how many cases in the same area could be identified without a small intestinal biopsy. Methods: By a stratified cross-sectional retrospective study design, we examined clinical, histological and laboratory data from 749 consecutive unselected CD children diagnosed by national referral centers. Results: The vast majority of cases were diagnosed before the age of 10 (median: 5 years), affected by diarrhea, weight loss and food refusal, as expected. Only 59 cases (7.8%) did not suffer of major complaints. Tissue transglutaminase (tTG) assay was available, but one-third of centers reported financial constraints in the regular purchase of the assay kits. 252 cases (33.6%) showed tTG values over 10 times the local normal limit. Endomysial antibodies and HLA typing were routinely available in only half of the centers. CD was mainly diagnosed from small intestinal biopsy, available in all centers. Based on these data, only 154/749 cases (20.5%) would have qualified for a diagnosis of CD without a small intestinal biopsy, according to the new ESPGHAN protocol. Conclusions: This cross-sectional study of CD in the Mediterranean referral centers offers a puzzling picture of the capacities to deal with the emerging epidemic of CD in the area, giving a substantive support to the World Gastroenterology Organization guidelines.

Efficiency improvement of organic light-emitting diodes using 8-hydroxy-quinolinato lithium as an electron injection layer

Organic light-emitting diodes (OLEDs) using tris-(8-hydroxy-quinolinato) aluminum (Alq(3)) as an emitter, 8-hydroxy-quinolinato lithium (Liq) as an electron injection layer, were prepared. Experimental results show that the efficiency of device with Liq is three times higher than that without Liq. The device using Liq as an injection layer is less sensitive in efficiency to the Liq thickness than that using LiF. In addition to the Alq3 based devices, Liq is also very effective as an electron injection layer for 4,4'-bis(2,2-diphenylvinyl)-1,1'-biphenyl based blue OLED and poly (2-methoxy,5-(2-ethyl-hexyloxy)-1,4-phenylenevinylene) based orange polymer OLED. (c) 2004 Elsevier B.V. All rights reserved.

Microsatellite primers for red drum (Sciaenops ocellatus)

In this note, we document polymerase-chain-reaction (PCR) primer pairs for 101 nuclear-encoded microsatellites designed and developed from a genomic library for red drum (Sciaenops ocellatus). Details of the genomic library construction, the sequencing of positive clones, primer design, and PCR protocols may be found in Karlsson et al. (2008). The 101 microsatellites (GENBA NK Accession Numbers EU015882-EU015982) were amplified successfully and used to genotype 24 red drum obtained from Galveston Bay, Texas (Table 1). A total of 69 of the microsatellites had an uninterrupted (perfect) dinucleotide motif, and 30 had an imperfect dinucleotide motif; one microsatellite had an imperfect tetranucleotide motif, and one had an imperfect and compound motif (Table 1 ). Sizes of the cloned alleles ranged from 84 to 252 base pairs. A ‘blast’ search of the GENBANK database indicated that all of the primers and the cloned alleles were unique (i.e., not duplicated).