Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose

Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.

Estimation and evaluation of dynamic properties as indicators of changes on soil structure in sugarcane fields of São Paulo State - Brazil

The indiscriminate management and use of soils without moisture control has changed the structure of it due to the increment of the traffic by agricultural machines through the years, causing in consequence, a soil compaction and yield reduction in the areas of intensive traffic. The purpose of this work was to estimate and to evaluate the performance of preconsolidation pressure of the soil and shear stress as indicators of changes on soil structure in fields cropped with sugarcane, as well as the impact of management processes in an Eutrorthox soil structure located in São Paulo State. The experimental field was located in Piracicaba's rural area (São Paulo State, Brazil) and has been cropped with sugarcane, in the second harvest cycle. The soil was classified by Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA) [Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA), 1999. Centro Nacional de Pesquisa de Solos. Sistema Brasileiro de Classificao de Solos, Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA), Brasilia, 412 pp.] as an Eutrorthox. Undisturbed samples were collected and georeferenced in a grid of 60 m x 60 m from two depths: 0-0.10 m (superficial layer - SL) and in the layer of greatest mechanical resistance (LGMR), previously identified by cone index (CI). The investigated variables were pressure preconsolidation (sigma(p)), apparent cohesion (c) and internal friction angle (phi). The conclusions from the results were that the SLSC was predicted satisfactorily from up as a function of soil moisture; thus, decisions about machinery size and loading (contact pressures) can be taken. Apparent cohesion (c), internal friction angle (phi) and the Coulomb equation were significantly altered by traffic intensity. The sigma(p), c and phi maps were shown to be important tools to localize and visualize soil compaction and mechanical resistance zones. They constitute a valuable resource to evaluate the traffic impact in areas cropped with sugarcane in State of São Paulo, Brazil. (C) 2008 Elsevier B.V. All rights reserved.

Nutrient recycling and physical indicators of an alley cropping system in a sandy loam soil in the pre-Amazon region of Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A Proposal for System Performance Evaluation for an ERP Knowledge Extraction Model

Much has been researched and discussed in the importance played by knowledge in organizations. We are witnessing the establishment of the knowledge economy, but this "new economy" brings in itself a whole complex system of metrics and evaluations, and cannot be dissociated from it. Due to its importance, the initiatives of knowledge management must be continually assessed on their progress in order to verify whether they are moving towards achieving the goals of success. Thus, good measurement practices should include not only how the organization quantifies its knowledge capital, but also how resources are allocated to supply their growth. Thinking about the aspects listed above, this paper presents an approach to a model for Knowledge extraction using an ERP system, suggesting the establishment of a set of indicators for assessing organizational performance. The objective is to evaluate the implementation of projects of knowledge management and thus observe the general development of the organization.

Different nutritional-state indicators of HIV-positive individuals undergoing antiretroviral therapy

This study aimed at learning about the nutritional profile of HIV-positive individuals undergoing antiretroviral therapy and at comparing the performance of nutritional-state indicators. A transversal study was performed on 94 patients attending the Tropical Diseases Outpatient Hospital of Botucatu Medical School (FMB)-UNESP. The body mass index (BMI) and the classification by Papini-Berto (PB) were used to evaluate nutritional state, aiming at detecting malnutrition and obesity. The waist-to-hips ratio (W/HR) and waist circumference (WC) were adopted for identification of abdominal obesity and lipodystrophy. According to BMI, most of the individuals were eutrophic, followed by 30.9% overweight and 6.4% malnourished. By using the PB classification, the frequency of malnourished increased (22.3%). The analysis of the PB classification in relation to BMI indicated that the former presented high sensitivity and good specificity for malnutrition diagnosis, namely 100% and 83%, respectively. The prevalence of abdominal obesity was 7.44% according to WC, and a higher prevalence (38.3%) was observed when taking W/HR into account. There was significant positive association between nutritional diagnosis according to PB and T CD4(+) lymphocyte. The results support the use of PB classification for malnutrition detection as well as that of BMI and W/HR for overweight and fat redistribution.

Spatial distribution of trachoma cases in the City of Bauru, State of São Paulo, Brazil, detected in 2006: defining key areas for improvement of health resources

Introduction: The objective of this study was to analyze the spatial behavior of the occurrence of trachoma cases detected in the City of Bauru, State of São Paulo, Brazil, in 2006 in order to use the information collected to set priority areas for optimization of health resources. Methods: the trachoma cases identified in 2006 were georeferenced. The data evaluated were: schools where the trachoma cases studied, data from the 2000 Census, census tract, type of housing, water supply conditions, distribution of income and levels of education of household heads. In the Google Earth® software and TerraView® were made descriptive spatial analysis and estimates of the Kernel. Each area was studied by interpolation of the density surfaces exposing events to facilitate to recognize the clusters. Results: of the 66 cases detected, only one (1.5%) was not a resident of the city's outskirts. A positive association was detected of trachoma cases and the percentage of heads of household with income below three minimum wages and schooling under eight years of education. Conclusions: The recognition of the spatial distribution of trachoma cases coincided with the areas of greatest social inequality in Bauru City. The micro-areas identified are those that should be prioritized in the rationalization of health resources. There is the possibility of using the trachoma cases detected as an indicator of performance of micro priority health programs.

Genetic group x ambient temperature interaction effects on physiological responses and growth performance of rabbits

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

Performance of a reciprocal shaker in mechanical dispersion of soil samples for particle-size analysis

A dispersão da amostra de solo é uma etapa fundamental da análise granulométrica, sendo realizada mediante o uso de dispersantes químicos e agitação mecânica. O objetivo deste trabalho foi avaliar a eficiência de mesa agitadora reciprocante de baixa rotação na dispersão mecânica de amostras de solos de diferentes classes texturais. Foram realizadas análises granulométricas em 61 amostras com quatro repetições, empregando o método da pipeta para determinação da fração argila e tamisagem para determinação das frações areia grossa, areia fina e areia total, sendo o silte determinado por diferença. Na avaliação de desempenho, os resultados obtidos com uso da mesa agitadora reciprocante (MAR) foram comparados com dados disponíveis para as mesmas amostras oriundos de relatórios do Ensaio de Proficiência IAC para Laboratórios de Análises de Solos - Prolab/IAC. Análises de acurácia foram realizadas com base nos valores dos intervalos de confiança definidos para cada fração granulométrica componente de cada amostra ensaiada. Indicadores gráficos também foram utilizados na comparação de dados, por meio de dispersão e ajuste linear. A estatística descritiva indicou preponderância de baixa variabilidade em mais de 90 % dos resultados obtidos para as amostras de texturas arenosa, média e argilosa e em 68 % dos obtidos para as amostras de textura muito argilosa, indicando boa repetibilidade dos resultados obtidos com a MAR. Média variabilidade foi mais frequentemente associada à fração silte, seguida da fração areia fina. Os resultados das análises de sensibilidade indicam acurácia de 100 % nas três frações granulométricas - areia total, silte e argila - para todas as amostras analisadas pertencentes às classes texturais muito argilosa, argilosa e média. Para as nove amostras de textura arenosa, a acurácia média foi de 85,2 %, e os maiores desvios ocorreram em relação à fração silte. Nas aproximações lineares, coeficientes de correlação igual (silte) ou superiores (areia total e argila) a 0,93, bem como diferenças menores do que 0,16 entre os coeficientes angulares das retas e o valor unitário, indicam alta correlação entre os resultados de referência (Prolab/IAC) e os obtidos nos ensaios com a MAR. Conclui-se pelo desempenho satisfatório da mesa agitadora reciprocante de baixa rotação para dispersão mecânica de amostras de solo de diferentes classes texturais para fins de análise granulométrica, permitindo recomendar o uso alternativo do equipamento quando se emprega agitação lenta. As vantagens do uso do equipamento nacional incluem o baixo custo, a possibilidade de análise simultânea de grande número de amostras e o uso de frascos comuns, de vidro ou de plástico, baratos e de fácil reposição.

Simulation of the energy performance of maize production integrated to pig farming

Foi avaliado o desempenho energético da suinocultura integrada à produção de milho em grão em sistema de plantio direto mecanizado. Nesta concepção de integração proposta, os dejetos suínos são utilizados como fertilizantes na produção de milho. O sistema foi delimitado envolvendo as atividades associadas ao manejo dos suínos e de produção do milho (manejo do solo, cultivo e colheita). O período de análise considerado foi de um ano, o que possibilita a produção de três lotes de suínos e duas safras de milho. Para avaliar o desempenho energético, foram criados três indicadores: eficiência energética, eficiência de uso de fontes não renováveis e o custo de energia não renovável para a produção de proteína. As entradas energéticas são compostas pelos insumos e pela infraestrutura, utilizados na criação dos suínos e na produção de milho, e pela radiação solar incidente no agrossistema. Já as saídas são representadas pelos seus produtos (suínos terminados e o milho). Os resultados obtidos nas simulações apontam que a integração melhora o desempenho energético das granjas suinícolas, aumentando a eficiência energética (186%) e a eficiência não renovável (352%), além de reduzir o custo de energia não renovável para a produção de proteína (‑58%).

Evaluation of the performance of pharmacists in terms of providing health assistance at a university hospital

OBJETIVE: This study aimed to assess the practices of pharmacists in Hospital Care. Method - we interviewed 20 pharmacists from the Pharmacy Division by applying a structured instrument, in September 2005. This instrument addressed aspects related to the main activities at the Hospital Pharmacy, which were assessed according to indicators organized into five areas: sector management, hospital pharmacotechniques, committee activities, information and pharmacotherapeutic follow-up, as well as teaching and research activities.RESULTS: the Pharmacy Division considered all structural aspects under analysis as essential for the good development and application of its services. We found that some essential services, such as the Medication Information Service and Pharmacotherapeutic Follow-up, were absent. Pharmacist professionals were dissatisfied about human resource and physical structure dimensioning, and they presented as not very active in terms of Pharmaceutical Care.CONCLUSION: Results indicate that care is still centered on the drug, with few clinical activities. We suggest reformulations in service management, particularly in the management of pharmacists.

Dietary macronutrients and performance and plasma hormone and metabolite levels of broiler chickens fat by carbohydrate substitution

The present experiment was aimed to study the effects of an isocaloric substitution of fat by carbohydrate calories while maintaining the same CP content - on some endocrine parameters and key metabolites of the lipid (L), protein (CP) and carbohydrate (CHO) metabolism and muscle cell membrane integrity of broiler chickens. Ninety male broiler chicks (Cobb) were obtained at 1-day old and raised in an environmentally controlled room. Food and water was provided ad libitum. At day 7, the chicks were provided with the experimental diets: Control diet (CON: 20% CP; 9.1% L; 39.6% CHO), Low lipid diet (LowL: 22% CP; 3.36% L; 59.7% CHO), and low carbohydrate diet (LowCHO: 22% CP; 8.09% L; 46.7% CHO). T e chickens fed the CON manifested the best growth rate feed conversion compared to both other groups. The CO chickens showed the highest plasma T-3 Concentrations at 14 days of age as compared to both LowL and LowCHO chickens. At 35 days of age however, LowL chickens were characterized by the highest plasma T-3 levels. Overall, CON birds had the highest plasma T-4 levels (P < 0.0001) compared to LowL and LowCHO chickens. Plasma corticosterone levels were not affected by diet composition. Glucose levels increased towards the end of the experimental period, but there was no overall effect of diet composition on plasma glucose levels. Chickens fed the CON diet were consistently characterized by the highest plasma uric acid levels compared to LowL and LowCHO chickens. Irrespectively of diet, plasma triglyceride levels were high at 14 days of age, then decreased and finally increased again during the last week. This latter increase was most pronounced for the CON chickens and is congruous with their high fat deposition. At 28 days of age, a significant effect of diet was observed, as CON birds had lower plasma free fatty acid (FFA) levels compared to LowL but not to LowCHO chickens. However there was no overall effect of diet composition on plasma FFA levels. Creatine kinase (CK) activities increased significantly with age and were consistently higher in CON chickens. In conclusion, fast growth in broiler chickens is positively correlated with catabolism of protein from dietary or endogenous origin and (muscle) cell membrane disruption as reflected in high plasma uric acid levels and CK activity, respectively. The currently investigated substitution of fat by CHO had no marked effects on endocrine functioning and intermediary metabolism, but this does not exclude that larger substitutions between both nutrients can have an effect.

Pharmacokinetic Study of Nobiletin and Tangeretin in Rat Serum by High-Performance Liquid Chromatography-Electrospray Ionization-Mass Spectrometry

Nobiletin (NOB) and tangeretin (TAN), two of the main polymethoxylated flavones (PMFs) in citrus, influence a number of key biological pathways in mammalian cells. Although the impacts of NOB and TAN on glucose homeostasis and cholesterol regulation have been investigated in human clinical trials, much information is still lacking about the metabolism and oral bioavailability of these compounds in animals. In this study, NOB and TAN were administered to rats by gavage and intraperitoneal (ip) injection, and the blood serum concentrations of these compounds and their main metabolites were monitored by high-performance liquid chromatography-electrospray ionization-mass spectrometry (HPLC-ESI-MS). In addition to the administered compounds, two metabolites of TAN and eight metabolites of NOB were detected and measured over 24 h. With identical oral doses, nearly 10-fold higher absorption of NOB occurred compared to TAN. For both compounds, maximum levels of glucuronidated metabolites occurred in the blood serum at later time points (similar to 5-8 h) compared to the earlier T(max) a values for NOB and TAN. In most cases the glucuronides occurred at substantially higher concentrations than the aglycone metabolites. Low levels of NOB and TAN and their metabolites were detectable in rat blood serum even at 24 h after treatment.

Economic Survey of Latin America and the Caribbean 2007-2008: Macroeconomic policy and volatility

Includes bibliography

Economic Survey of Latin America and the Caribbean 2008-2009: Policies for creating quality jobs

Includes bibliography

Review of Caribbean economic and social performance in the 1980's and 1990's

Includes bibliography