Avaliação dos impactos de políticas públicas de transferência de renda na qualidade de vida no semiárido nordestino face às mudanças climáticas

Introdução: Os impactos das alterações climáticas são e serão sentidos localmente, e irão variar de lugar para lugar. Nas regiões mais sensíveis à variabilidade climática, onde outros fatores e restrições afetam o desenvolvimento, a mudança climática terá um impacto significativamente maior. Uma da preocupações mais recentes da comunidade científica é que esses impactos negativos das alterações climáticas sobre a sociedade, saúde e o meio ambiente possa vir a restringir quaisquer ganhos realizados até o momento na melhora da qualidade de vida das populações, e em especial na região nordeste do Brasil. Neste contexto, as mudanças climáticas, bem como a variabilidade climática natural com seus extremos, podem vir a acentuar uma vulnerabilidade social já existente, fazendo com que a qualidade de vida das populações mais vulneráveis seja especialmente e desproporcionalmente afetada. Objetivo: Analisar como os impactos das políticas públicas de transferência de renda em especial o Programa Bolsa Família e a Aposentadoria Rural influênciam a qualidade de vida frente à variabilidade e mudanças climáticas de famílias pobres no nordeste brasileiro. Métodos: Fez-se uso de métodos qualitativos e quantitativos de coleta e análise de dados sobre as diferentes formas de pobreza e vulnerabilidade e a relação com a capacidade de adaptação à seca, e como isso afeta a percepção de qualidade de vida em famílias pobres rurais e urbanas em dois municípios do estado do Ceará (Parambu e Boa Viagem) sobre o estresse da seca. Realizou-se 221 entrevistas domiciliares (141 na zona rural e 80 na zona urbana). Complementarmente foram coletados dados qualitativos obtidos através de entrevistas semiestruturadas com informantes-chaves (gestores municipais e estaduais, chefes religiosos, presidentes de associações rurais e agentes de saúde). Os dados foram codificados e analisados com o auxílio do N-Vivo e do SPSS. Resultados: Os resultados foram separados e apresentados em formato de três manuscritos. Em geral, os resultados mostram que apesar dos programas de transferência de renda agirem positivamente na 16 melhora da qualidade de vida da famílias beneficiadas, durante o evento de seca as famílias não conseguem superar os fatores que as tornam vulneráveis, o que pode afetar sua percepção de bem-estar subjetivo. Ao mesmo tempo, devido às limitações e deficiências das intervenções políticas de intervenção de seca, as relações de dependência e clientelismo, característica da região, continuam a perpetuar. Conclusão: Os ganhos materiais na qualidade de vida, promovidos pelos programas sociais, como o Bolsa Família e a pensão rural, apesar de serem necessários, não são suficientes para promover uma transformação na vida dessas famílias

Turismo imobiliário: uma reflexão sobre o impacto da crise financeira de 2008 e perspectivas no Rio Grande do Norte

Comunicación presentada en el V Encontro Nacional da Anppas, Florianópolis, Brasil, 4-7 outubro 2010.

Complejos turísticos residenciales: análisis del crecimiento del turismo residencial en el Mediterráneo español y en el Litoral Nordestino (Brasil) y su impacto socio-ambiental

Entre las diversas formas de turismo que aparecen a partir de la segunda mitad del siglo pasado, el turismo residencial surge como uno de los principales fenómenos en los escenarios brasileño e internacional. El crecimiento de esta actividad ha sido un factor importante para la generación de empleo e ingresos en los municipios del litoral sudeste de Brasil y de la costa española mediterránea. Pero recientemente, se observa un crecimiento acelerado de esta modalidad de turismo en la costa del Nordeste de Brasil. Este proceso ha generado beneficios económicos para la región al igual que impactos socioambientales. El primer objetivo de este artículo fue realizar un enfoque exploratorio, identificando el escenario de la oferta y la demanda de la construcción de complejos turísticos residenciales en el Nordeste brasileño por medio del relevamiento de sites y entrevistas a las inmobiliarias, constructoras, incorporadoras, operadoras hoteleras y organismos públicos. Los resultados de la investigación muestran el gran interés del capital internacional en construir mega proyectos de segunda residencia en el nordeste, adaptados a la demanda internacional, principalmente europea. El segundo objetivo fue comparar y analizar la evolución, las etapas y las características del turismo residencial en la costa española mediterránea, como ejemplo de modelo consolidado, con la actividad en el Nordeste brasileño, como modelo en expansión. Se verificó que ambas regiones turísticas fueron afectadas por la crisis económica y por deficiencias estructurales de sus respectivos modelos, las cuales potencian impactos económicos y socioambientales.

International residential tourism in north east Brazil: a stakeholder analysis

This paper analyses the system of actors involved in the development of residential tourism on the north east coast of Brazil. The study observes the socio-political effects of the 2001-2008 real estate boom, focused on the promotion of second homes in closed residential areas. Stakeholder Analysis (SA) is used to identify the various actors’ roles and positions within a particular social space in a tourist setting which is exposed to transnational and real estate interests. The method reveals an unequal and conflict-ridden social reality. The results show that residential tourism shapes the local socio-political configuration, strengthening some actors (urban developers, real estate companies) whilst positioning others in a situation of dependence (local communities, cities).

Avaliação do potencial da fibra e casca de coco maduro, casca de coco verde e cacto pré-tratados visando à produção de etanol

The present work investigated the potential of different residual lignocellulosic materials generated in rural and urban areas (coconut fibre mature, green coconut shell and mature coconut shell), and vegetable cultivated in inhospitable environments (cactus) aimed at the production of ethanol, being all materials abundant in the Northeast region of Brazil. These materials were submitted to pretreatments with alkaline hydrogen peroxide followed by sodium hydroxide (AHP-SHP), autohydrolysis (AP), hydrothermal catalyzed with sodium hydroxide (HCSHP) and alkali ethanol organosolv (AEOP). These materials pretreated were submitted to enzymatic hydrolysis and strategies of simultaneous saccharification and fermentation (SSF) and saccharification and fermentation semi-simultaneous (SSSF) by Saccharomyces cerevisiae, Zymomonas mobilis and Pichia stipitis. It was also evaluated the presence of inhibitory compounds (hydroxymethylfurfural, furfural, acetic acid, formic acid and levulinic acid) and seawater during the fermentative process. Materials pretreated with AHP-SHP have resulted in delignification of the materials in a range between 54 and 71%, containing between 51.80 and 54.91% of cellulose, between 17.65 and 28.36% of hemicellulose, between 7.99 and 10.12% of lignin. Enzymatic hydrolysis resulted in the conversions in glucose between 68 and 76%. Conversion yields in ethanol using SSF and SSSF for coconut fibre mature pretreated ranged from 0.40 and 0.43 g/g, 0.43 and 0.45 g/g, respectively. Materials pretreated by AP showed yields of solids between 42.92 and 92.74%, containing between 30.65 and 51.61% of cellulose, 21.34 and 41.28% of lignin. Enzymatic hydrolysis resulted in glucose conversions between 84.10 and 92.52%. Proceeds from conversion into ethanol using green coconut shell pretreated, in strategy SSF and SSSF, were between 0.43 and 0.45 g/g. Coconut fibre mature pretreated by HCSHP presented solids yields between 21.64 and 60.52%, with increased in cellulose between 28.40 and 131.20%, reduction of hemicellulose between 43.22 and 69.04% and reduction in lignin between 8.27 and 89.13%. Enzymatic hydrolysis resulted in the conversion in glucose of 90.72%. Ethanol yields using the SSF and SSSF were 0.43 and 0.46 g/g, respectively. Materials pretreated by AEOP showed solid reductions between 10.75 and 43.18%, cellulose increase up to 121.67%, hemicellulose reduction up to 77.09% and lignin reduced up to 78.22%. Enzymatic hydrolysis resulted in the conversion of glucose between 77.54 and 84.27%. Yields conversion into ethanol using the SSF and SSSF with cactus pretreated ranged from 0.41 and 0.44 g/g, 0.43 and 0.46 g/g, respectively. Fermentations carried out in bioreactors resulted in yields and ethanol production form 0.42 and 0.46 g/g and 7.62 and 12.42 g/L, respectively. The inhibitory compounds showed negative synergistic effects in fermentations performed by P. stipitis, Z. mobilis and S. cerevisiae. Formic acid and acetic acid showed most significant effects among the inhibitory compounds, followed by hydroxymethylfurfural, furfural and levulinic acid. Fermentations carried out in culture medium diluted with seawater showed promising results, especially for S. cerevisiae (0.50 g/g) and Z. mobilis (0.49 g/g). The different results obtained in this study indicate that lignocellulosic materials, pretreatments, fermentative processes strategies and the microorganisms studied deserve attention because they are promising and capable of being used in the context of biorefinery, aiming the ethanol production.

Desenvolvimento e calibração de fotômetro solar para medições da profundidade óptica por aerossóis e coluna de água precipitável

Instrumentation is a tool of fundamental importance for research in several areas of human knowledge. Research projects are often unfeasible when data cannot be obtained due to lack of instruments, especially due to impor ting difficulties and the high costs there associated. Thus, in order to collaborate with the enhancement of a national technology, a multiband hand - held sun p hotometer (FSM - 4) was developed to operate in the 500 nm, 670 nm, 870 nm and 940 nm bands. In the 500 nm, 670 nm and 870 nm bands aerosols are monitored for evaluation of the AOD (Aerosol Optical Depth), and the PWC (Precipitable Water Column) is evaluated in the 940 nm band. For the development of the mech anical and electronic parts for the FSM - 4, th e materials and componen ts should combine low cost and quality of the data collected. The calibration process utilized the Langley method (ML) and Modified Langley Method (MLM). These methods are usually applied at high altitudes in order to provide atmosp heric optical stability. This condition however can be found in low height sites as shown in the research by Liu et al. (2010). Thus, for calibration of the FSM - 4, we investigated the atmospher ic optical stability utilizing the ML and MLM at a site in the cit y of Caicó / RN, located in the s emiarid region in northeastern Brazil. This site lies in a region far aw ay from large urban centers and activities generating anthropogenic atmospheric pollution. Data for calibration of the prototype were collected usin g the FSM - 4 in two separate operations during the dry season, one in December 2012 and another in September 2013. The methodologies showed optical atmospheric instability in the studied region through the dispersion of the values obtained for the calibrati on constant. This dispersion is affected by the variability of AOD and PWC during the appl ication of the above mentioned methods . As an alternative to the descr ibed sun photometer calibration , a short study was performed using the sun photometer worldwide network AERONET/NASA (AERsol RObotic NETwork – US Space Agency), installed in Petrolina / PE in Brazil. Data were collected for three days utilizing the AERONET instruments and the FSM - 4, operating simultaneously on the same site. By way of the ML and MLM techniques, convergent test values were obtained for the calibration constants, despite the low amount of data collected. This calibration transfer methodology proved to be a viable alternative to the FSM - 4 calibration .

Geoquímica de elementos maiores e traços de granitoides neoproterozoicos da província Borborema e sua correlação com propriedades físicas de rochas

This paper discusses the correlation of thermal conductivity, density and magnetic susceptibility with composition of major and trace elements of Neoproterozoic igneous bodies from Borborema Province, Northeastern Brazil. These properties were used as potential markers among the studied magmatic suites. For the correlation between petrophysical and geochemical properties it was considered a set of 195 chemical analyzes of granitoid rocks, separated by the degree of acidity in basic, intermediate and acidic. Major (SiO2, Al2O3, Fe2O3, MgO, CaO, Na2O, K2O and TiO2) and some trace elements (Rb, Sr, Ba, Zr, Th and U) that are usually linked to the formation of the most common minerals of igneous rocks were used. The results show that SiO2 has the best positive correlation with the thermal conductivity, while Al2O3, CaO, Fe2O3, MgO and TiO2 exhibit negative correlation for the same property. The correlation with density is opposite to that one for these oxides with the thermal conductivity. The magnetic susceptibility did not correlate with the elements studied. The results for thermal conductivity and density indicate a tendency of SiO2 and oxides with higher affinity with mafic minerals (Al2O3, CaO, Fe2O3, TiO2 and MgO) in controlling these petrophysical parameters. The set of samples was divided into five different magmatic suites based on their lithogeochemical aspects into: i) peralkaline / alkaline; ii) alkaline; iii) calc-alkaline; iv) high potassium calcium alkaline; and v) shoshonitic. Data analysis showed that the thermal conductivity and density presented good results in the individualization of these suites, notably between peralkaline / alkaline, alkaline suites, calc-alkaline and shoshonitic. However, the high-K calc-alkaline suite overlapped with the other. In contrast, the magnetic susceptibility did not show effective results for separating the five chemical suites.

Avaliação do potencial das fibras de Ceiba Pentandra (Kapok) e Calotropis Procera como adsorventes de petróleo

On the basis of human evolution and the population increase was necessary, the emergence of new sources of energy, the development of new products and technologies. One such product, object of the industry revolution and of great importance to the development of humanity is the oil, a substance composed primarily of hydrocarbons which give rise to several other products as fuels, lubricants, polymers, solvents, cooking gas, asphalt for roads, fertilizers, medicines, paints, among other. However, mishandling this product may cause leaks and spills that generate huge damages to the environment and the economy. Soon, with the purpose of contributing to decrease is problematic, in this master's work was carried out an intensive search of the possible potential of the fibers of Ceiba pentandra (L.) "Kapok" and Calotropis Procera as bioadsorbents of petroleum in water. The choice of these fibers is due to surface properties such as oleophylics and hydrophobic, their buoyancy and yet, being biodegradable natural polymers derived from the Brazilian Northeast. This research was used experimental planning with response surface methodology (RSM) with the software Design Expert. The results were statistically efficient, obtaining a R2= 0.9995 for Calotropis Procera and a R2= 0.9993 for Kapok. And that, both fibers showed adsorption efficiency, removing more than 80% petroleum in water static and dynamic state.

Consanguinidade e efeito fundador da mutação G377S da doença de Gaucher em população de Tabuleiro do Norte – Ceará – Brasil

Gaucher’s disease (GD) is caused by a β-glucocerebrosidase deficiency, leading to the accumulation of glucocerebroside in the reticuloendothelial system. The prevalence of GD in Tabuleiro do Norte (TN) (1:4000) is the highest in Brazil. The purpose of this study was to present evidence of consanguinity and founder effect for the G377S mutation (c.1246G>A) among GD patients in TN based on enzyme, molecular and genealogical studies. Between March 2009 and December 2010, 131 subjects at risk for GD (GC in dried blood ≤2.19 nmol/h/ml) and 5 confirmed GD patients from the same community were submitted for molecular analysis to characterize the genetic profile of the population. Based on the enzymatic and molecular analysis, the subjects were classified into three categories: affected (n=5), carrier (n=20) and non-carrier (n=111). All carriers were (G377S/wt). Affected subjects were homozygous (G377S/G377S). The identification of a single mutation in carriers and homozygotes from different generations, the history of the community and the genealogy study suggest that the high prevalence of GD in this population may be due to a combination of consanguinity and founder effect for the G377S mutation

Estudo do balanço de umidade por meio de modelos regionais para o clima do passado e do futuro sobre a América do Sul

In the context of climate change over South America (SA) has been observed that the combination of high temperatures and rain more temperatures less rainfall, cause different impacts such as extreme precipitation events, favorable conditions for fires and droughts. As a result, these regions face growing threat of water shortage, local or generalized. Thus, the water availability in Brazil depends largely on the weather and its variations in different time scales. In this sense, the main objective of this research is to study the moisture budget through regional climate models (RCM) from Project Regional Climate Change Assessments for La Plata Basin (CLARIS-LPB) and combine these RCM through two statistical techniques in an attempt to improve prediction on three areas of AS: Amazon (AMZ), Northeast Brazil (NEB) and the Plata Basin (LPB) in past climates (1961-1990) and future (2071-2100). The moisture transport on AS was investigated through the moisture fluxes vertically integrated. The main results showed that the average fluxes of water vapor in the tropics (AMZ and NEB) are higher across the eastern and northern edges, thus indicating that the contributions of the trade winds of the North Atlantic and South are equally important for the entry moisture during the months of JJA and DJF. This configuration was observed in all the models and climates. In comparison climates, it was found that the convergence of the flow of moisture in the past weather was smaller in the future in various regions and seasons. Similarly, the majority of the SPC simulates the future climate, reduced precipitation in tropical regions (AMZ and NEB), and an increase in the LPB region. The second phase of this research was to carry out combination of RCM in more accurately predict precipitation, through the multiple regression techniques for components Main (C.RPC) and convex combination (C.EQM), and then analyze and compare combinations of RCM (ensemble). The results indicated that the combination was better in RPC represent precipitation observed in both climates. Since, in addition to showing values be close to those observed, the technique obtained coefficient of correlation of moderate to strong magnitude in almost every month in different climates and regions, also lower dispersion of data (RMSE). A significant advantage of the combination of methods was the ability to capture extreme events (outliers) for the study regions. In general, it was observed that the wet C.EQM captures more extreme, while C.RPC can capture more extreme dry climates and in the three regions studied.

Produção de filtrantes ativados a partir de aproveitamento de resíduos: uma proposta para a proteção respiratória ocupacional

A Proteção Respiratória Ocupacional é atualmente uma exigência legal do Ministério do Trabalho e Emprego para garantia da saúde e segurança de milhares de trabalhadores que labutam com exposição habitual a substâncias nocivas que possam ocasionar doenças ocupacionais por inalação de ar contaminado no local de trabalho, cuja principal via de penetração no organismo humano é o Sistema Respiratório. Carvões ativados são materiais obtidos a partir de fontes carbonáceas e utilizados como elemento tecnológico filtrante nos equipamentos destinados a proteção respiratória individual. Fomentada por esse contexto, e visando potencializar conceitos de eco-eficiência e sustentabilidade em produção de materiais, este trabalho destina-se a produção de carvão ativado com potencial filtrante a partir de um rejeito agrícola abundante na região Nordeste do Brasil através de uma rota que favorece carbonização e ativação simultâneas, seguido de neutralização térmica. A biomassa precursora foi caracterizada por Ensaios padrões para determinação do teor de umidade e cinzas, Análise Química Elementar, Análises Térmicas (TG e DSC) e Distribuição Granulométrica por difração a laser. As amostras de carvões ativos sintetizadas foram caracterizadas por Difração de Raios X (DRX), Medidas de área específica por BET, Microscopia Eletrônica de Varredura (MEV), Análise assistida com ultravioleta visível e Redução à Temperatura Programada (TPR) por Amônia. A rota empregada favorece uma tecnologia alternativa para o aproveitamento de resíduos e aplicável para a Proteção Respiratória Ocupacional. A atmosfera de queima influencia diretamente na produção. A temperatura de carbonização variou conforme a estabilidade térmica da amostra. A cristalinidade, morfologia, teor mineralógico, área superficial específica e a adsorção em fase líquida e gasosa variaram em função da interação do resíduo precursor com o tipo e concentração de ácido utilizado. Os ensaios de adsorção demonstraram a efetividade da ativação segundo a rota experimental proposta. O potencial catalítico dos materiais produzidos para uso em máscaras respiratórias foi evidenciado pelo ensaio de TPR. O processo de produção estudado se mostrou eficaz para obtenção dos carvões promovendo processamentos e aplicações mais nobres para materiais cujo uso tem sido restrito a meras aplicações primárias ou descarte, mas cujo potencial tecnológico é amplo, empreendedor, sustentável, viável em escala industrial e de baixo custo.

Impacts of the Madden-Julian oscillation on intraseasonal precipitation over northeast Brazil

Este estudo tem como objetivo investigar os impactos da oscilação de Madden-Julian (OMJ) na precipitação da região Nordeste do Brasil (NEB). Para tanto foram utilizados dados diários de precipitação baseados em 492 pluviômetros distribuídos na região e cobrindo um período de 30 anos (1981 − 2010). As análises através de composições de anomalias de precipitação, radiação de onda longa e fluxo de umidade, foram obtidas com base no índice da OMJ desenvolvido por Jones-Carvalho. Para distinguir o sinal da OMJ de outros padrões de variabilidade climática, todos os dados diários foram filtrados na escala de 20 − 90 dias; portanto somente dias classificados como eventos da OMJ foram considerados nas composições. Uma análise preliminar baseada apenas nos dados de precipitação foi feita para uma pequena área localizada no interior semiárido do NEB, conhecida como Seridó. Essa microrregião é uma das áreas mais secas do NEB e foi reconhecida pela Convenção das Nações Unidas para o Combate à Desertificação e Mitigação dos Efeitos das Secas como particularmente vulnerável à desertificação. Composições de anomalias de precipitação foram feitas para cada uma das oito fases da OMJ durante Fevereiro-Maio (principal período chuvoso da microrregião). Os resultados mostraram a existência de variações significativas nos padrões de precipitação (de precipitação excessiva à deficiente) associados à propagação da OMJ. A combinação dos sinais de precipitação obtidos durantes as fases úmidas e secas da OMJ mostrou que a diferença corresponde cerca de 50 − 150% de modulação das chuvas na microrregião. Em seguida, uma investigação abrangente sobre o papel da OMJ sobre toda a região Nordeste foi feita considerando-se as quatro estações do ano. Os resultados mostraram que os impactos da OMJ na precipitação intrassazonal do NEB apresentam forte sazonalidade. A maior coerência espacial dos sinais de precipitação ocorreram durante o verão austral, quando cerca de 80% das estações pluviométricas apresentaram anomalias positivas de precipitação durante as fases 1 − 2 da OMJ e anomalias negativas de precipitação nas fases 5 − 6 da oscilação. Embora impactos da OMJ na precipitação intrassazonal tenham sido encontrados na maioria das localidades e em todas as estações do ano, eles apresentaram variações na magnitude dos sinais e dependem da fase da oscilação. As anomalias de precipitação do NEB observadas são explicadas através da interação existente entre as ondas de Kelvin-Rossby acopladas convectivamente e as características climáticas predominantes sobre a região em cada estação do ano. O aumento de precipitação observado sobre a maior parte do NEB durante o verão e primavera austrais encontra-se associado com o fluxo de umidade de oeste (regime de oeste), o qual favorece a atividade convectiva em amplas áreas da América do Sul tropical. Por outro lado, as anomalias de precipitação durante o inverno e outono austrais apresentaram uma variabilidade espacial mais complexa. Durante estas estações, as anomalias de precipitação observadas nas estações localizadas na costa leste do NEB dependem da intensidade do anticiclone do Atlântico Sul, o qual é modulado em grande parte por ondas de Rossby. As características topográficas do NEB parecem desempenhar um papel importante na variabilidade observada na precipitação, principalmente nestas áreas costeiras. A intensificação do anticiclone aumenta a convergência dos ventos alísios na costa contribuindo para a ocorrência de precipitação observada à barlavento do planalto da Borborema. Por outro lado, o aumento da subsidência parece ser responsável pelos déficits de precipitação observados à sotavento. Tais condições mostraram-se típicas durante o predomínio do regime de leste sobre a região tropical da América do Sul e o NEB, durante o qual ocorre uma diminuição no fluxo de umidade proveniente da Amazônia.

Arquitetura, cidade e território no Brasil colonial: a contribuição dos carmelitas calçados da Bahia e Pernambuco (1580-1800)

This study investigates the religious group named 'shoe wearing carmelites' (or Calced Carmelites) from Brazil´s Order of Carmo, from 1580 until 1800, in the Capitaincy of Bahia de Todos os Santos (Recôncavo, city of Salvador and Sergipe) and in the Capitaincy of Pernambuco (Alagoas, Pernambuco and Itamaracá). The study does not include the religious group known as the 'Reformed' Carmelites from Goiana, Recife and Paraíba convents. The Order of Carmo is a religious order from the Roman Catholic Church, founded in the 12th century. By the 16th century they were split into 'Calced' and 'Discalced'. In 1580 the Calced ones came from Portugal to Brazil, built convents in urban areas and were able to acquire slaves, farms and other assets. As any other religious order, the Carmelites had their modus operandi. This work emphasizes the way they operated or acted in the city, either individually or in association with other Carmelite religious foundations elsewhere (networking). Their action affected, although indirectly, the building of some specific aspects of the architecture, the city and the territory in colonial Brazil. The main objective of this study is to demonstrate the impact of the Calced Carmelites from Bahia and Pernambuco upon the territory of colonial Brazil, which is analyzed according to three scales: 1) the region or interurban; 2) the city or intraurban; 3) the building or the architecture. The research employs the comparative method of analysis, especially for the architectural scale. The work demonstrates that although not acting as architects or urbanists, the Carmelites contributed to the formation of the colonial territory of Brazil, behaving as a well-articulated and hierarchized religious network, from an economic and social perspective. Moreover, they influenced the emergence and growth of several colonial urban nuclei, from Bahia to Pernambuco, mainly in the surroundings of their religious buildings. Finally, it is very clear this religious order’s contribution to colonial architecture, as it can be seen by the architectural characteristics of the convents and churches which have been analyzed, many of which still stand in a good state of conservation nowadays.

Referência e contra referência em saúde bucal: regulação do acesso aos centros de especialidades odontológicas

Objective Based on the system of reference and counter-reference and comprehensiveness in oral health care, we aimed to examine ways of refering users to Specialized Dental Care Centers (SDCC) and the interface between them and Primary Care. Methods This is a cross-sectional study carried out with users and dentists of SDCC in a metropolitan region of Northeast of Brazil. Analyses were descriptive, and the association test was done with chi-square. Results Six forms of entry to specialized service were identified: free demand (13.8 %) and reference by the Primary Care dentist (63.2 %) were most frequent. Users referred by the basic health unit dentist had more interest in making a counter-reference than the others (p<0.001, PR=4.65, 95 % CI: 2.74 to 7.91), while individuals without this referral had 1.49 times more difficulty obtaining care (95 % CI: 1.02 to 2.17). Referral procedures are a decisive factor for counter-references. However, the high demand for primary care services and the short supply these services can offer in the face of needs make SDCC performance difficult. Conclusion The analysis of oral health practices from the perspective of network modeling points to the service's need to establish protocols for regulation in a bid to improve access to and the quality of care provided.

Referência e contra referência em saúde bucal: regulação do acesso aos centros de especialidades odontológicas

Objective Based on the system of reference and counter-reference and comprehensiveness in oral health care, we aimed to examine ways of refering users to Specialized Dental Care Centers (SDCC) and the interface between them and Primary Care. Methods This is a cross-sectional study carried out with users and dentists of SDCC in a metropolitan region of Northeast of Brazil. Analyses were descriptive, and the association test was done with chi-square. Results Six forms of entry to specialized service were identified: free demand (13.8 %) and reference by the Primary Care dentist (63.2 %) were most frequent. Users referred by the basic health unit dentist had more interest in making a counter-reference than the others (p<0.001, PR=4.65, 95 % CI: 2.74 to 7.91), while individuals without this referral had 1.49 times more difficulty obtaining care (95 % CI: 1.02 to 2.17). Referral procedures are a decisive factor for counter-references. However, the high demand for primary care services and the short supply these services can offer in the face of needs make SDCC performance difficult. Conclusion The analysis of oral health practices from the perspective of network modeling points to the service's need to establish protocols for regulation in a bid to improve access to and the quality of care provided.