Determinantes socioeconômicos e ambientais do declínio das hospitalizações por diarréias em lactentes no Rio Grande do Norte - 1992 a 2001

There was a significant decline in hospitalizations for acute diarrhea in children younger than 1 year of age in Brazil between 1992 to 2001. The less economically developed state of Rio Grande do Norte is a case example of the national trend. In this work, we show a significant association between improvements in socioeconomic variables as well as increased access to sanitation and the decreased rate of hospitalization. Additionally, we observed a positive, seasonal correlation between rainfall and hospitalizations. Most notably, however, we show that improvements in income and inflation were positively correlated with a decline in hospitalizations. Improvements in public health infrastructure, socioeconomic variables like education and literacy, and increased investment in health services were important in reducing severe early childhood diarrheas. However, the data suggests that increased buying power and reductions in poverty played an equally crucial role in reducing hospitalizations for acute diarrhea in infants in Brazil. The work includes elements of the demography of the period for the age groups involved, children under one year, women in fertile age and fertility rate

IgA sérica, secretora, IgE total e estado nutricional em crianças com infecções por enteroparasitas

Infections for intestinal parasites are one of the main morbidade causes in humans and, its relationships with socioeconomic levels and hygiene conditions in countries in development are already very established. Many works, even so, they are being accomplished to elucidate the complex interactions among nutrition, these infections and answer imunológica, because it is seen that malnutrition commits the immunity increasing the susceptibilidade for infectious diseases and these for its time can harm the state human nutricional. It is known that sponge helmínticos they stimulate synthesis of IgE so much policlonal as specific for the same ones and that IgA secretora, main imunoglobulina of defense of the mucous ones, can act against protozoa as the Giardia lamblia and against helmintos as Trichuris tichiura and Strongyloides stercorales. Some studies show that the malnutrition energy protéica influences in the production of these answers, but some authors show results divergentes. In this work it was evaluated the levels of total IgE, IgA sérica and secretora, contagem of sanguine eosinófilos, levels of proteins séricas and state nutricional, in 103 children of low socioeconomic level, to discover a correlation between those and infection for enteroparasitas. They participated in the study children of both sexes, with age of 3 to 6 years, visitors of the same creche and residents in a neighborhood with precarious hygiene conditions and basic saneamento, in the city of Christmas. The obtained results showed that the faulty environmental and socioeconomic conditions favored to a high infection frequency for enteroparasitas, mainly Trichuris trichiura and Ascaris lumbricoides between the helmintos and Endolimax sleep and Giárdia lamblia among the protozoa. Light malnutrition without deficit protéico was observed in 30% of the children, which didn't also present significant deficiencies of IgA sérica and secretora. The sponged children

Iniqüidade em saúde: uma extensão das desigualdades sociais no sistema público de saúde do Brasil (2003-2006)

This issue analises the unevenness in the brazilian system of public health care as an extension of socials inequities. It is a theoretical study based in a historical method, using empirical camp from academic, corporation and institution researchs, along the period 2002-2006. Equality and effectiveness in health systems are analitical basic cathegories grap in the root of the doctrine, principles and organization of the Unique Health System, in which sectorial actions are inserted. Discuss the estructural prodution and determined those inequalities through some social determiners of health system: income, land, food securitiy, nutritional situation, basic sanitation, epidemiological inequities and public management policy. Carry out a thematic review over health social production, it formlation and the goals of social policies, as well as the insertion of the equality principle in the assistance system, in the frame of the running public health regulations. It uses reflections that enlighted the correlation between the process of political-institutional actions and equity on health assistance. Analized the pertinency of sectorial reorganizational strategies on basic attendance, confronting the hipothesis that those strategies reinforce social inequities in health system, because it organize diferential assistance levels over not equal baselines. The results show up that social inequalities, even remaining, have had a small decrease; that the selectiviness of actual public policies and the duplication of the health system, increases the differences within and between the social classes and configures the assistance as inequal. The basic care system has great shortages that also appeares in middle and complex assistance levels. As conclusion, it remarks that the health assintance system, even with it integrality has limits; structural problems on material conditions of living and health system could not be reversed only with institutional legal arragements; by the contrary, in border conditions, these strategies produce policies that reinforce inequities, neglecting the equity principle of the system in which frame, they work. One patina of this tim

O princípio constitucional do desenvolvimento sustentável: análise da sua concretização no Estado do Rio Grande do Norte

The Article 225 of Constitution of the Federative Republic of Brazil in its main body, stipulates that everyone is entitled to ecologically balanced environment and the use of common people and essential to the healthy quality of life, should be imposed on public authorities and the community the duty to defend it and preserve it for present and future generations. Following a universal trend, the letter raised the Brazilian environment the category of one of those values ideals of social order, dedicating it, along with a constitution of rules sparse, a chapter, itself, which definitely, institutionalized the right to healthy environment as a fundamental right of the individual. The national public policies and state should be in line with modern theories of Sustainable Development, outlined within the international society, and certainly instruments that should be made effective through the mobilization of civil society as a whole. The implementation of Human Rights, in fact, depends on a strong political action and not just a legal problem. Thus, this work of theoretical-descriptive nature we will address various dimensions of sustainable development, such as environmental education, water, sanitation, health and sustainable development plans, evaluating its current stage in our state

O serviço público de fornecimento de água nas regiões metropolitanas: cooperação entre entes da federação e desenvolvimento

This work aims to study the material conflict of jurisdiction as to the ownership of public water supply, between the municipalities and the Member States, in metropolitan areas. One of the important points of analysis is the realization of the fundamental right of access to water, a right that is implicit in the Constitution of 1988, being prevented from having their achievement considering the lack of definition of the ownership of the service. Knowing discussed the essential public service, in all its stages, it will realize it is a complex activity that depends for its operation, joint activities of federal entities and the society. In its pursuit of development (understood as better conditions of life), that in view of the Federal Law nº 11.445 of 2007 is the universal access to service, require the adoption of popular participation and the positive benefits of the state, such as planning. Moreover, it will find cooperation between federal entities (after the study of Brazilian federalism) peaceful solution to the conflict through the adoption of joint management or shared, depending on the factual situation and legal

Direito à moradia em cidades sustentáveis: parâmetros de políticas públicas habitacionais Natal 2013

The right to housing is included in several international human rights instruments and in Brazilian legal system integrates the constitutional catalog of fundamental social rights (art. 6) and urban development policy (art. 182 and 183). Besides, it is for all federative governments its effectiveness by building programs and improvement of housing conditions and sanitation (art. 23, IX), which justifies the investment in urban planning and public policy of housing affordability because they are tools for achieving this right. Newer strategies in this area have been based on tax incentives, combined with the mortgage as a way to induce the construction of new housing units or reform those in a precarious situation. However, there is still a deficit households and environmental soundness, compounded with the formation of informal settlements. Consequently, we need constant reflections on the issue, in order to identify parameters that actually guide their housing policies in order to meet the constitutional social functions of the city and ensure well-begins of its citizens (art. 182). On the other hand, the intervention of the government in this segment can not only see the availability of the home itself, but also the quality of your extension or surroundings, observing aspects related to environmental sanitation, urban mobility, leisure and services essential health, education and social assistance. It appears that the smoothness and efficiency of a housing policy condition to the concept of adequate housing, in other words, structurally safe, comfortable and environmentally legally legitimate, viable from the extensive coordination with other public policies. Only to compliance with this guideline, it is possible to realize the right to housing in sustainable cities

Pobreza multidimensional na região nordeste: uma aplicação da Teoria dos Conjuntos Fuzzy (em 2010)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Avaliação da eficiência de filtros anaeróbios na remoção de coliformes fecais e ovos de helmintos

The technology of anaerobic reactors for sanitary wastewater treatment has been extensively developed in Brazil, and today it is practically consolidated. They present several advantages, such as low construction and operating costs, and low sludge production, the anaerobic reactors are an attractive alternative to minimize problematic lack of basic sanitation in urban areas, and also of the rural areas. The anaerobic filters have been widely used in Brazil. It produces an effluent with low concentration of organic matter and solids suspended, besides conserving the nutrients, therefore, it is good for use in irrigation, but the practice must be associated with knowledge of the pathogens presence. The main objective of this study was to evaluate the efficiency of anaerobic filters in removal faecal coliforms and helminth eggs, and to verify if the effluent can be used for agricultural purposes, according to the World Organization of Health (WHO, 1989). The protocol used to enumerate helminths eggs was the modified Bailenger method, (Ayres and Mara, 1996) recommended by WHO for evaluation of raw effluent and treated effluent. The membrane filtration method was utilized to determine the concentrations of faecal coliforms. Three different systems of sewer treatment composed by anaerobic filters were analyzed. The results, in a general analysis, showed that all the researched systems reached a larger removal than 93% to helminth eggs, resulting in an effluent with smaller average than 1 egg/L. One of these systems, Sistema RN, reached a larger removal than 99%, confirming the good performance of the anaerobic filters in removal helminths eggs. Even with low concentrations of eggs in the influent, the filters were capable to remove this parameter efficiently. About faecal coliforms, it was observed for all the researched systems an effluent with 106 CFU/100mL. The high concentrations to faecal coliforms in the effluent just allow reuse for restricted irrigation, in agreement with the guidelines of WHO. Although the researched systems have not removed faecal coliforms efficiently, the results indicated a good efficiency of the anaerobic filters in removal helminth eggs

Avaliação da eficiência de lagoas de estabilização no tratamento de resíduos esgotados de fossas sépticas

Because of disability in public policy development in mind to attend issues of sanitation in the municipalities, companies known as "clean-blue" appeared proposing to solve a simple collection and management of wastewater produced in single or multifamily residences, commercial, hospitals, etc. In the case of an activity in which there are no worries about the fate of sewage, emerged some doubts about the degree of health and environmental safety in these companies. Traditionally, most of them makes the provision of waste depleted soil or wetland, open, usually located on the outskirts of cities (MENESES, 2001). In turn, the sludge from septic tanks exhausted, provided no technical criteria - in the soil, rivers and as an agricultural fertilizer put in risk the health of the population and environmental quality. This work was entered in the search network 5 of the Notice of the Research Program in Sanitation - PROSAB-5, aimed to study the theme 'Characterization and study of alternative ways of treating sludge from septic tanks in the city of Natal, RN', proposing to evaluate the performance of the use of stabilization ponds as a system to handle waste from septic tanks exhausted. A series of lakes studied belong to one of the largest clean-pit of Natal, consisting of two anaerobic ponds, one facultative and maturation, and a tank disinfection, the wastewater being released in the Potengi River. Samples were collected between the months of October 2007 to October 2008, at six points previously defined and judged as more appropriate to what is proposed study. The analysis results in field and laboratory showed the most significant removal of COD (88.93%), total suspended solids (94.87%), organic nitrogen (66.87%) and thermotolerant coliforms (99.88%). Some results have not reached the expected because the system under study had operating problems that have undermined the efficiency of the reactors

Levantamento epidemiológico das parasitoses intestinais: viés analítico decorrente do tratamento profilático

As parasitoses intestinais constituem um grave problema de saúde pública, especialmente nos países subdesenvolvidos, sendo esse problema associado e agravado por condições sanitárias precárias e falta de informação. Neste trabalho foram avaliados alguns parâmetros epidemiológicos vinculados às principais enteroparasitoses em diferentes regiões da cidade de Assis, Estado de São Paulo, Brasil. Os dados foram confrontados com aqueles obtidos em um levantamento anterior referente ao ano de 1991 e apresentam uma redução de três pontos percentuais. Há indícios de que, antiparasitários estariam sendo distribuídos profilaticamente, antes dos resultados do exame parasitológico de fezes. Este fato pode levar a importantes implicações epidemiológicas e distorções analíticas. Esta conduta terapêutica pode estar ocultando condições sanitárias e/ou educacionais desfavoráveis, de forma que haveria uma baixa prevalência de parasitoses em razão de reiterados tratamentos e não pela melhoria das condições de saneamento básico e educação sanitária da população.

Estudo de manejo de águas pluviais urbanas na cidade Natal-Rio Grande do Norte

Urban stormwater can be considered as potential water resources as well as problems for the proper functioning of the manifold activities of the city, resulting from inappropriate use and occupation of the soil, usually due to poor planning of the occupation of the development areas, with little care for the environmental aspects of the drainage of surface runoff. As a basic premise, we must seek mechanisms to preserve the natural flow in all stages of development of an urban area, preserving the soil infiltration capacity in the scale of the urban area, comprising the mechanisms of natural drainage, and noting preserving natural areas of dynamic water courses, both in the main channel and in the secondary. They are challenges for a sustainable urban development in a harmonious coexistence of modern developmental, which are consistent with the authoritative economic environmental and social quality. Integrated studies involving the quantity and quality of rainwater are absolutely necessary to achieve understanding and obtaining appropriate technologies, involving both aspects of the drainage problems and aspects of use of water when subjected to an adequate management of surface runoff , for example, the accumulation of these reservoirs in detention with the possibility of use for other purposes. The purpose of this study aims to develop a computer model, adjusted to prevailing conditions of an experimental urban watershed in order to enable the implementation of management practices for water resources, hydrological simulations of quantity and, in a preliminary way, the quality of stormwater that flow to a pond located at the downstream end of the basin. To this end, we used in parallel with the distributed model SWMM data raised the basin with the highest possible resolution to allow the simulation of diffuse loads, heterogeneous characteristics of the basin both in terms of hydrological and hydraulic parameters on the use and occupation soil. The parallel work should improve the degree of understanding of the phenomena simulated in the basin as well as the activity of the calibration models, and this is supported by monitoring data acquired during the duration of the project MAPLU (Urban Stormwater Management) belonging to the network PROSAB (Research Program in Basic Sanitation) in the years 2006 to 2008

Análise da salubridade do meio urbano com base na utilização de índices ambientais: aplicação na bacia de drenagem XII da cidade do Natal-RN

The growing accumulation of people in urban centers caused chronic problems of the cities to begin to take an increasingly unsustainable. Primarily related to lack of infrastructure coupled with sanitation and lack of investment in critical sectors such as health, education, housing and transportation, these problems start to deteriorate markedly the quality of life of city dwellers and put into test management policies of the spaces urbanized. To reverse this situation, shows is essential to the use of tools (highlighting this harvest rates and environmental indicators) that help in assessing the current conditions and may assist in predicting future scenarios. From the information listed above, now put the research seeks to present an index called ISBA Environmental (Sanitation Index) which looks at the four urban systems (water, sewer, solid waste and urban drainage) from the viewpoint of application in a geographical cutout specific - in this case the Drainage Basin XII, defined by the Plan of Urban Drainage Stormwater in the city of Natal, capital of Rio Grande do Norte. This index, together with analysis of other factors sought to trace the current conditions of the basin and thus, assist in proposing the best solutions. For the preparation of the index was applied a questionnaire with a sample of 384 (three hundred eighty-four) households that aimed to study two variables: access to services and satisfaction of the population in relation to these. The ISBA has shown that the system is the most deficient collection and disposal of effluents (ICE = 47.66%), followed by the drainage of rainwater (IDAP = 54.17%), water supply (AAI = 61, 36) and solid waste collection (IRS = 78.28). With the ISBA was possible to verify that the qualitative data shows whose subjectivity is evident (as is the case of user satisfaction) can be of great importance when an assessment, since we obtained the correlation coefficient between the variables "Access" and " Satisfaction "equal to 0.8234, showing a strong correlation between the existence / quality of service offered and the impressions of the population that receives them

Os rostos da pobreza brasileira: análise crítica dos discursos do governo federal, da Veja e da Cufa

Brazilian constitution says that all Brazilians have basic survival rights such as education, sanitation and food, but these basic rights are luxury for some. So, thinking about this, this paper aims to develop a critical analysis about the (re)production of the discourse on poverty, and consequently on the poor, given by the federal government, through the official website of the program Brazil Without Poverty (Brasil Sem Pobreza), the media, represented by Veja magazine, and by those who affirm to be representatives of the poor; like the Single Central Slums (Central Única das Favelas CUFA). Our aim is to present a critical reflection on the discourses about the poverty in the voices of the government, Veja magazine (media representative) and CUFA (poor representative) and their contribution to the development of the meanings of the theme in Brazilian society. In order to do so, we have identified categories based upon Bajoit (2006a) to classify which the author calls faces of poverty . We have used the Sociological and Communicational Discourse Approach (ASCD) as developed by Pedrosa (2012a, 2012b, 2012c), within the Critical Discourse Analysis as theoretical apparatus, and also the studies in which the ASCD is built upon such as Sociology for Social Change (BAJOIT, 2006), the Cultural Studies (HALL, 2005), and the Functional Systemic Linguistic, especially the Evaluating System (MARTHIN & WHITE, 2005, VIAN JR et al, 2011). Thus, the discourse on poverty or on fighting poverty, extracted from news, chronicles and other genres of the mentioned vehicles, are taken as object of study to understand identities that are created and renewed on poverty and on the Brazilian poor, as their dependence on the government and civil society, their exploitation by the economy, and even the media that sometimes features them as delinquent

Frequency of Blastocystis hominis and other intestinal parasites in stool samples examined at the Parasitology Laboratory of the School of Pharmaceutical Sciences at the São Paulo State University, Araraquara

Blastocystis hominis é um protozoário, causador de infecção intestinal denominada blastocistose humana, cujo diagnóstico é realizado pelo exame coproparasitológico e por meio de técnicas de coloração permanente. Este estudo foi desenvolvido para avaliar a freqüência da infecção por Blastocystis hominis em habitantes da região de Araraquara/SP, bem como comparar diferentes métodos para a pesquisa desse protozoário em amostras de fezes. Foram estudadas 503 amostras de fezes submetidas ao exame direto a fresco, às técnicas de Faust e cols, Lutz e de Rugai e cols, além das colorações pela hematoxilina férrica, tricrômio e de Kinyoun modificada. Entre as 503 amostras examinadas, 174 (34,6%) apresentaram-se positivas para a presença de parasitas intestinais. O protozoário e o helminto mais freqüentes foram Entamoeba coli (14,6%) e Strongyloides stercoralis (6,7%), respectivamente. Blastocystis hominis foi observado em 23 (4,6%) amostras fecais com consistência predominantemente pastosa, não caracterizando quadro diarréico. Apesar da baixa freqüência de Blastocystis hominis encontrada na região de Araraquara, comparativamente a outras regiões brasileiras, é importante a realização do diagnóstico laboratorial desse protozoário. O encontro de Blastocystis hominis em material fecal é indicativo de contaminação de alimentos e água de consumo, desde que se admita a rota de transmissão oral-fecal desse parasita, o que implica na orientação da população sobre as medidas de saneamento básico e higiene como meio para se controlar problemas de saúde ocasionados pelos enteroparasitas.

Caminhos para a universalização dos serviços de água e esgotos no Brasil: a atuação das entidades reguladoras para indução da eficiência dos prestadores de serviços

The deficit of water and sewerage services is a historic problem in Brazil. The introduction of a new regulatory framework, in 2007, presented ways intending to overcome these deficits, among them, the providers efficiency improvement. This thesis aims to analyze the regulators performance regarding its ability to induce the efficiency of the Brazilian water and sewerage services providers. To this end, an analytical approach based on a sequential explanatory strategy was used, and it consists of three steps. In the first step, the Data Envelopment Analysis ( DEA ) was used to measure the providers efficiency in 2006 and 2011. The results show that the average efficiency may be considered high; however significant inefficiencies among the 29 analyzed providers were detected. The ones in the Southeast region showed better performance level and Northeast had the lowest. The local and the private providers were more efficient on average. In 2006 and 2011 the average performance was higher among non-regulated providers. In 2006 the group regulated by local agencies had the best average performance, in 2011, the best performance was the group regulated by the consortium agencies. To analyse the second step was used the Malmquist Index, it pointed that the productivity between 2006 and 2011 dropped. The analysis through decomposing Malmquist Index showed a shift of technical efficiency frontier to a lower level, however was detected a small provider s advance towards the frontier. Only the Midwest region recorded progress in overall productivity. The deterioration in the total factor productivity was higher among regional providers but the local ones and the private agencies moved quickly to the frontier level. The providers regulated from 2007 showed less decrease on the total productivity and the results of the catch up effect were more meaningful. In the last step, the regulators standardization activity analyses noted that there are agencies that had not issued rules until 2011. The most standards topics discussed in the issued rules were the tariff adjustments and the setting of general conditions for the provision and use of services; in another hand, the least covered topics were new technologies incentive and the introduction of efficiency-inducing regulatory mechanisms and productivity gains for price reviews. Regulators created from 2007 were more active proportionately. Even with the advent of the regulatory framework and the creation of new regulatory bodies, the evidence points to a reality in which the actions of these agencies have not been ensuring that providers of water and sewage, regulated by them, has achieved better performance. The non- achievement of regulatory goals can be explained by the incipient level of performance of the Brazilian regulatory authorities, which should be strengthened because of its potential contribution to the Brazilian basic sanitation department