O princípio da integralidade no Sistema Único de Saúde (SUS): utopia?

The Brazilian Federal Constitution promulgated in 1988 created the concept of Social Welfare, which is based on the triad: Health, Social Security and Social Assistance. The Unified Health System (SUS) was then instituted. SUS is a conquest of a society that seeks social justice, integrality, equalitarian and universal access to health services. In the present essay, I succinctly discourse on the various meanings of integrality. I present the theoretical basis of complexity and transdisciplinarity by opposing to reductionism, aiming at showing that, by means of transdisciplinarity and intersectoriality, integrality can be achievable.

Comportamiento de mujeres y sus parejas referentes a la planificación familiar

Objective. To describe women behavior regarding birth control and analyze if such behavior has any cultural influence. Methodology. Qualitative study in which patients were women who were waiting for their family health program consult in three health units of the city Ilah Comprida in Sao Paulo, Brazil. Data were collected during October and November of 2007, the interview was used as source of information, subsequently they were subjected to the content analysis technique. Results. Women are responsible for birth control; they consider there are difficulties with birth control especially due to inefficient information about methods of contraception and family influence over this adopted behavior. Conclusion. Birth control is influenced by cultural models, moral, social and religious values related with the exercise of sexuality.

Bacteria on the hands of school-age children at a Pediatric Hospitalization Unit

Objective. To estimate the prevalence of bacteria isolated in samples from the hands of school-age children at a hospitalization unit. Methodology. In 2009, strains were cultured from the hands of 90 school-age children at the pediatric hospitalization unit of Hospital Estadual Bauru (São Paulo, Brazil). After culture of the samples, the isolated bacteria were identified. Results. In 98% of the samples taken from the children, bacteria were isolated. Coagulase-negative Staphilococcus was isolated in 64% of the samples, followed by Staphilococcus aureus (5%) and Pseudomonas aeruginosa (1%). Conclusion. In most of the samples from the children’s hands, bacteria were isolated. Therefore, educative actions about hygiene habits in- and outside the hospital environment should be reinforced, aimed at children and their companions.

Interdependência entre os níveis de atenção do Sistema Único de Saúde (SUS): significado de integralidade apresentado por trabalhadores da Atenção Primária

Integrality constitutes an important principle of the SUS, achieved through the struggles of the Brazilian health movement. It represents an expansion of the concepts of health and illness, to include the social determinants of healthcare needs. Intending to investigate the meanings of integrality reported by primary care workers, a study was developed in a medium-sized municipality in the state of São Paulo, concerning distinct technological work organization models in primary healthcare units. Among the results, the dimension of system integrality appeared with greatest frequency, according to analysis on focus groups. The workers pointed out difficulties in integration and communication between the healthcare levels, determined by selective social policies and medium/high-technology services delegated to the private market. The theoretical-philosophical framework of this study was based on cultural-historical psychology, taking into consideration the categories of work/activity, consciousness, mediation and totality.

Valores de referência de uréia e creatinina para javali (sus scrofa scrofa, linnaeus, 1758) em cativeiro

In Brazil, the commercial breeding of wild boars (Sus scrofa scrofa) is rapidly expanding. Given the significance of reference values for biochemical analysis for diagnosis of pathological processes and the limitation of data in the literature on this species, Blood samples were collected for determination of biochemical values in 160 wild boars from 180 to 300 days old, clinically healthy farms. The reference range for creatinine was similar to the normal range for swine (1,0 – 2,7mg/dL). There were differences between genders, only for the determination of urea, where the males were higher, although similar to pigs (10 – 30mg/dL). The females, with values from 13.03 to 44.78 mg / dL, do not have statistically significant.

Construção de índice percentual de “status” de desenvolvimento sus-tentável de assentamentos rurais utilizando procedimento estatísti-co multivariado

The objective of the present work is the construction of percentual indexes of sustainable development "Status" - PIDSD (%) aiming to order and classify the rural settlements, considering agricultural, socioeconomic and environmental aspects, in order to diagnose their sustainable reality. This way, we considered multivariate statistical procedure to establish analytical descriptors - indexes - like the principal components technique (CP). The CP technique was used in a matrix formed by 47 variables observed in 50 rural settlements, distributed in seven different regions of the state of Mato Grosso, obtained from diagnostics, provided by "Mato-Grossense" Enterprise of Research, Assistance and Rural Extension S/A - EMPAER - MT, in order to obtain the indexes used in the construction of PIDSD (%). The settlements with higher PIDSD (%) were considered "higher potential" or "higher sustainable" in relation to the analyzed variables, making the establishment of assistance strategies and cooperation possible, allowing the government and civil society in general, to improve those with worse results ("lower potential" or "lower sustainable"), and search for ways to strengthen and multiply the results of the "higher potential" settlements. Vale do Seringal settlement had the best conditions in relation to the variables, mainly those of higher weigh and was considered the one with "higher potential". São Sebastião had the worst conditions and was considered "lower potential".

Biochemical changes during the induction of mineral stress in plants of bell pepper cultivated in fertigation system

The greenhouse production associated with the fertigation management, have established in Brazil as economical alternative for several horticultural species. With this strategy this study had as aim to evaluate possible impacts in the metabolism of plants of bell pepper (Capsicum annuum L.; cv Elisa) in response to the increase of mineral concentration in the soil. During the experiments, the some nutrient concentrations were altered, to obtain high values of electric conductivity (EC) in the soil solution. The EC values commonly observed in the traditional fertigation system were adopted, as control. It was also verified the possibility of reduction of the mineral stress impact by the application of organic matter in the soil. Parameters of the antioxidative response system, as the superoxide dismutase (SOD) and catalase enzyme activities besides the proline content were evaluated to measure the extension of the saline stress and their effects on the plants. The increase of EC of the soil induced to the increase of the proline concentration and the SOD activity. Unexpectedly, it was verified that the saline stress inhibited the activity of the enzyme catalase. It was also concluded that the monitoring of EC of the soil is an indispensable tool to reach success in the fertigation system and that the study of the activity of the enzymes of the antioxidative response system, and the proline contents can be assumed as indicators in of the levels of stress in bell pepper plants (Capsicum annuum L.; cv Elisa).

Acessibilidade e resolutividade em assistência oftalmológica para o SUS

Pós-graduação em Bases Gerais da Cirurgia - FMB

Práticas integrativas e complementares no SUS: revisão integrativa

Pós-graduação em Saúde Coletiva - FMB

Wild Boar and Red Deer Display High Prevalences of Tuberculosis-Like Lesions in Spain

We describe the distribution of tuberculosis-like lesions (TBL) in wild boar (Sus scrofa) and red deer (Cervus elaphus) in Spain. Animals with TBL were confirmed in 84.21% of mixed populations (n = 57) of red deer and wild boar and in 75% of populations of wild boar alone (n = 8) in central and southern Spain (core area). The prevalence of TBL declined towards the periphery of this region. In the core area, the prevalence ranged up to 100% in local populations of wild boar (mean estate prevalence 42.51%) and up to 50% in red deer (mean estate prevalence 13.70%). We carried out exploratory statistical analyses to describe the epidemiology of TBL in both species throughout the core area. Prevalence of TBL increased with age in both species. Wild boar and red deer mean TBL prevalence at the estate level were positively associated, and lesion scores were consistently higher in wild boars than in red deer. The wild boar prevalence of TBL in wild boar did not differ between populations that were or were not cohabiting with red deer. Amongst the wild boars with TBL, 61.19% presented generalized lesions, and the proportion of generalized cases was similar between sex and age classes. In red deer, 57.14% of TBL-positive individuals presented generalized lesions, and the percentage of generalized cases increased with age class, but did not differ between the sexes. These results highlight the potential importance of wild boar and red deer in the maintenance of tuberculosis in south central Spain.

Risk Factors Associated With the Prevalence of Tuberculosis-Like Lesions in Fenced Wild Boar and Red Deer in South Central Spain

In recent decades the management of large game mammals has become increasingly intensive in south central Spain (SCS), resulting in complex epidemiological scenarios for disease maintenance, and has probably impeded schemes to eradicate tuberculosis (TB) in domestic livestock. We conducted an analysis of risk factors which investigated associations between the pattern of tuberculosis-like lesions (TBL) in wild boar (Sus scrofa) and red deer (Cervus elaphus) across 19 hunting estates from SCS and an extensive set of variables related to game management, land use and habitat structure. The aggregation of wild boar at artificial watering sites was significantly associated with an increasing risk of detecting TBL in both species, which probably relates to enhanced opportunities for transmission. Aggregation of wild boar at feeding sites was also associated with increased risks of TBL in red deer. Hardwood Quercus spp. forest availability was marginally associated with an increased risk of TB in both species, whereas scrubland cover was associated with a reduced individual risk of TBL in the wild boar. It is concluded that management practices that encourage the aggregation of hosts, and some characteristics of Mediterranean habitats could increase the frequency and probability of both direct and indirect transmission of TB. These findings are of concern for both veterinary and public health authorities, and reveal tuberculosis itself as a potential limiting factor for the development and sustainability of such intensive game management systems in Spanish Mediterranean habitats.

HEALTH RISKS TO HUMANS AND DOMESTIC LIVESTOCK POSED BY FERAL PIGS (Sus scrofa) IN NORTH QUEENSLAND

A sample of 608 adult pigs from Cape York and adjacent islands was examined for parasites and their serum tested for livestock diseases associated with the Queensland tropics. Feral pigs from North Queensland pose a significant health threat to humans with the incidence of Spargana (the plerocercoid of Spirometra erinacei) through the consumption of undercooked pork. Meliodosis (Pseudomonas pseudomalleO. Leptospirosis (L. yar. pomona). and Brucellosis (Brucella suis) are capable of infecting humans directly during unhygienic butchering of infected carcasses. In North Queensland, the widespread intermingled distribution of feral pigs and cattle increases the potential for the transmission of Actinobacillus, Leptospirosis, and Brucellosis from feral pigs to cattle. Both Europeans and Aborigines on Cape York also raise wild-caught feral pigs for meat. It is important to realize that parasites and diseases are present in young pigs and that poor husbandry practices increase the risk of infection from several parasites, i.e., Lungworm (Metastrongylus sp.) Stomach worm (Physocephalus sexalatus. Hvostrongvlus rubidus). Thorny headed worm (Macracanthorrhynchus hirudinaceus) and Kidney worm (Stephanurus dentatus). Heavy infection of these parasites reduce growth rates and cause unthriftiness in infected ani¬mals.

Acessibilidade e resolutividade em assistência oftalmológica para o SUS

Pós-graduação em Bases Gerais da Cirurgia - FMB

Práticas integrativas e complementares no SUS: revisão integrativa

Pós-graduação em Saúde Coletiva - FMB

PREVALENCE AND DETERMINANTS OF EXCLUSIVE BREASTFEEDING IN THE CITY OF SERRANA, SAO PAULO, BRAZIL

The objective of this cross-sectional and quantitative study was to identify the prevalence and determinants of exclusive breastfeeding among infants less than six months of age in the city of Serrana, Sao Paulo, Brazil in 2009. A validated semi-structured questionnaire was administered to the guardians of the children less than six months of age who attended the second phase of a Brazilian vaccination campaign against polio. Univariate and multivariate analysis presented in odds ratios and confidence intervals was accomplished. Of the total of 275 infant participants, only 29.8% were exclusively breastfed. Univariate analysis revealed that mothers who work outside the home without maternity leave, mothers who did not work outside the home, adolescent mothers, and the use of pacifiers have a greater chance of interrupting exclusive breastfeeding. In the multivariate analysis, mothers who work outside the home without maternity leave are three times more likely to wean their children early. Results provide suggestions for the redirection and planning of interventions targeting breastfeeding.