Organização do trabalho, conflitos e agressões em uma emergência hospitalar na cidade de São Paulo, Brasil

As condições e processos de trabalho penosos dos pronto-socorros somados a elevada demanda frente à capacidade e gravidade dos casos, dificultam as decisões, impactam no atendimento e favorecem conflitos. Trata-se de um estudo de caso, exploratório e qualitativo, utilizou-se dados documentais, entrevistas semiestruturadas e observação do trabalho, especificamente dos porteiros. Objetivou-se verificar como características da organização do trabalho aumentam conflitos e agressões em um pronto-socorro comprometendo os atendimentos. Constatou-se que os porteiros estão na linha de frente e são expostos à pressão dos usuários por atendimento. Para solucionar conflitos, extrapolam regras e procedimentos, realizam tarefas além da sua competência, podendo alterar o fluxo e a qualidade do atendimento. Os arranjos organizacionais desconsideram os porteiros como parte da equipe de cuidados expondo-os a conflitos e agressões. Espera-se contribuir para mudanças, melhorar as relações, a segurança e o fluxo de atendimento.

Prevalência e fatores associados à síndrome metabólica em usuários de unidades básicas de saúde em São Paulo - SP

OBJETIVO: Determinar a relação da síndrome metabólica (SM) com o nível socioeconômico, hábitos comportamentais, condições de saúde, antecedentes familiares de morbidades e áreas de residência. MÉTODOS: Trata-se de um estudo de corte transversal. A amostra aleatória foi constituída por usuários de duas Unidades Básicas de Saúde da cidade de São Paulo - Jardim Comercial (UBS1) e Jardim Germânia (UBS2) -, totalizando 452. Para o diagnóstico de SM utilizou-se o critério do Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III). Na avaliação antropométrica foram aferidas medidas de peso, estatura, circunferências abdominal e do quadril. Foi utilizado questionário geral para obtenção de dados sociodemográficos, socioeconómicos, antecedentes familiares e pessoais de morbidades, hábitos comportamentais como tabagismo, etilismo e nível de atividade física. Foi estabelecida associação entre as variáveis explicativas de interesse e SM, empregando-se a regressão logística multivariada. RESULTADOS: Na UBS1, o percentual de SM foi de 56,1% e na UBS2, de 34,0%. Houve associação direta e significativa entre SM e idade, sexo feminino, cor, tabagismo, etilismo, nível de atividade física, estresse e antecedentes familiares de doença cardíaca e de diabetes mellitus. A escolaridade apresentou associação inversa: morar no bairro de menor nível socioeconómico aumentou a chance de SM. CONCLUSÃO: Os resultados sugerem que as morbidades que compõem a SM são um grave problema de saúde pública nessa população.

Metals and semi-metals in street soils of So Paulo city, Brazil

So Paulo is the largest city in Brazil and South America with about 20 million inhabitants in the metropolitan area, more than nine million motor vehicles and intense industrial activity, which are responsible for increasing pollution in the region. Nevertheless, little is known concerning metal and semi-metal content in the soils of this metropolitan region. This type of information could be extremely useful as a fingerprint of environmental pollution. The present study determined the elements As, Ba, Co, Cr, Sb, and Zn concentrations in soils adjacent to avenues of highly dense traffic in So Paulo city to assess their levels and possible sources. The analytical technique employed was Instrumental neutron activation analysis. The results showed, except for Co, concentration levels higher than the reference values for soils of So Paulo, according to the Environmental Protection Agency of the State of So Paulo guidelines. When compared to similar studies in other cities around the world, So Paulo soils presented higher levels, probably due to its high density traffic and industrial activity. The concentrations obtained for As and Cr indicate anthropogenic origin. The high levels of the traffic-related elements Ba, Sb, and Zn in soils nearby high density traffic avenues indicate they may originate from vehicular exhausts.

The Gracilariaceae Germplasm Bank of the University of So Paulo, Brazil-a DNA barcoding approach

The University of So Paulo Gracilariaceae Germplasm Bank has 50 strains collected mostly in Brazil, but also elsewhere in the world. This bank has been used as a source of material for research developed locally and abroad. With over 200 species, some of which have high economic value, the family Gracilariaceae has been extensively studied. Nonetheless, taxonomic problems still persist by the existence of cryptic species, phenotypic plasticity, and broad geographic distribution. In the case of algae kept in culture for long periods of time, the identification is even more problematic as a consequence of considerable morphological modification. Thus, the use of molecular markers has been shown to be an efficient tool to elucidate taxonomic issues in the group. In this work, we sequenced the 5'-end of the cox1 gene for 41 strains and the universal plastid amplicon (UPA) plastid region for 45 strains, covering all 50 strains in the bank. In addition, the rbcL for representatives of the cox1/UPA clusters was sequenced for 14 strains. The original species identification based on morphology was compared with the molecular data obtained in this work, resulting in the identification of 13 different species. Our analyses indicate that cox1 and UPA are suitable markers for the delineation of species of Gracilariales in the germplasm bank. The addition of DNA barcode tags to the samples in the Gracilariaceae germplasm bank and the molecular identification of the species will make this bank even more useful for future research as the species can be easily traced and confirmed.

Characterization of atmospheric aerosols in the city of So Paulo, Brazil: comparisons between polluted and unpolluted periods

The objective of this study was to determine the size and composition of atmospheric aerosols in the downtown area of the city of So Paulo, Brazil, for a polluted and an unpolluted period. Aerosols were sampled with a portable air sampler (PAS), Micro-Orifice Uniform Deposit Impactor (MOUDI), and Scanning Mobility Particle Sizer. At the study site, air quality is poor, especially during the winter, high concentrations of pollutants being emitted primarily by the light- and heavy-duty vehicle fleet. We analyzed mass, black carbon (BC), Al, Si, P, S, Cl, K, Ca, Ti, V, Cr, Mn, Fe, Ni, Cu, Zn, Br, Rb, Sn, Zr, and Pb. During the polluted period, diurnal PM(10) was higher than nocturnal PM(10), whereas the inverse was true during the unpolluted period. The FPM was rich in BC, S, and Pb, whereas CPM was rich in Al, Si, Ca, Ti, and Fe. Mass balance was performed by category: ammonium sulfate, sodium chloride, crustal material, BC, and other. The PAS-determined FPM was mainly BC. The MOUDI-determined FPM crustal material explained more mass than did ammonium sulfate and BC during the polluted period, whereas ammonium sulfate had the largest mass during the unpolluted period. Crustal material was the major CPM component, followed by ammonium sulfate and BC. During the unpolluted period, FPM concentrations were lower, whereas those of ammonium sulfate were relatively higher, especially at night, and particle number was inversely proportional to particle size. Aerosol growth was more intense during the polluted period.

Magmatism and fenitization in the Cretaceous potassium-alkaline-carbonatitic complex of Ipanema So Paulo State, Brazil

The Ipanema alkaline-carbonatitic complex is part of the Meso-Cenozoic alkaline magmatism located within the southeastern part of the Brazilian Platform. Drill-core and field sampling have indicated the occurrence of glimmerites, with subordinate shonkinites (mela-syenites), clinopyroxene-bearing glimmerites, diorites and syenites. The glimmerites are cross-cut by lamprophyric dykes and calciocarbonatites. Fenitization has deeply affected the country rocks, originating dioritic and syenitic rocks. The Ipanema rocks show a distinct potassic affinity. The initial Sr-Nd- isotopic composition of the Ipanema rocks ((87)Sr/(86)Sr = 0.70661-0.70754 and (143)Nd/(144)Nd = 0.51169-0.51181) is similar to that of tholeiitic and potassium-rich-alkaline rocks of the Eastern Paraguay. Stable isotope data for the Ipanema calciocarbonatite suggest interaction with fluids at temperatures typical of hydrothermal stages, as hypothesized for other carbonatite complexes from southeastern Brazil. The chemical differences between the lamprophyre, glimmerites, carbonatites, apatitites and magnetitites, and the absence of marked REE enrichment in the evolved lithologies, all indicate that fractional crystallization and accumulus of liquidus phases in a magma reservoir, likely coupled with liquid immiscibility processes, may have played an important role in the genesis of the Ipanema rocks.

Radiation balance at the surface in the city of So Paulo, Brazil: diurnal and seasonal variations

The main goal of this work is to describe the diurnal and seasonal variations of the radiation balance components at the surface in the city of So Paulo based on observations carried out during 2004. Monthly average hourly values indicate that the amplitudes of the diurnal cycles of net radiation (Q*), downwelling and upwelling shortwave radiation (SW(DW), SW(UP)), and longwave radiations (LW(DW), LW(UP)) in February were, respectively, 37%, 14%, 19%, 11%, and 5% larger than they were in August. The monthly average daily values indicate a variation of 60% for Q*, with a minimum in June and a maximum in December; 45% for SW(DW), with a minimum in May and a maximum in September; 50% for SW(UP), with a minimum in June and a maximum in September; 13% for LW(DW), with a minimum in July and a maximum in January; and 9% for LW(UP), with a minimum in July and a maximum in February. It was verified that the atmospheric broadband transmissivity varied from 0.36 to 0.57; the effective albedo of the surface varied from 0.08 to 0.10; and the atmospheric effective emissivity varied from 0.79 to 0.92. The surface effective emissivity remained approximately constant and equal to 0.96. The albedo and surface effective emissivity for So Paulo agreed with those reported for urban areas in Europe and North America cities. This indicates that material and geometric effects on albedo and surface emissivity in So Paulo are similar to ones observed in typical middle latitudes cities. On the other hand, it was found that So Paulo city induces an urban heat island with daytime maximum intensity varying from 2.6A degrees C in July (16:00 LT) to 5.5A degrees C in September (15:00 LT). The analysis of the radiometric properties carried out here indicate that this daytime maximum is a primary response to the seasonal variation of daily values of net solar radiation at the surface.

Population biology of Stellifer rastrifer, S. brasiliensis and S. stellifer in Caraguatatuba Bay, northern coast of São Paulo, Brazil

Ecosystems may reflect environmental changes in many respects, from the debilitation of individuals to alterations in community composition. Equally, population parameters may provide reliable indications of environmental changes. Members of the sciaenid fish genus Stellifer are usually very abundant where they occur, often with two or more species living in sympatry. Here, the population dynamics of three Stellifer species from southeastern Brazil were assessed. Sampling was carried out in shallow marine areas of Caraguatatuba Bay, from August 2003 to October 2004. The species evaluated were Stellifer rastrifer (n=3183), S. brasiliensis (n=357) and S. stellifer (n=116). The area under greater continental influence tended to support more, but smaller individuals. Size variations over time were similar among species and negatively correlated with Krel, which showed smooth fluctuations. The general length-frequency distribution was concentrated between 6.0 and 9.0 cm, and the great majority of females did not present mature gonads during the sampling period. The findings support the existence of a stratification by size for these species, indicating that the area is essential for the development of younger fish. Failure to consider these characteristics for the management of similar areas may have serious implications for these environments.

Biomonitoring of coastal regions of So Paulo State, Brazil, using mussels Perna perna

The marine environment is constantly affected by anthropic actions, with causes consequent degradation of the waters and marine biota by various discharges of xenobiotics. In the present study, the focus was the study of a region of the marine coast of the State of So Paulo (city of Santos), which is one of the most industrialized parts of Brazil and suffers also from a strong impact of domestic effluents. The mussel Perna perna, very abundant in the coast of the State of So Paulo, Brazil, was selected as the biomonitoring organism for the determination of inorganic elements and a passive biomonitoring was performed. The organisms were collected at two sites in So Paulo State coast: Cocanha beach in Caraguatatuba (mussel farm) and Santos Bay (Itaipu and Palmas). Seasonally, the Perna perna were collected between September/08 and July/09 in each study sites. After removal and sample preparation, the elements As, Co, Cr, Fe, Se and Zn were determined by instrumental neutron activation analysis (INAA) and Cd, Pb and Hg were determined by atomic absorption spectroscopy (AAS) in this organism.

Macroalgal composition and its association with local hydrodynamics in the Laje de Santos Marine State Park, southwestern Atlantic, São Paulo, Brazil

The Laje de Santos Marine State Park (LSMSP), located in southeastern Brazil, is the only marine park in Sao Paulo State. This conservation unit has been established as a protected area of high biological diversity. Despite its importance for the conservation of the marine biota, little is known about the park's seaweed flora. The objectives of this study were as follows: to furnish increased knowledge of the composition of the macroalgae in the Park area; to relate the area's macroalgal composition to the presence of an important water mass in the region, the South Atlantic Central Water (SACW); and to investigate the possible influence of the Port of Santos on the composition of the macroalgae of the LSMSP. This study registered 31 new records for the LSMSP, 11 for Sao Paulo State, four for Brazil, one for the western Atlantic and one for the South Atlantic Ocean, in addition to the possible occurrence of one new species of Osmundea (Rhodomelaceae) and one new genus belonging to Ceramiaceae. The taxonomic composition of the macroalgae had a direct correlation with the arrival of the SACW in the summer-fall season. The SACW generated a strong thermocline and increased the supply of nutrients in the water column. Hydrodynamic and dispersion modeling analyses suggested that the Port of Santos influenced the composition of the LSMSP phycoflora.

Frailty criteria and cognitive performance are related: data from the fibra study in Ermelino Matarazzo, São Paulo, Brazil

Objectives: To assess the relationship between the CHS frailty criteria (Fried et al., 2001) and cognitive performance. Design: Cross sectional and population-based. Setting: Ermelino Matarazzo, a poor sub district of the city of Sao Paulo, Brazil. Participants: 384 community dwelling older adults, 65 and older. Measurements: Assessment of the CHS frailty criteria, the Brief Cognitive Screening Battery (memorization of 10 black and white pictures, verbal fluency animal category, and the Clock Drawing Test) and the Mini-Mental State Examination (MMSE). Results: Frail older adults performed significantly lower than non-frail and pre frail elderly in most cognitive variables. Grip strength and age were associated to MMSE performance, age was associated to delayed memory recall, gait speed was associated to verbal fluency and CDT performance, and education was associated to CDT performance. Conclusion: Being frail may be associated with cognitive decline, thus, gerontological assessments and interventions should consider that these forms of vulnerability may occur simultaneously.

Evidence of contamination by oil and oil products in the Santos-São Vicente estuary, São Paulo, Brazil

Different components of the mixed function oxidase (MFO) system and the levels of fluorescent aromatic compounds in bile (FACs) were measured in Cathorops spixii in order to assess the impact of polycyclic aromatic hydrocarbons (PAHs). Fish were sampled in an estuary (Santos/Sao Vicente) with a history of contamination by PAHs, mainly due to the presence of the industrial complex of Cubatao city and of another of low anthropogenic influence (Cananeia) on the Brazilian coast. FACs were higher in fish from the polluted site, and the PAH 5 and 6-ring metabolites were the most frequent - with 14% and 15%, respectively. Levels of the different components of the MFO system showed the same variation profile as the FACs for both estuaries. Therefore, the values found for somatic indexes and biomarkers with data of bile PAH metabolites indicate the presence of organic contaminants, especially in the area subject to the influence of the industrial complex on the Santos/Sao Vicente estuary.

Vanadium biomonitoring by using Perna perna (Linnaeus, 1758) mussels transplanted in the coast of the State of So Paulo, Brazil

The increased pollution in the aquatic ecosystem has led to the investigation of toxic elements in sea water by using marine organisms to assess marine pollution from human activities. Among these organisms, the mollusks bivalves have been used as biomonitors since they can accumulate trace elements and other substances, without the occurrence of their death. In this study, Perna perna mussels were transplanted from a mussel farm (reference region) to four sites located in coastal regions of So Paulo State, Brazil, close to anthropic discharge areas. Vanadium was determined in mussel tissues by instrumental neutron activation analysis (INAA). Quality control of V analysis was checked by analyzing biological reference materials and the results obtained were precise and in good agreement with the certified values. Comparisons between the V concentrations obtained in transplanted mussels indicated that those from So Sebastio region, close to an oil terminal presented the highest concentration of this element, during spring.

Alien shrimps in evidence: new records of the genus Athanas Leach, 1814 on the coast of So Paulo, southern Brazil (Caridea: Alpheidae)

The occurrence of two alien alpheid shrimps of the genus Athanas Leach, 1814 [in Leach 1813-1814], the Indo-West Pacific A. dimorphus Ortmann, 1894 and the Eastern Atlantic A. nitescens (Leach, 1813 [in Leach 1813-1814]), on the coast of the state of So Paulo, Brazil, is reported. The presence of A. dimorphus extends the range of this species in the western Atlantic farther to the south in Brazil, whereas A. nitescens is reported for the first time in the western Atlantic, representing the second alien alpheid species on this side of the Atlantic and the twenty-first decapod crustacean introduced in Brazil. We provide morphological accounts of the material examined and illustrate the most important diagnostic characters of both species. An overview of the possible mechanisms of their introduction on the coast of So Paulo is also provided.

Desigualdade social no adoecimento e morte por câncer de boca e orofaríngeo no Município de São Paulo, Brasil: 1997 a 2008

A ocupação do espaço geográfico é determinada historicamente pelo modelo socioeconômico e pelo dinamismo de suas relações sociais, políticas e ideológicas. O objetivo deste trabalho é avaliar a distribuição espacial e o efeito de indicadores socioeconômicos no adoecimento e morte por câncer de boca e orofaríngeo no Município de São Paulo, Brasil, no período de 1997 a 2008. Os dados foram coletados no Registro de Câncer de Base Populacional e no Programa de Aprimoramento das Informações de Mortalidade - PRO-AIM e georreferenciados pelos softwares Terraview e GeoDa. O referencial teórico para avaliação dos resultados foi baseado na teoria de Milton Santos. As taxas de incidência apresentaram um índice de autocorrelação Global de Moran de 0,226 e as taxas de mortalidade de 0,337. A Incidência de câncer de boca e orofaríngeo não apresenta um padrão espacial bem definido no Município de São Paulo, mas é bastante desigual no que se refere à Mortalidade, concentrando as suas menores taxas na área central, mais rica e economicamente menos desigual.