Tecnologia em saúde : uso do aplicativo "Saúde do Bugre" no processo de territorialização da UBS Presidente Tancredo Neves no município de Balsa Nova, Paraná

Orientadora: Profª. Me. Renata Oppitz de Lima e Cirne Ortiz VargasMonografia (especialização) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Curso de Especialização em Atenção BásicaInclui referênciasResumo: O território em Estratégia e Saúde da Família (ESF) é entendido como processo biopsicossocial no qual a equipe de saúde está inserida e interage de forma contínua com a população em que nele habita, sendo portanto a territorialização o ato de apropriar-se da localidade adscrita. O presente estudo objetivou o levantamento de dados epidemiológicos e geográficos para elaboração do perfil populacional e mapas de atuação da população adscrita à Unidade Básica de Saúde (UBS) Presidente Tancredo Neves, localizada na cidade de Balsa Nova, Paraná. A metodologia empregada caracterizou-se como qualitativa essencialmente, com utilização de método quantitativo quando da análise dos dados coletados. Um questionário foi elaborado pela equipe ESF e a partir deste, um aplicativo para smartphones denominado "Saúde Bugre" foi desenvolvido para fim de coleta de dados para a territorialização. Participaram da pesquisa 388 famílias e 938 pessoas de dezembro/2020 a fevereiro/2021, o que corresponde a 17% da população da área de abrangência da UBS. As perguntas englobavam dados sociodemográficos e de saúde. Os resultados demonstraram população predominantemente adulta (55%), com pirâmide etária em processo de envelhecimento, alta prevalência de baixa escolaridade (61%) e de pobreza (27%). Quanto às comorbidades, constatou-se que 216 (23%) pacientes apresentavam hipertensão, 115 (12%) ansiedade, 87 (9%) insônia, 67 (7%) depressão e 61 (6,5%) diabetes. Encontrou-se tabagismo em 138 (15%) dos entrevistados, uso de fogão a lenha em 254 (27%), e 139 (35%) habitações com potencial exposição a agrotóxicos. O uso de contracepção de alta eficácia foi verificado em 79 mulheres em idade fértil (37%) e a realização de exames para prevenção de neoplasia de colo uterino e mamária possui aderência de 130 (73%) e 33 (40%) mulheres, respectivamente. O aplicativo permitiu a construção de mapas setorizando os usuários por região de ACS, e categorizando-os através de suas comorbidades e características sociodemográficas. Concluiu-se do presente estudo que essa é uma população com vulnerabilidades educacionais, financeiras e sanitárias, necessitando avaliação de equipe multiprofissional e contínua, afim de melhorar acurácia da territorialização e acompanhamento evolutivo.Abstract: The territory on Primary Health Care (PHC) is understood as biopsichosocial process in which the heatl team is inserted na continuously interacting with the population in witch it lives., since territorialization is the act of appropriation of the locality. The presente study aimed to collected epidemiological and geographic data for the elaboration of the population profile and local maps, of a Basic Health Unit (BUH) located in the city of Balsa Nova, Paraná. The methodology used is essentially qualitative, with the use of a quantitative method when analyzing the collected data. A questionnaire was prepared by the PHC team and from this a smartphone application was developed for the purpose of data collection for the territorialization. Participated in the research 388 families and 938 people from December/2020 to February/2021, witch corresponds to 17% of the population in the BHU área. The questions included socio-demographic and health data. The results showed a predominantly adult population (55%), with an aging pyramid, a high prevalence of precarious schooling (61%) and poverty (27%). As for comorbidities, 216 (23%) patients with hypertension, 115 (12%) with anxiety, 87 (9%) with insomnia, 67 (7%) with depression and 61 (6.5%) with diabetes were reported. Smoking was found in 138 (15%) of the interviews, use of wood stove in 254 (27%), and 139 (35%) homes with potential exposure to pesticides. The use of highly effective contraception was seen in 79 women of childbearing age (37%), and tests for the prevention of cervical and breast cancer with adherence of 130 (73%) and 33 (40%) respectively. The application allowed the construction of maps sectoring users by region of community health agents, and categorizing them through their comorbities and sociodemographic chacacteristics. It was concluded from the present study that this is a population with educational, financial and health vulnerabilities, requiring evaluation by a multidisciplinary and continuous team, as well as the application of questionnaires for specific diseases, in order to improve the accuracy of territorialization and evolutionary monitoring

Sistemas inteligentes e transformação digital: evidências empíricas para os municípios brasileiros

Objetivo: O estudo analisa se os municípios brasileiros conseguem aproveitar o potencial gerado pela difusão de Sistemas Inteligentes (SIs), responsáveis por integrar e melhorar o desempenho dos serviços fornecidos a partir da experiência e da interação com os cidadãos. Assim, o objetivo do estudo é caracterizar e identificar os fatores que influenciam na aplicação dessas tecnologias pelos municípios brasileiros. Método: A metodologia utilizada é a construção de um indicador que mensurar a oferta de SIs, a elaboração de estatísticas descritivas e a estimação de uma regressão pelo método de Mínimos Quadrados Ordinários (MQO) para os 5.570 municípios brasileiros, a partir de dados tabulados para o ano de 2019. Resultado: Os resultados mostram que a utilização de SIs ainda é incipiente nas administrações públicas locais, sendo a sua oferta positivamente influenciada pela hierarquia urbana, número de habitantes, PIB, acesso à internet e pela presença de centros de TI nos municípios. Conclusões: Apesar da utilização de SIs no setor público contribuir para a oferta de melhor qualidade pelos municípios, sua utilização ainda é incipiente no território nacional

Characteristics of the gene pool of spring wheat (<i>Triticum aestivum</i> L.) for resistance to loose smut in the forest-steppe of Western Siberia

Among the many diseases of spring wheat caused by pathogenic fungi, loose smut Ustilago tritici (Pers.) Jens. remains to be a dangerous disease with a wide range of distribution. In fields where there is no control over the emergence and spread of the disease, the yield reduction can be up to 10 %, and in the case of highly susceptible varieties, up to 40–50 %. Taking into account the increasing cost of seed protectants and their environmental damage, the cultivation of varieties resistant to loose smut is still the most affordable way to protect plants, reducing the pesticide load on agrocenoses. The crucial point in breeding for resistance is the use of resistant varieties as parental forms. The aim of our research was to isolate samples of spring wheat that are immune to loose smut against the background of artificial infection of plants with a population specific to the West Siberian region. The article presents the results of long-lasting studies of 350 genotypes of spring wheat of different ecological and geographical origin for resistance to disease. Physiological specialization of races was carried out on the basis of a differentiating set consisting of six varieties of soft wheat and three varieties of durum spring wheat. The obtained results in combination with literature data reveal changes in the racial composition of the pathogen population over the past 30–35 years. Varieties of foreign and domestic selection resistant to the West Siberian population of loose smut have been identified. Based on the analysis of pedigree samples, highly and practically resistant to loose smut, we concluded that in breeding for immunity to U. tritici, the same sources of resistance genes are most often used. Among the gene pool of spring wheat of foreign selection, the largest number of genotypes resistant to loose smut is assigned to the countries of the North American geographical zone (USA, Canada, Mexico). These are largely samples containing Ut1 genes, genes from spring wheat ‘Thatcher’ and its sister line ‘DC II-21-44’. Resistance genes in Russian wheat varieties can be traced from cultivars Beloturka, Poltavka, Selivanovsky Hare (using Saratovskaya 29 and its derivatives), and genes from wheatgrass lines AGIS 1 and Grecum 114

Cardiovascular effects of fentanyl in conscious rats

Abstract.: The polymicrobial sepsis induced by cecal ligation and puncture (CLP) in the rat is widely used in shock research. For ethical reasons, narcotic analgesics are often administered in this model, with the potential risk of confounding effects. In conscious non-septic rats, we investigated the cardiovascular effects of a continuous i.v. infusion of fentanyl (20µg/kg per h) administered with fluid loading (10ml/kg per h) for 24h, a regimen commonly applied in rat CLP. Animals were randomly allocated to receive analgesia with fluid loading (Fentanyl group), or fluid loading alone (Control). All endpoints were assessed after 24h of infusion. At that time, Control animals had mild respiratory alkalosis, which was essentially abolished by fentanyl. Analgesia mildly elevated the plasma norepinephrine levels [median (interquartile range): Control 232pg/ml (0-292), Fentanyl 302pg/ml (234-676), P=0.045] but was devoid of any effect on blood pressure, heart rate, cardiac output (mean ±SD: Control 388±61ml/kg per min, Fentanyl 382±62ml/kg per min, P=0.87) and indices of left ventricular function derived from high-fidelity recordings of left ventricular pressure (dP/dt max: Control 11782±2324mmHg/s, Fentanyl 12107±2816mmHg/s, P=0.77). In ex vivo experiments carried out immediately after animal sacrifice, no differences were noted between the Control and Fentanyl groups in the sensitivity of endothelium-intact aortic rings to norepinephrine-induced vasoconstriction (-logEC50: Control 8.78±0.28, Fentanyl 8.83±0.26, P=0.52) or acetylcholine-induced vasodilatation (-logEC50: Control 7.00±0.37, Fentanyl 7.06±0.26±0.53, P=0.75). In conclusion, the present data provide no contraindication, and even some support for the ethical use of a high dose i.v. infusion of fentanyl in cardiovascular studies of conscious catheterized rats undergoing CLP or other painful procedure

Treatment of peri-implantitis with surface decontamination and particulate bone graft in a smoker patient

Introduction: With the increase of implant-supported rehabilitation, the cases of patients with peri-implantitis become more frequent. Objective: To report the treatment of peri-implantitis by associating techniques of surface decontamination and particulate bone graft. Case report: The treatment was carried through curettage of the granulation tissue, mechanical bone decontamination withbicarbonate jet, chemical decontamination with tetracycline solution, and particulate graft in the place of the bone defect. Conclusion: After 45 postoperative days, the peri-implant tissues were health without inflammation. After 6 postoperative months, the bone defect was repaired.Introduction: With the increase of implant-supported rehabilitation, the cases of patients with peri-implantitis become more frequent. Objective: To report the treatment of peri-implantitis by associating techniques of surface decontamination and particulate bone graft. Case report: The treatment was carried through curettage of the granulation tissue, mechanical bone decontamination withbicarbonate jet, chemical decontamination with tetracycline solution, and particulate graft in the place of the bone defect. Conclusion: After 45 postoperative days, the peri-implant tissues were health without inflammation. After 6 postoperative months, the bone defect was repaired

The implementation of physicians assistant in a surgical ward improves continuity in daily clinical work and increases comprehensibility of nurses and physicians

INTRODUCTION Physician Assistant (PA) have been deployed to increase the capacity of a team, supporting continuity and medical cover. The goal of this study was to assess the implementation of PAs on continuity of surgical rounds, on the collaboration of nurses and physicians and on support of administrative work. METHODS This cross-sectional survey was performed on nurses and physicians who work full-time at a surgical ward in a Swiss reference center. PAs were introduced in our institution in 2019. Participants answered a self-developed questionnaire 6 and 12 months after the implementation of PAs. Administrative work, teamwork, improvement of workflow, and training of physicians has been assessed. Participants answered questions on a 5-point Likert scale and were stratified according to profession (nurse, physician). RESULTS Participants (n = 53) reported a positive effect on the regular conduct of rounds (2.9, SD 1.1 points after 6 weeks and 3.5, SD 1.1 points after 12 weeks, p = 0.05). A significant improvement of nurse-doctor collaboration has been reported (3.6, SD 1.0 and 4.2, SD 0.8, p = 0.05). Nurses (n = 28, 52.8%) reported the that PAs are integrated in the physicians team rather than the nurses team (4.0, SD 0.0 points and 4.4, SD 0.7 points, p = 0.266) and a significant beneficial effect on the surgical clinic (3.7, SD 1.0 points and 4.4, SD 0.8 points, p = 0.043). Improved overall management of surgical cases was reported by the physicians (n = 25, 47.2%) (4.8, SD 0.4 and 4.3, SD 0.6, p = 0.046). CONCLUSION The implementation of PA has improved the collaboration of physicians and nurses substantially. Continuity of rounds has improved and the administrative workload for residents decreased substantially. Overall, the implementation of PA was reported to be beneficial for the surgical clinic

Esthetic rehabilitation of anterior teeth through gingival recontouring and ceramic veneers: a case report

Esthetic rehabilitations require a broad and thorough evaluation of all the elements that make up the smile such as lips, dental, and periodontal structures to plan the treatment to provide harmony to the whole set. Objective: To demonstrate through a case the association of Periodontics and Restorative Dentistry in the esthetic rehabilitation of anterior teeth replacing resin restorations by modifying the gingival architecture conservatively and harmonically. Case report: It is essential for a multidisciplinary approach to succeed in treatment. The replacement of previous restorations is an increasing demand in currently clinical practice, for many reasons, mainly due to dissatisfaction with the esthetics. It is observed that many of these patients involve not only dissatisfaction with the dental structure but also with the periodontal health, for this reason, it is necessary a previous adaptation of the gingival tissues for proper restorative rehabilitation. Conclusion: Ceramic laminates have proved to be a great choice for anterior teeth restorations, but they must be indicated in specific situations, to obtain excellent results as most conservative as possible.Esthetic rehabilitations require a broad and thorough evaluation of all the elements that make up the smile such as lips, dental, and periodontal structures to plan the treatment to provide harmony to the whole set. Objective: To demonstrate through a case the association of Periodontics and Restorative Dentistry in the esthetic rehabilitation of anterior teeth replacing resin restorations by modifying the gingival architecture conservatively and harmonically. Case report: It is essential for a multidisciplinary approach to succeed in treatment. The replacement of previous restorations is an increasing demand in currently clinical practice, for many reasons, mainly due to dissatisfaction with the esthetics. It is observed that many of these patients involve not only dissatisfaction with the dental structure but also with the periodontal health, for this reason, it is necessary a previous adaptation of the gingival tissues for proper restorative rehabilitation. Conclusion: Ceramic laminates have proved to be a great choice for anterior teeth restorations, but they must be indicated in specific situations, to obtain excellent results as most conservative as possible

Estrutura de monitoramento e controle como base para a inovação em governança: o caso TáxiGov

O estudo analisa como se encontra organizada a Estrutura de Monitoramento e Controle (EMC) do TáxiGov. Os princípios de design propostos por Ostrom (1990) são revisitados com base nas novas evidências fornecidas pela literatura de plataformas digitais, mediante a aplicação de um questionário e uma pesquisa documental. Os resultados mostram que quatro dos oito princípios de design são aplicados, sendo a EMC descentralizada para os órgãos públicos locais, o que confere autonomia para os gestores locais que complementam e customizam as regras. Assim, o principal avanço do artigo é demonstrar que os princípios de design, identificados pela literatura de bens sociais, somados à flexibilidade das plataformas digitais, possibilitam a construção de EMCs mais dinâmicas, adaptáveis e inovadoras, capazes de contribuir para a construção de regimes de utilização mais adequados aos serviços públicos. Resultado aderente ao caráter contingente e dinâmico associado à classificação dos bens.El estudio analiza cómo está organizada la Estructura de Monitoreo y Control (EMC) de TaxiGov. Se revisan los principios de diseño propuestos por Ostrom (1990) a partir de nuevas evidencias aportadas por la literatura sobre plataformas digitales, mediante la aplicación de una encuesta y una investigación documental. Los resultados muestran que se aplican cuatro de los ocho principios de diseño, siendo la EMC descentralizada a los organismos públicos locales, lo que da autonomía a los gestores locales que complementan y personalizan las reglas. Así, el principal avance del artículo es demostrar que los principios de diseño, identificados por la literatura de bienes sociales, sumados a la flexibilidad de las plataformas digitales, posibilitan la construcción de EMC más dinámicos, adaptables e innovadores, capaces de contribuir a la construcción de regímenes de uso más adecuado de los servicios públicos. Resultado adherente al carácter contingente y dinámico asociado a la clasificación de activos.The study analyzes how TaxiGov’s Monitoring and Control Structure (EMC) is organized. The design principles proposed by Ostrom (1990) are revisited based on new evidence provided by the literature on digital platforms, through the application of a questionnaire and documentary research. The results show that four of the eight design principles are applied, with EMC being decentralized to local public bodies, which gives autonomy to local managers who complement and customize the rules. Thus, the main advance of the article is to demonstrate that the design principles, identified by the social goods literature, added to the flexibility of digital platforms, enable the construction of more dynamic, adaptable, and innovative EMCs, capable of contributing to the construction of regimes of the more appropriate use of public services. Result adherent to the contingent and dynamic character associated with the classification of goods.Revista do Serviço Público - RSP, v. 74, n. 2, 390-409 p.Gestão PúblicaGoverno e Transformação DigitalInovaçãoISSN Impresso: 0034-9240ISSN Eletrônico: 2357-801