GESTÃO MUNICIPAL E DESENVOLVIMENTO DA SAÚDE EM A MICRORREGIÃO TEÓFILO OTONI – MG BRASIL

A partir do contexto da descentralização, hierarquização e regionalização da saúde no Brasil, o presente trabalho tem por objetivo verificar os impactos da gestão municipal sobre o desenvolvimento do setor nos municípios da microrregião de Teófilo Otoni (Minas Gerais). Utilizando como indicadores o Índice de Desenvolvimento Municipal da Saúde e os componentes do Índice de Gestão Fiscal, foi realizada uma análise a partir de dados de painel para o período 2008-2018. A análise permitiu demonstrar os distanciamentos em termos dos avanços da saúde dentro da própria microrregião, com o município de Teófilo Otoni apresentando melhores resultados em relação aos demais municípios componentes. Os resultados sugerem que o nível de investimentos realizados na microrregião não tem sido revertido em maior desenvolvimento na área de saúde e que, devido às restrições de acesso a crédito, as prefeituras usam cada vez mais a postergação de despesas via restos a pagar como fonte de financiamento de suas despesas.Desde el contexto de la descentralización, jerarquización y regionalización de la salud en Brasil, el presente trabajo tiene como objetivo verificar los impactos de la gestión municipal en el desarrollo del sector en los municipios de la Microrregión de Teófilo Otoni (Minas Gerais). Utilizando como indicadores el Índice de Desarrollo de Salud Municipal y los componentes del Índice de Gestión Fiscal, se realizó un análisis a partir de datos de panel para el período 2008-2018. El análisis mostró las distancias en términos de avances en salud dentro de la propia microrregión, presentando el municipio de Teófilo Otoni mejores resultados en relación con los otros municipios componentes. Los resultados sugieren que el nivel de inversiones realizadas en la microrregión no se ha revertido en un mayor desarrollo en el área de la salud y que, debido a las restricciones en el acceso al crédito, los municipios utilizan cada vez más el aplazamiento de los gastos a través de las sobras para pagar como fuente de financiamiento de sus gastos.From the context of decentralization, hierarchization, and regionalization of health in Brazil, this study aims to verify the impact of municipal management on sector development in municipalities of the Teófilo Otoni microregion. Using the Municipal Health Development Index and the components of the Fiscal Management Index as indicators, an analysis was carried out based on panel data from 2008-2018. The analysis demonstrated the distances in health advances within the microregion, where Teófilo Otoni (Minas Gerais) showed better results than other municipalities. Results suggest that investments made in the microregion have not reversed into greater health developments and that, due to credit restrictions, municipalities increasingly postpone expenses through remnants to be paid as a source financing.A partir do contexto da descentralização, hierarquização e regionalização da saúde no Brasil, o presente trabalho tem por objetivo verificar os impactos da gestão municipal sobre o desenvolvimento do setor nos municípios da microrregião de Teófilo Otoni (Minas Gerais). Utilizando como indicadores o Índice de Desenvolvimento Municipal da Saúde e os componentes do Índice de Gestão Fiscal, foi realizada uma análise a partir de dados de painel para o período 2008-2018. A análise permitiu demonstrar os distanciamentos em termos dos avanços da saúde dentro da própria microrregião, com o município de Teófilo Otoni apresentando melhores resultados em relação aos demais municípios componentes. Os resultados sugerem que o nível de investimentos realizados na microrregião não tem sido revertido em maior desenvolvimento na área de saúde e que, devido às restrições de acesso a crédito, as prefeituras usam cada vez mais a postergação de despesas via restos a pagar como fonte de financiamento de suas despesas

Visceral leishmaniasis (kala-azar) and pregnancy.

OBJECTIVE: The aim of the present review was to close the gap in the approach to pregnant women with visceral leishmaniasis (kala-azar) by providing up-to-date information to obstetricians about physiopathology, epidemiology, vertical transmission, drugs and treatment during pregnancy. BACKGROUND: Infection with Leishmania chagasi during pregnancy is rare and deserves special attention since little information is available regarding the occurrence of visceral leishmaniasis during gestational period and the real possibility of vertical transmission of this disease. Because specific areas in the world are endemic for the disease and considering the continuous growth of the population, cases of pregnant women with visceral leishmaniasis are becoming more frequent. Unfortunately, textbooks on infectious diseases do not include this specific group of patients, and studies in the literature on aspects related to pregnancy and visceral leishmaniasis are scarce. CONCLUSIONS: Vertical transmission of leishmaniasis is possible and the institution of treatment is imperative in cases of pregnant women with kala-azar. Amphotericin B is strongly recommended as the first choice drug due to its fewer maternal-fetal adverse effects

A conceptual model for understanding the zoonotic cutaneous leishmaniasis transmission risk in the Moroccan pre-Saharan area

Publisher Copyright: © 2022 The AuthorsLeishmanioses are of public health concern in Morocco, mainly the Zoonotic Cutaneous Leishmaniasis (ZCL) endemic in the Moroccan pre-Saharian area. Transmission of this disease depends on eco-epidemiological and socio-economic conditions. Therefore, a multivariable approach is required to delineate the risk and intensity of transmission. This will help outline main disease risk factors and understand interactions between all underlying factors acting on disease transmission at a local and regional scale. In this context, we propose a new conceptual model, the Biophysical-Drivers-Response-Zoonotic Cutaneous Leishmaniasis (BDRZCL), adapted to the Pre-Saharian area. The proposed model highlights how the physical and human drivers affect the environment and human health. The incidence of ZCL is linked to human activity and biophysical changes or by their interactions. The human response added to risk drivers are the main components that influence the biophysical part. This model improves our understanding of the cause-effect interactions and helps decision-makers and stakeholders react appropriately.publishersversionpublishe

Exome sequencing followed by large-scale genotyping suggests a limited role for moderately rare risk factors of strong effect in schizophrenia.

Schizophrenia is a severe psychiatric disorder with strong heritability and marked heterogeneity in symptoms, course, and treatment response. There is strong interest in identifying genetic risk factors that can help to elucidate the pathophysiology and that might result in the development of improved treatments. Linkage and genome-wide association studies (GWASs) suggest that the genetic basis of schizophrenia is heterogeneous. However, it remains unclear whether the underlying genetic variants are mostly moderately rare and can be identified by the genotyping of variants observed in sequenced cases in large follow-up cohorts or whether they will typically be much rarer and therefore more effectively identified by gene-based methods that seek to combine candidate variants. Here, we consider 166 persons who have schizophrenia or schizoaffective disorder and who have had either their genomes or their exomes sequenced to high coverage. From these data, we selected 5,155 variants that were further evaluated in an independent cohort of 2,617 cases and 1,800 controls. No single variant showed a study-wide significant association in the initial or follow-up cohorts. However, we identified a number of case-specific variants, some of which might be real risk factors for schizophrenia, and these can be readily interrogated in other data sets. Our results indicate that schizophrenia risk is unlikely to be predominantly influenced by variants just outside the range detectable by GWASs. Rather, multiple rarer genetic variants must contribute substantially to the predisposition to schizophrenia, suggesting that both very large sample sizes and gene-based association tests will be required for securely identifying genetic risk factors. © 2012 The American Society of Human Genetics

Pregnant and breastfeeding women: A priority population for HIV viral load monitoring

With more than 18 million HIV-infected individuals having initiated antiretroviral therapy (ART) in low- and middle-income countries (LMICs) by the end of 2016, ensuring effective HIV care and treatment services is a global public health priority [1]. Viral load (VL) quantification provides a direct measure of the effectiveness of ART, with a consistently elevated VL suggesting poor adherence or treatment failure and the need for intervention. In turn, HIV VL monitoring is now recognised as a key component of ART services in LMICs in World Health Organization (WHO) guidelines, with an emphasis on scaling up access to VL testing for ART programmes [2]. Pregnant and postpartum women are an important population within ART programmes. In many countries, the majority of identified HIV-infected adults are women, and many women of reproductive age are diagnosed with HIV infection during pregnancy through prevention of mother-to-child transmission of HIV (PMTCT) services in antenatal care (ANC) [3]. With universal eligibility for ART for all HIV-infected pregnant and postpartum women (based on the WHO’s 2013 ‘Option B+’ policy [4]), many women of reproductive age initiating ART do so during pregnancy. PMTCT services extend through early infant diagnosis around 6–10 weeks postpartum until the cessation of breastfeeding and documentation of the infant’s final HIV testing status, which may extend well beyond 1 year postpartum based on the recently updated infant feeding recommendations [5]. With ongoing risk of HIV transmission throughout breastfeeding, maintaining ART adherence and viral suppression is especially crucial during this period. Although the importance of routine VL monitoring for HIV-infected individuals on ART is widely recognised [6], there has been minimal attention to VL monitoring in pregnancy and the postpartum period. Here we discuss key considerations for VL monitoring in pregnant and breastfeeding women in the context of expanding access to VL monitoring (summarised in Box 1)

"SMARTHFONE QUE NÃO DESLIGA”: O USO E A DEPENDÊNCIA DO CELULAR POR GESTORES DE UMA GRANDE EMPRESA

The influence of technology on people's lives can alter the way they work, relate, and live. The objective of this case study is to analyze the use and symptoms associated with the frequent use of smartphones by executives of a large company. To this end, a qualitative research was carried out, and a link to the questions of interest to the investigation was sent by e-mail. Six managers from a large company who frequently use smartphones in their daily lives were intentionally chosen by accessibility. The results found the existence of four paradoxes (control/cause; freedom/slavery; independence/dependence; integration/isolation), which represent the way the cell phone can be perceived in both the personal and professional lives of the participants. This study contributes to the understanding about the influence of cell phone use by Brazilian managers, reinforcing the relevance of considering the theme in studies related to organizational behavior in the country.La influencia de la tecnología en la vida de las personas puede cambiar su forma de trabajar, relacionarse y vivir. El objetivo de este estudio de caso es analizar el uso y los síntomas asociados al uso frecuente de los smartphones en los ejecutivos de una gran empresa. Para ello, se realizó una investigación cualitativa, enviándose por correo electrónico un enlace para acceder a las preguntas de interés para la investigación. Se eligió intencionadamente a seis directivos de una gran empresa que utilizaban con frecuencia los teléfonos inteligentes en su vida diaria por su accesibilidad. Los resultados verificaron la existencia de cuatro paradojas (control/causa; libertad/esclavitud; independencia/dependencia; integración/aislamiento), que representan la forma de percibir el teléfono móvil en la vida personal y profesional de los participantes. Este estudio contribuye a la comprensión de la influencia del uso del teléfono móvil por parte de los directivos brasileños, reforzando la relevancia de considerar el tema en los estudios relacionados con el comportamiento organizacional en el país.A influência da tecnologia na vida das pessoas pode alterar a forma como trabalham, se relacionam e vivem. O objetivo deste estudo de caso é o de analisar o uso e os sintomas associados à utilização frequente do smartphone em executivos de uma empresa de grande porte. Para tanto, realizou-se uma pesquisa de característica qualitativa, sendo encaminhado por e-mail um link de acesso aos questionamentos de interesse da investigação. Foram escolhidos intencionalmente e por acessibilidade seis gestores de uma grande empresa que utilizavam o smartphone de forma frequente em seus cotidianos. Os resultados constataram a existência de quatro paradoxos (controle/caos; liberdade/escravidão; independência/dependência; integração/isolamento), que representam a forma como o celular pode ser percebido tanto na vida pessoal como profissional dos participantes. Este estudo contribui para o entendimento acerca da influência do uso celular por gestores brasileiros, reforçando a relevância de se considerar a temática nos estudos relacionados ao comportamento organizacional no país.A influência da tecnologia na vida das pessoas pode alterar a forma como trabalham, se relacionam e vivem. O objetivo deste estudo de caso é o de analisar o uso e os sintomas associados à utilização frequente do smartphone em executivos de uma empresa de grande porte. Para tanto, realizou-se uma pesquisa de característica qualitativa, sendo encaminhado por e-mail um link de acesso aos questionamentos de interesse da investigação. Foram escolhidos intencionalmente e por acessibilidade seis gestores de uma grande empresa que utilizavam o smartphone de forma frequente em seus cotidianos. Os resultados constataram a existência de quatro paradoxos (controle/caos; liberdade/escravidão; independência/dependência; integração/isolamento), que representam a forma como o celular pode ser percebido tanto na vida pessoal como profissional dos participantes. Este estudo contribui para o entendimento acerca da influência do uso celular por gestores brasileiros, reforçando a relevância de se considerar a temática nos estudos relacionados ao comportamento organizacional no país

Active sensing coating for early detection of corrosion processes

A corrosion sensing coating based on specially developed polymeric microcapsules with a pH-indicator is reported. The synthesis of the microcapsules is designed in a way to ensure their optimal compatibility with the polyurethane protective coatings and to allow release of the indicator at higher pH values. The obtained polyurea microcapsules have a regular and microsized morphology and a loading content of 12 wt%. The developed sensing coating applied on aluminium and magnesium alloys is able to indicate initiation of corrosion processes through a pink coating coloration, as a result of local pH increase in the cathodic areas

Screening the human exome: a comparison of whole genome and whole transcriptome sequencing

BACKGROUND: There is considerable interest in the development of methods to efficiently identify all coding variants present in large sample sets of humans. There are three approaches possible: whole-genome sequencing, whole-exome sequencing using exon capture methods, and RNA-Seq. While whole-genome sequencing is the most complete, it remains sufficiently expensive that cost effective alternatives are important. RESULTS: Here we provide a systematic exploration of how well RNA-Seq can identify human coding variants by comparing variants identified through high coverage whole-genome sequencing to those identified by high coverage RNA-Seq in the same individual. This comparison allowed us to directly evaluate the sensitivity and specificity of RNA-Seq in identifying coding variants, and to evaluate how key parameters such as the degree of coverage and the expression levels of genes interact to influence performance. We find that although only 40% of exonic variants identified by whole genome sequencing were captured using RNA-Seq; this number rose to 81% when concentrating on genes known to be well-expressed in the source tissue. We also find that a high false positive rate can be problematic when working with RNA-Seq data, especially at higher levels of coverage. CONCLUSIONS: We conclude that as long as a tissue relevant to the trait under study is available and suitable quality control screens are implemented, RNA-Seq is a fast and inexpensive alternative approach for finding coding variants in genes with sufficiently high expression levels