Primary healthcare and the construction of thematic health networks: what role can they play?

The enhancement of primary healthcare has been a core strategy for the empowerment of the Brazilian Unified Health System (SUS). Recent guidelines issued by OPAS and the Ministry of Health highlight the role it has played as a thematic communication network center, a regulating agent for the access and use of services required for comprehensive healthcare. Sponsored by PPSUS/Fapesp, this study examines the possibilities of the primary healthcare network exercising such a strategic function. Life narratives involving 15 regular users were produced in two cities of ABC Paulista, which have adopted the Family Health Strategy for the organization of their primary healthcare networks. The study presents three main findings: the primary healthcare network serves as an outpost of SUS by producing user values even for high complexity service users; the primary network is perceived is a place for simple care needs; there is shared impotence between users and teams when it comes to the network functioning as the coordinator of care, indicating that it does not possess the technological, operational and organizational material conditions or symbolic conditions (values, meanings, and representations) to be in a central position in the coordination of thematic healthcare networks.O fortalecimento da atenção básica tem sido valorizado como estratégia central para a construção do SUS. Diretrizes recentes emanadas pela OPAS e pelo MS destacam seu papel como centro de comunicação de redes temáticas, como reguladora do acesso e utilização dos serviços necessários para a integralidade do cuidado. O presente estudo, financiado com recursos PPSUS/Fapesp, problematiza as possibilidades da rede básica exercer tal função estratégica. Foram produzidas narrativas de vida de 15 usuários altamente utilizadores de serviços de saúde em dois municípios do ABC paulista, que adotaram a Estratégia de Saúde da Família para organização de suas redes básicas. O estudo apresenta três achados principais: a rede básica funciona como posto avançado do SUS, produzindo valores de uso mesmo para os pacientes utilizadores de serviços de alta complexidade; a rede básica é vista como lugar de coisas simples; há uma impotência compartilhada entre usuários e equipes quando se trata da rede básica funcionar como coordenadora do cuidado, indicando como ela não reúne condições materiais (tecnológicas, operacionais, organizacionais) e simbólicas (valores, significados e representações) de deter a posição central da coordenação das redes temáticas de saúde.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Medicina PreventivaInstituto Superior de Ciências do Trabalho e da Empresa Instituto Universitário de Lisboa Faculdade de Ciências Médicas Departamento de Saúde ColetivaUniversidade Estadual de Campinas Faculdade de Ciências Médicas Departamento de Saúde ColetivaUNIFESP, EPM, Depto. de Medicina PreventivaSciEL

Impact of multi-metals (Cd, Pb and Zn) exposure on the physiology of the yeast Pichia kudriavzevii

Metal contamination of the environment is frequently associated to the presence of two or more metals. This work aimed to study the impact of a mixture of metals (Cd, Pb and Zn) on the physiology of the non-conventional yeast Pichia kudriavzevii. The incubation of yeast cells with 5 mg/l Cd, 10 mg/l Pb and 5 mg/l Zn, for 6 h, induced a loss of metabolic activity (assessed by FUN-1 staining) and proliferation capacity (evaluated by a clonogenic assay), with a small loss of membrane integrity (measured by trypan blue exclusion assay). The staining of yeast cells with calcofluor white revealed that no modification of chitin deposition pattern occurred during the exposure to metal mixture. Extending for 24 h, the exposure of yeast cells to metal mixture provoked a loss of membrane integrity, which was accompanied by the leakage of intracellular components. A marked loss of the metabolic activity and the loss of proliferation capacity were also observed. The analysis of the impact of a single metal has shown that, under the conditions studied, Pb was the metal responsible for the toxic effect observed in the metal mixture. Intracellular accumulation of Pb seems to be correlated with the metals toxic effects observed.The authors thank the FCT Strategic Project PEst-OE/EQB/LA0023/2013 and the Project "BioInd-Biotechnology and Bioengineering for improved Industrial and Agro-Food processes" (NORTE-07-0124-FEDER-000028), Co-funded by the Programa Operacional Regional do Norte (ON.2-O Novo Norte), QREN, FEDER. Manuela D. Machado gratefully acknowledges the post-doctoral grant from FCT (SFRH/BPD/72816/2010). Vanessa A. Mesquita gratefully acknowledges the grant from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES). The authors also thank to Doctor Rosane Freitas Schwan to offer the yeast strain and to Doctor Helena M.V.M. Soares, from the Faculty of Engineering of Porto University, for the use of analytical facilities (AAS with flame atomization and AAS with electrothermal atomization)

Deep Learning assessment of galaxy morphology in S-PLUS Data Release 1

The morphological diversity of galaxies is a relevant probe of galaxy evolution and cosmological structure formation, but the classification of galaxies in large sky surveys is becoming a significant challenge. We use data from the Stripe-82 area observed by the Southern Photometric Local Universe Survey (S-PLUS) in 12 optical bands, and present a catalogue of the morphologies of galaxies brighter than r = 17 mag determined both using a novel multiband morphometric fitting technique and Convolutional Neural Networks (CNNs) for computer vision. Using the CNNs, we find that, compared to our baseline results with three bands, the performance increases when using 5 broad and 3 narrow bands, but is poorer when using the full 12 band S-PLUS image set. However, the best result is still achieved with just three optical bands when using pre-trained network weights from an ImageNet data set. These results demonstrate the importance of using prior knowledge about neural network weights based on training in unrelated, extensive data sets, when available. Our catalogue contains 3274 galaxies in Stripe-82 that are not present in Galaxy Zoo 1 (GZ1), and we also provide our classifications for 4686 galaxies that were considered ambiguous in GZ1. Finally, we present a prospect of a novel way to take advantage of 12 band information for morphological classification using morphometric features, and we release a model that has been pre-trained on several bands that could be adapted for classifications using data from other surveys. The morphological catalogues are publicly available.Facultad de Ciencias Astronómicas y GeofísicasInstituto de Astrofísica de La Plat