Comunicação em saúde no Brasil : um estudo exploratório na Rede COSEMS das Secretarias Municipais de Saúde

Tese (doutorado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, 2017.Objetivo: investigar as características dos serviços de comunicação em Saúde, a partir da Rede dos Conselhos das Secretarias Municipais de Saúde (COSEMS) no Brasil. Métodos: estudo exploratório quantitativo, e qualitativo do tipo participante, conduzido de 2014 a 2015, com amostra não probabilística. Utilizou-se quatro questionários estruturados divididos em 4 dimensões: 1) estrutura do trabalho das assessorias de comunicação; 2) perfil dos profissionais que nelas atuam; 3) as principais atribuições destas assessorias e, 4) possíveis variantes de quem não possuía este serviço especializado, e dois roteiros semiestruturado para as entrevistas. Resultados: participaram 122 municípios, somente dois núcleos da Rede possuíam diretoria de comunicação e 64,8% dos municípios não possuíam Assessoria de Comunicação; as instalações de trabalho são precárias, os profissionais não têm estabilidade empregatícia, são comissionados e com pouca experiência (3,7) anos. Articular as ações de prevenção e promoção da saúde, balizados pela informação, educação, e comunicação, demarcados pelos princípios e valores da defesa da saúde e vida, com qualidade e dignidade. Conclusão: os profissionais de comunicação realizam assessoramento direto aos secretários, não possuem assento nos conselhos gestores, tem comprometidas suas ações de planejamento, o que fragiliza os processos organizativos. É necessário construir uma agenda política estratégia de comunicação em saúde, fortalecimento dos processos de informação, educação e comunicação voltados para prevenção das doenças e promoção da saúde, compreendidos como um ideal ético-político-formativo a ser alcançado na direção cidades saudáveis solidária, democrática e socialmente justa.Objective: to investigate the characteristics of the health communication services of the Network of Councils of Municipal Health Secretariats (COSEMS) in Brazil. Methods: qualitative and quantitative exploratory and participatory study conducted from 2014 to 2015, with a non-probabilistic sample. Four structured questionnaires divided into four dimensions were applied: 1) work structure of the communication offices; 2) profile of professionals who work in the communication offices; 3) main duties/responsibilities of the communication offices, and 4) possible variant models of those units that did not have this specialized service, and two semi- structured questionnaires for interviews. Results: 122 municipalities participated. Only two units of the network had a communication directing board and 64.8% of the municipalities did not have a communication office; the work facilities are precarious; the professionals have no job security, they are commissioned and have little experience (3.7 years). Articulating actions of prevention and health promotion, based on information, education, and communication, in the scope of the principles and values of the defense of health and life, with quality and dignity. Conclusion: communication professionals provide direct advice to the secretaries; they do not have a seat in the managing councils which compromises their planning actions and weakens the organizational processes. It is necessary to build a strategic political communication agenda in health, strengthen information, education and communication processes aimed at disease prevention and health promotion understood as an ethical-political-formative ideal to be achieved towards healthy, democratic, sympathetic cities that are socially and democratically just

Evaluation Of The Ergonomic Quality Of The Graphical Interface Of The Solidworks 2003 Through One Analytical Technique

Este trabalho aborda uma avaliação através de uma técnica analítica, sobre a qualidade ergonômica da interface gráfica do Solidworks 2003. A ferramenta utilizada foi o Ergolist. O processo de avaliação foi realizado por usuários com experiência na utilização da ferramenta. Finaliza apresentando uma análise sobre o resultados da avaliação

Osteotomies of the coracoid process: an anatomical study

OBJECTIVE: Relate the main tendinous and ligamentous structures attached in the coracoid process, correlating it to several levels of osteotomy and describing the involved structures. METHODS: Thirty shoulders were dissected. The coracoid process with mainly inserted anatomic structures was dissected, and five levels of osteotomy (1.0; 1.5; 2.0; 2.5; 3.0 cm) were made from the apex of the process and the mainly involved structures were recorded. RESULTS: In osteotomies of 1.0 cm, in 100% of the cases only the conjoint tendon (CT). In osteotomies of 1.5 cm there were 63.33% of cases involved with the CT and the Pectoralis minor (PMi), in 20% of cases only the CT, and in 16.66% the CT, PMi, and the coracohumeral ligament (CUL). In osteotomies of 2.0 cm, in 80% of the shoulders, the osteotomies embraced the CT, PMi and the CUL, and in 20% only the CT and the PMi were involved. In the osteotomies of 2.5cm there was involvement of the CT, PMi and CUL in 100% of cases. In the osteotomies of 3.0cm, six cases (20%) have presented an injury on the trapezoid ligament, and in 100% of these osteotomies, the osteotomized distal fragment had embraced the CT, PMi, CUL. CONCLUSION: The knowledge of anatomic structures inserted and involved in the osteotomies cuts of the coracoid process is very importan to lead with osteotomies performed in the treatment techniques of the coracoid process. Osteotomies of 3.0 cm can injure the trapezoid ligament.OBJETIVO: Estudar as principais estruturas tendinosas e ligamentares inseridas no processo coracoide, correlacionando com diversos níveis de osteotomia e relatando as estruturas envolvidas no fragmento distai osteotomizado. MÉTODOS: Trinta ombros de 15 cadáveres (10 masculinos e cinco femininos) frescos foram dissecados. O processo coracoide com as principais estruturas anatômicas inseridas foram dissecados e cinco níveis de osteotomias (1,0; 1,5; 2,0; 2,5; 3,0cm) foram realizadas a partir do ápice e anotadas as principais estruturas inseridas no fragmento distal osteotomizado. RESULTADOS: Nas osteotomias de 1,0cm, em 100% dos casos houve envolvimento somente do tendão conjunto (TC). Nas osteotomias de 1,5cm, em 63,33% houve envolvimento do TC e peitoral menor (PMe), em 20% apenas do TC e em 16,66% do TC, PMi e ligamento coracoumeral (LCU). Nas osteotomias de 2,0cm, em 80% dos ombros, as osteotomias abrangeram o TC, PMe e o LCU e em 20% houve apenas envolvimento de TC e PMe. Nas osteotomias de 2,5cm, em 100% dos casos houve envolvimento do TC, PMe e LCU. Nas osteotomias de 3,0cm, em seis casos (20%) houve lesão do ligamento trapezoide e em 100% destas osteotomias, o fragmento distal osteotomizado abrangia o TC, PMe, LCU e em 90% envolvia também totalmente o ligamento coracoacromial. CONCLUSÃO: O conhecimento das estruturas anatômicas inseridas e envolvidas nos cortes das osteotomias do processo coracoide é de fundamental importância no manejo das osteotomias realizadas nas técnicas que utilizam o processo coracoide como enxerto ou referência anatômica. Nas osteotomias de 3,0cm há o risco de lesão do ligamento trapezoide.Universidade Federal de São Paulo (UNIFESP) Centro de Traumatologia do Esporte Grupo de Ombro e CotoveloUniversidade Federal de São Paulo (UNIFESP) Centro de Traumatologia do EsporteUNIFESP, Centro de Traumatologia do Esporte Grupo de Ombro e CotoveloUNIFESP, Centro de Traumatologia do EsporteSciEL

Paracoccidioidomicose sarcoídica: relato de caso

Importância do problema: Paracoccidioidomicose (PCM) é a micose sistêmica mais prevalente em indivíduos imunocompetentes no Brasil, sendo causado pelo fungo dimórfico Paracoccidioides spp. O fungo vive no solo e geralmente sua porta de entrada no paciente ocorre pelos pulmões por inalação de propágulos presentes no ar. Em áreas de maior endemicidade, como no Brasil, a incidência chega a três casos por 100 mil habitantes. As lesões cutâneas na PCM são frequentes. Lesões ulceradas ou ulcerovegetantes são os tipos morfológicos mais comuns, sendo o padrão infiltrativo o segundo mais descrito. A histologia demonstra inflamação granulomatosa na derme. A PCM infiltrativa pode ser facilmente confundida com sarcoidose, visto que ambas possuem similaridades clínicas e histopatológicas. Comentários: Nós descrevemos um caso de PCM cutânea com diagnóstico inicial incorreto de sarcoidose, tanto pelo quadro morfológico, como pelo exame histopatológico semelhante. Exames posteriores revelaram a presença de Paracoccidioides sp na coloração pelo Grocott e na cultura do material para fungos. Os autores acreditam que esse caso possa ajudar médicos a suspeitarem e considerarem PCM no diagnóstico diferencial de lesões cutâneas infiltrativas, especialmente se houver história epidemioló- gica de viagem a área endêmica ou resposta insatisfatória ao tratamento para sarcoidose.Paracoccidioidomycosis (PCM), which is caused by the dimorphic fungus Paracoccidioides spp, is the most prevalent systemic mycosis in immunocompetent individuals in Brazil. The fungus lives in the soil and usually infects the patient through inhalation of airborne propagules, the lungs being the portal of entry. In areas of larger endemicity, such as Brazil, the annual incidence reaches 3 cases per 100,000 inhabitants. Cutaneous lesions in PCM are frequent and ulcer or ulcerous-vegetative lesions are the commonest morphological type, followed by the infiltrative pattern. The histology shows a dermal granulomatous inflammation. Infiltrative PCM can be easily misdiagnosed, once clinical and histological similarities may occur specially with cutaneous sarcoidosis. We describe a case of cutaneous paracoccidioidomycosis misdiagnosed as sarcoidosis both in clinical examination and in the histopathological analysis. Further exams confirmed Paracoccidioides sp. as the causative agent through mycological cultures and Grocott’s stain. We believe this case may help physicians around the world to suspect and consider PCM as a differential diagnosis, especially if the patient has traveled to endemic area or the current therapy for sarcoidosis lacks clinical improvement

Introducing the Sistema de Acreditação Bem da Terra: a methodology for the guarantee and monitoring the agroecological transition

The Sistema de Acreditação Bem da Terra is a proposal based on agroecology and solidarity economy principles. The System seeks to ensure consumers of the Bem da Terra Virtual Trade Fair the agroecological provenance of commercialized food items. The goal of the present survey was present the development of the System and its application in 3 levels of the agroecological transition (Initial, Transitory, and Recommended), and each level in 3 dimensions (Social, Environmental, and Technical-productive). In each dimension, 3 to 5 indicators are evaluated per level, summing up to 38. The time range between the Initial and the Recommended level is eight years. The scientific bases supporting the proposal are detailed and discussed herein. By bringing up consumers, farmers, and technical support entities committed to agroecology, in direct contact, the Sistema de Acreditação Bem da Terra becomes a tool to perceive the agroecological transition within the territory.O Sistema de Acreditação Bem da Terra é uma proposta baseada nos princípios da agroecologia e da economia solidária. O Sistema busca garantir aos consumidores da Feira Virtual Bem da Terra a procedência agroecológica dos alimentos nela comercializados. O objetivo do presente trabalho foi apresentar a construção do Sistema e sua aplicação, a partir de três níveis da transição agroecológica (Inicial, Transitório e Recomendado), e cada nível em três dimensões (Social, Ambiental e Técnico-Produtiva). Em cada dimensão, são avaliados de três a cinco indicadores por nível, totalizando 38 indicadores. O tempo decorrido entre o nível Inicial e o Recomendado é de oito anos. A seguir são descritas e discutidas as bases científicas que dão lastro à proposta. Ao colocar em contato direto famílias consumidoras, famílias agricultoras e entidades de apoio técnico comprometidas com a agroecologia, o Sistema de Acreditação Bem da Terra se torna uma ferramenta de percepção da transição agroecológica no território

Investigation Of Bacterial Contents From Persistent Endodontic Infection And Evaluation Of Their Inflammatory Potential

This clinical study investigated and quantified cultivable bacteria and their levels of endotoxins in persistent endodontic infection, determining their antigenicity against macrophages and fibroblast cells by IL-1β and TNF-α secretion and evaluating their relationship with clinical and radiographic features. Samples from the root canals were obtained after root filling removal. Culture techniques were used to determine the bacterial count and the endotoxins were determined by LAL-assay. PCR analysis (16S rDNA) was used for bacterial detection. Raw 264.5 macrophages and V79 fibroblast were stimulated with endodontic contents. ELISA assay measured the amounts of IL-1ß/TNF-?#61537; secretion. Bacteria and endotoxin medians were 1.24x105 CFU/mL and 9.62 EU/mL, respectively. Porphyromonas endodontalis was the most frequently detected species. Higher levels of endotoxins were found in teeth with pain on palpation (23.56 EU/mL) rather than in its absence (8.21 EU/mL). Larger areas of bone destruction were related to higher levels of endotoxins and IL-1β and TNF-α secretion. The study findings revealed the presence of Gram-negative bacteria species in persistent endodontic infection, with their endotoxins related to both severity of bone destruction and development of symptomatology. Moreover, larger areas of bone destruction were related to higher levels of IL-1β and TNF-α secreted by macrophages and fibroblast cells.27441241

Análise in vivo do selamento do canal protéico com diferentes materais adesivos

This in vivo study analyzed the sealing ability of two adhesives in post spaces, cyanoacrylate (Super Bonder® - Henkel Loctite Adesivos Ltda., Itapevi, SP, Brazil) and ScotchbondTM Multi-Purpose (3M Dental Products, St. Paul, MN, USA), testing the hypothesis that their use would result in a decreased leakage through the remaining filling material. Forty extracted premolars (80 root canals) of dogs were used. The root canals were cleaned, shaped and filled by the lateral condensation technique using Sealer 26TM. The post space was created removing two thirds of the filling material within the root canal. The canals were randomly divided in three groups, which were treated as follows: Group A received the ScotchbondTM Multi-Purpose adhesive system; for Group B the cyanoacrylate adhesive, Super BonderTM, was employed; and no adhesive was applied into the post space for Group C (control group). A glass ionomer provisional restoration was placed allowing the sealer to set for 72 hours. Then the restoration was removed and the root canal was exposed to the oral environment for 45 days. The dogs were then killed and their jaws were removed. The post spaces were filled with India ink and the teeth were restored for 96 hours. Afterwards, the teeth were extracted and the roots were sectioned at the furcation for allocation to their specific groups. The teeth were turned transparent and the quantitative analysis of leakage was performed using light microscopy. The results showed no significant differences between groups, rejecting the initial hypothesis. Leakage occurred in a great extent in all specimens. Therefore, sealing post spaces with the adhesives used in this study was not an effective method to prevent microleakage.Esse estudo in vivo analisou a capacidade de selamento do canal protético com dois adesivos, o Super Bonder® (Henkel Loctite Adesivos Ltda., Itapevi, SP) e o Scotchbond® Multi-Purpose (3M Dental Products, St. Paul, MN, EUA), testando a hipótese de que a aplicação desses adesivos resulta em menor infiltração de corante no material obturador remanescente. Quarenta dentes pré-molares (80 canais) de cães foram obturados pela técnica da condensação lateral usando o cimento endodôntico Sealer 26®. O canal protético foi preparado removendo-se 2/3 da obturação do canal radicular. Os canais preparados foram distribuídos, aleatoriamente, em três grupos: no grupo A, foi realizado o selamento do canal protético com o adesivo dentinário; no grupo B, esta impermeabilização foi realizada com o Super Bonder®; e no grupo C, controle, não foi aplicado qualquer material às paredes do canal protético. Os dentes foram selados, provisoriamente, com cimento de ionômero de vidro por 72 horas, objetivando a presa do cimento endodôntico. Removido o selamento coronário, os canais ficaram expostos ao meio bucal por 45 dias, quando os cães foram mortos e os maxilares removidos. Tinta nanquim foi colocada no canal protético e os dentes foram selados por 96 horas. Depois de extraídos, os dentes foram seccionados na região da furca e cada raiz alocada em seu respectivo grupo. Feita a diafanização, foi realizada a análise quantitativa da infiltração do corante com lupa esteroscópica. Os resultados mostraram não haver diferenças entre os três grupos experimentais, negando a hipótese inicial. Houve infiltração do corante no remanescente obturador de todas as raízes analisadas

THE FUNDAMENTAL RIGHT TO PRIVACY IN BRAZIL AND THE INTERNET PRIVACY RIGHTS IN REGULATING PERSONAL DATA PROTECTION

The Brazilian Constitution, Article 5, paragraph X, ensure the inviolability of privacy, intimacy and honour as a fundamental right. The Brazilian Internet Bill of Rights, called ‘Marco Civil da Internet’, instituted in Brazil diversity of principles and parameters for regulation of internet in the country. The existence of the gap in the Brazilian legal system, around laws and infrastructure for the effective guarantee to the right to data protection on the Internet, as identified in other countries, coupled with the absence of specific conceptual precision to privacy on the internet, justifies the adoption in this research, the innovative concept of ‘Internet Privacy Rights’, based on Bernal (2014), composed of four rights-based: a right to roam the internet with privacy; a right to monitor those who monitor us; a right to delete personal data; a right to an online identity. This research has the overall objective to propose a conceptual incorporation, explicit and expressed, of Internet Privacy Rights as one of the pillars to ensure greater extent on the effectiveness of the fundamental right to privacy, particularly in Brazilian process of creation of laws, related to the protection of personal data on the internet. This research uses the methods of comparative and historical procedure in order to establish relationships and analysis within the historicity linked to aspects of the internet and Law, the evolution of fundamental rights to the effective recognition of privacy as a right. The research uses the hypothetical-deductive method of approach, with theoretical evidence, ranging from general aspects to the most specific, building the theoretical framework that allowed and confirm or refute the preliminary hypotheses and presented as the problem solving possibilities. The type of developed research was qualitative and exploratory nature, associated with the technical of review and literature analysis, covering the query varied references, allowed the construction of the results presented in the research, particularly the proposed conceptual incorporation. The study concludes that the express reception of Internet Privacy Rights by the laws that deal and also will address related topics in Brazil, especially those which regulate or will regulate the protection of personal data in the country, allows the recovery of the core of the fundamental right to privacy that, according to the theories presented in this research, only the protection of private life, honour, intimacy and image are considered. The research embodies a theoretical and conceptual construction to support the premise that the Internet Privacy Rights are included in the core of the fundamental right to privacy, which is why they deserve the explicit and express incorporation into legal rules, that in one imminent way, will regulate, in the context of the Internet, the fundamental right to privacy and protection of personal data in Brazil

Comparative analyses of the obtaiment of odontometric with radiographics methods (long and short cone) and electrical methods (Endometer)

Os autores analisaram in vivo comparativamente a obtenção de odontometria com métodos radiográficos (Técnica do paralelismo e Técnica da bissetriz) e método elétrico (Endometer), em 90 dentes unirradiculares com polpas vivas, indicados para extração por motivos diversos. Quando da obtenção de odontometria com a técnica do paralelismo, observaram-se os melhores resultados, seguido pelo método elétrico (Endometer) e, por último, da técnica da bissetriz.The aim of this study was to compare the determination of the tooth lenght of two radiographic methods (the Paralellism Technique and the Bissector Technique and an electric method (The Endometer Technique) in 90 vital anterior teeth that had to be extracted for different reasons

The roles of Tenascin C and Fibronectin 1 in adhesive capsulitis: a pilot gene expression study

OBJECTIVES: We evaluated mRNA expression levels of genes that encode TGF-β1; the TGF-β1 receptor; the collagen-modifying enzymes LOX, PLOD1, and PLOD2; and the extracellular matrix proteins COMP, FN1, TNC and TNXB in synovial/capsule specimens from patients with idiopathic adhesive capsulitis. Possible associations between the measured mRNA levels and clinical parameters were also investigated. METHODS: We obtained glenohumeral joint synovium/capsule specimens from 9 patients with idiopathic adhesive capsulitis who had not shown improvement in symptoms after 5 months of physiotherapy. Adhesive capsulitis was confirmed in all patients by magnetic resonance imaging. We also obtained specimens from 8 control patients who had underwent surgery for acute acromioclavicular joint dislocation and who had radiological indication of glenohumeral capsule alteration based on arthroscopic evaluation. mRNA expression in the synovium/capsule specimens was analyzed by quantitative reverse transcription PCR. The B2M and HPRT1 genes were used as references to normalize target gene expression in the shoulder tissue samples. RESULTS: The synovium/capsule samples from the patients with adhesive capsulitis had significantly higher TNC and FN1 expression than those from the controls. Additionally, symptom duration directly correlated with expression of TGFβ1 receptor I. CONCLUSION: Elevated levels of TNC and FN1 expression may be a marker of capsule injury. Upregulation of TGFβ1 receptor I seems to be dependent on symptom duration; therefore, TGFβ signaling may be involved in adhesive capsulitis. As such, TNC, FN1 and TGFβ1 receptor I may also play roles in adhesive capsulitis by contributing to capsule inflammation and fibrosis