Employment and sociodemographic characteristics: a study of increasing precarity in the health districts of Belo Horizonte, Brazil

<p>Abstract</p> <p>Background</p> <p>The fundamental importance of human resources for the development of health care systems is recognized the world over. Health districts, which constitute the middle level of the municipal health care system in the city of Belo Horizonte, Brazil, deal with demands from all parts of the system. This research seeks to provide the essential features required in order to understand the phenomenon of increase in precarity of employment in these health districts.</p> <p>Methods</p> <p>The legal and human resource management documents used by the Municipal Health Secretariat of the City of Belo Horizonte were adopted as the corpus for this research. In order to analyse the changes in employment (2002–2006), the data were collected from ArteRH, a computerized database dealing specifically with data related to human resources, which began operating in 2001. The workers were classified into permanent and non-permanent groups, and their contractual rights were described. Employment dynamics and changes were examined, concentrating on the incorporation of workers and on their social and employment rights during the period under study. The comparative data for the two groups obtained were presented in frequency distribution tables according to type of employment, sex, age group, level of education and wages from 2002 to 2006.</p> <p>Results</p> <p>There was a clear difference between the permanent worker and non-permanent worker groups as regards existing guaranteed employment rights and social security. The increase in the number of non-permanent workers in the workforce, the growing proportion of older workers among the permanently employed and the real wage reductions during the period from 2002 to 2006 are indicative of the process of growing precarity of employment in the group studied.</p> <p>Conclusion</p> <p>It is a plausible supposition that the demand for health reforms, along with the legal limits imposed on financial expenditure, gave rise to the new types of contract and the present employment situation in the health districts in Belo Horizonte.</p

Factors associated with the prevalence of hypertension and control practices among elderly residents of São Paulo city, Brazil

The aim of this study was to analyze the prevalence of hypertension and control practices among the elderly. The survey analyzed data from 872 elderly people in São Paulo, Brazil, through a cluster sampling, stratified according to education and income. A Poisson multiple regression model checked for the existence of factors associated with hypertension. The prevalence of self-reported hypertension among the elderly was 46.9%. Variables associated with hypertension were self-rated health, alcohol consumption, gender, and hospitalization in the last year, regardless of age. The three most common measures taken to control hypertension, but only rarely, are oral medication, routine salt-free diet and physical activity. Lifestyle and socioeconomic status did not affect the practice of control, but knowledge about the importance of physical activity was higher among those older people with higher education and greater income. The research suggests that health policies that focus on primary care to encourage lifestyle changes among the elderly are necessary.O objetivo deste estudo foi analisar a prevalência de hipertensão e práticas de controle em idosos. Inquérito transversal analisou dados de 872 idosos de São Paulo, Brasil, por meio de uma amostra por conglomerados, estratificada segundo escolaridade e renda. O modelo de regressão múltiplo de Poisson verificou a existência de fatores associados à hipertensão. A prevalência de hipertensão referida entre os idosos foi de 46,9%. As variáveis associadas à hipertensão foram autopercepção de saúde, consumo de álcool, sexo e hospitalização no último ano, independentemente da idade. As três medidas mais adotadas para o controle da hipertensão, embora pouco praticadas, são tomar medicação oral de rotina, dieta sem sal e atividade física. O estilo de vida e a condição socioeconômica não influenciaram a prática de controle, mas o conhecimento sobre a importância da atividade física foi maior entre os idosos com mais escolaridade e renda. Fazem-se necessárias políticas de saúde com foco na atenção primária que incentivem mudanças no estilo de vida dos idosos.El objetivo de este estudio fue analizar la prevalencia de hipertensión y prácticas de control en ancianos. Un estudio transversal analizó los datos de 872 ancianos de São Paulo, Brasil, mediante una muestra por conglomerados, estratificada según la escolaridad y renta. El modelo de regresión múltiple de Poisson verificó la existencia de factores asociados a la hipertensión. La prevalencia de hipertensión referida a los ancianos fue de un 46,9%. Las variables asociadas a la hipertensión fueron: autopercepción de salud, consumo de alcohol, sexo y hospitalización durante el último año, independientemente de la edad. Las tres medidas más adoptadas para el control de la hipertensión, aunque poco practicadas, son: tomar medicación oral de rutina, dieta sin sal, y actividad física. El estilo de vida y la condición socioeconómica no influenciaron la práctica de control, sin embargo, el conocimiento sobre la importancia de la actividad física fue mayor entre los ancianos con mayor escolaridad y renta. Se necesitan políticas de salud enfocadas a la atención primaria que incentiven cambios en el estilo de vida de los ancianos.Universidade de São Paulo Faculdade de MedicinaUniversidade de São Paulo Faculdade de Saúde PúblicaUniversidade Estadual de Campinas Faculdade de Ciências MédicasUniversidade Estadual Paulista Faculdade de Medicina de BotucatuUniversidade Estadual Paulista Faculdade de Medicina de Botucat

Interplay between the intracellular energy sensor AMP-activated protein kinase (AMPK) and the estrogen receptor activities in regulating rat pituitary tumor cell (GH3) growth in vitro

Estrogen receptor α has a role in regulating rat somatolactotroph tumor cell growth (GH3 cells). AMP-activated protein kinase (AMPK) is a metabolic checkpoint which is able to negatively regulate intracellular signaling downstream of growth factors receptors in conditions increasing cellular AMP levels. We have recently reported on the role of AMPK activation in affecting viability and proliferation of GH3 cells. In the present study, we investigated the interplay between ER- and AMPK-pathways. Results can be regarded as relevant to the development of novel multi-targeted pharmacological therapies against pituitary tumors. We confirmed that estradiol (E2) and the ER antagonist fulvestrant exert stimulatory and inhibitory effects, respectively on GH3 cell growth in a competitive manner. The upstream kinase LKB1 is known to phosphorylate and activate AMPK. Here we showed that neither E2 nor fulvestrant caused a downregulation of LKB1 expression and phospho-AMPK levels in GH3 cells. Actually, fulvestrant strongly reduced the phosphorylation of ACC, which is a direct target of AMPK and a known index of AMPK activity. 2-deoxyglucose, a compound reducing glucose utilization, caused an increase in AMPK activity vs baseline and was able to hinder the stimulatory effect of E2 on cell viability, confirming that the exposure of GH3 cells to estrogens does not prevent them from being responsive to the inhibitory activity of compounds activating AMPK. Finally, the AMPK activator AICAR (AMP analog) did not cause further decrease in cell viability in the course of co-treatments with fulvestrant versus fulvestrant alone, in agreement with impaired phospho-AMPK activity in the presence of the anti-estrogen