Avaliação económica da cadeia de abastecimento de bens de consumo em saúde: o caso da ARS Algarve

Dissertação de mestrado, Gestão de Unidades de Saúde, Faculdade de Economia, Universidade do Algarve, 2017A Administração Regional de Saúde do Algarve (ARS Algarve) tem adjudicado, ao longo dos últimos anos, a uma empresa o transporte dos Bens de Consumo em Saúde entre o Centro de Armazenagem Central e as diversas Unidades de Saúde e outros Serviços na Região do Algarve. A ARS Algarve tem interesse em saber se existem outras alternativas economicamente mais vantajosas a essa contratação, nomeadamente com recurso a meios próprios. Neste sentido, o presente Trabalho de Projeto recorreu à Análise de Minimização de Custos, comparando os custos tangíveis de diversas alternativas para o transporte dos Bens de Consumo em Saúde. Foram ainda aplicados questionários online a stakeholders de modo a aferir das suas opiniões sobre a viabilidade de implementação da alternativa preconizada. Através da Análise de Minimização de Custos conclui-se que é economicamente mais vantajoso para a ARS Algarve abandonar o contrato de outsourcing e internalizar o transporte dos Bens de Consumo em Saúde. Todavia, os resultados dos questionários não suportam os resultados obtidos na Análise Económica. Apesar dos inquiridos concordarem que a internalização do transporte é economicamente mais vantajosa para a ARS Algarve não consideram que esta tenha condições para a sua implementação. Os resultados contraditórios da análise económica e dos questionários aos stakeholders podem ser a tradução de forças de resistência à mudança, consubstanciando-se em custos intangíveis os quais podem diminuir a poupança gerada nos custos com a internalização, a qual foi estimada em duzentos mil euros no período de cinco anos

What is the impact of interventions that prevent fetal mortality on the increase of preterm live births in the State of Sao Paulo, Brazil?

BACKGROUND: There is a global growing trend of preterm births and a decline trend of fetal deaths. Is there an impact of the decline of fetal mortality on the increase of preterm live births in State of Sao Paulo, Brazil? METHODS: The time trends were evaluated by gestational age through exponential regression analysis. Data analyzed included the fetal mortality ratio, proportion of preterm live births, fertility rate of women 35 years and over, prenatal care, mother's education, multiple births and cesarean section deliveries. A survival analysis was carried out for 2000 and 2010. RESULTS: Preterm births showed the highest annual increase (3.2%) in the less than 28 weeks of gestation group and fetal mortality ratio decreased (7.4%) in the same gestational age group. There was an increase of cesarean section births and it was higher in the < 28 weeks group (6.1%). There was a decreased annual trend of mothers with inadequate prenatal care (6.1%) and low education (8.8%) and an increased trend in multiple births and fertility rates of women of 35 years and over. The variables were highly correlated to which other over time. In 2000, 8.2% of all pregnancies resulted in preterm births (0.9% in fetal deaths and 7.3% in live births). In 2010, the preterm birth increased to 9.4% (0.8% were preterm fetal deaths and 8.6% preterm live births). CONCLUSIONS: The results suggest that 45.2% could be the maximum contribution of successful interventions to prevent a fetal death on the increase in preterm live births. This increasing trend is also related to changes of the women reproductive profile with the change of the women reproductive profile and access to prenatal care

Geochemical assessment of metals in fluvial systems affected by anthropogenic activities in the Iron Quadrangle.

O presente estudo foi realizado na bacia hidrogr?fica do Rio do Peixe, Quadril?tero Ferr?fero (QF), em Minas Gerais. Essa bacia apresenta um cen?rio geol?gico distinto e atividades antr?picas diversificadas, como a minera??o de ferro, ouro e gemas, a agropecu?ria e a silvicultura. O principal objetivo desta pesquisa foi investigar as poss?veis fontes de contribui??es antropog?nicas dos metais em sedimentos de fundo. Para isso, foram realizadas duas campanhas com amostragens de sedimentos de fundo em 12 pontos da bacia, nos meses de mar?o e julho de 2015. A partir da t?cnica anal?tica de espectrometria de emiss?o ?ptica com plasma, foram detectadas concentra??es de Al, Ca, Co, Cr, Cu, Fe, Mn, Ni, Pb, Ti e Zn nos sedimentos de fundo. Os resultados dos indicadores da qualidade dos sedimentos fator de contamina??o (FC), fator de enriquecimento (FE) e ?ndice de geoacumula??o (IGEO) demonstraram que h? interfer?ncias antr?picas, sendo as atividades miner?rias e industriais, o despejo de efluentes dom?sticos e o uso e a ocupa??o do solo inapropriado apontados como as principais fontes de contamina??o de metais da bacia.The present study was carried out in the river basin area of Rio do Peixe, Iron Quadrangle, in Minas Gerais, Brazil. This basin presents geological scenario and diversified anthropic activities, such as iron, gold and gems mining, agriculture, and forestry. The main objective of this research was to investigate the possible sources of anthropogenic contributions of metals in bottom sediments. Thus, two surveys were carried out on bottom sediments at twelve basin sites from March to July of 2015. Based on the plasma optical emission spectrometry analytical technique, we found concentrations of Al, Ca, Co, Cr, Cu, Fe, Mn, Ni, Pb, Ti and Zn in the bottom sediments. The results of the FC, FE and IGEO sediment quality indicators showed that there are anthropic interferences, in which mining and industrial activities, disposal of domestic effluents and use and occupation of inappropriate soil are identified as the main sources of metals contamination of the basin

EXISTE RELAÇÃO ENTRE TRANSTORNO DE ANSIEDADE E TRABALHO ENTRE ESTUDANTES DE PSICOLOGIA?

Objetivou-se avaliar a associação entre Transtorno de Ansiedade (TA) e trabalho entre estudantes de psicologia. Para a coleta de dados utilizou-se: Inventário de Ansiedade Traço-Estado (IDATE), Critério de Classificação Econômica Brasil e Questionário variáveis demográficas e socioeconômicas. Avaliaram-se as associações através do Teste Qui-quadrado de Pearson (p?0,05). Responderam ao IDATE 305 estudantes, registrando-se entre estudantes-trabalhadores prevalências de ansiedade-estado (AE) e de ansiedade-traço (AT) de 87,7%. Entre os não trabalhadores as respectivas prevalências foram de: 92,8% e 89,9%. Não se registraram associações entre AE e AT com trabalho (p= 0,147 e 0,562)

Genomics and phenotypical characterization of two new lytic bacteriophages for biocontrol of Salmonella enterica

Aims: To perform the isolation, characterization and sequencing of the bacteriophages. To demonstrate that the bacteriophages can be used for biocontrol of different Salmonella enterica serovars. Study Design: This study was an experimental study. Place and Duration of Study: Bacteriology and Mycology Laboratory in the Veterinary Hospital at the Faculty of Agronomy and Veterinary Medicine of the University of Passo Fundo (FAMV/UPF), Biotechnology Center (CBiotec) of the Federal University of Paraíba (UFPB), Center for Microscopy and Microanalysis at the Faculty of Veterinary of the Federal University of Rio Grande do Sul (UFRGS), between January – September 2016. Methodology: Twelve Salmonella enterica serovars (S. Anatum, S. Agona, S. Brandenburg, S. Bredeney, S. Infantis, S. Lexington, S. Panama, S. Rissen, S. Schwarzengrund, S. Tennessee, S. Enteritidis ATCC 13076 and S. Typhimurium ATCC 14028) were selected to be the hosts. We isolate, purify, produce and determine the bacteriophage titers to verify the potential for lysis of these phages against the hosts. Having determined the action of the phages against the hosts, we performed the sequencing of the bacteriophages on the Illumina Mi-Seq platform and the morphology was performed by transmission electron microscopy (TEM). Results: We isolated, characterized and sequenced the genome of two new bacteriophages, Salmonella phage UPF_BP1, belonging to the family Podoviridae and Salmonella phage UPF_BP2, family Myoviridae. UPF_BP1 has lytic action against seven tested Salmonella enterica serovars, while UPF_BP2 has action against the twelve tested serovars. Conclusion: The two new bacteriophages have a lytic action against different Salmonella enterica serovars, feeding our expectations for the development of alternatives for the use of antimicrobials, being possible candidates for use as a biocontrol of Salmonella enterica in food, animals and the environment

VACCINATION IN PREGNANCY: CONSTRUCTION AND VALIDATION OF EDUCATIONAL TECHNOLOGY

Objective: to build and validate the content of an educational technology to guide pregnant women about immunization. Method: a methodological study carried out from December 2020 to October 2021 in Belém, Pará, Brazil. It consisted of two stages: Construction through an Integrative Literature Review and face and content validation with 16 judges using a Likert scale for data collection and the Content Validity Index for analysis.Results: a double-sided table flipbook was created on immunization, which was assessed by 100% of the judges as relevant, with a mean Content Validity Index per block greater than 0.86.Conclusion: the technology was built with technically correct information and validated by experts in the respective areas. It is understood that its use will ease the prenatal Nursing practice, considering it to be a tool capable of arousing interest and encouraging dialogue between professionals and pregnant women, solving doubts in the immunization context

Gender differences in biochemical markers and oxidative stress of rats after 28 days oral exposure to a mixture used for weight loss containing p-synephrine, ephedrine, salicin, and caffeine

A associação de p-sinefrina, efedrina, salicina, e cafeína em suplementos alimentares e produtos para perda de peso é muito utilizada em todo o mundo, embora a efedrina tenha sido proibida em muitos países. O objetivo deste estudo foi avaliar o perfil de toxicidade à exposição oral de 28 dias à associação de p-sinefrina, efedrina, salicina e cafeína (na proporção de 10:4:6:80 m/m respectivamente) em ratos Wistar machos e fêmeas. Diariamente, os animais foram observados quanto ao peso corporal, sinais de toxicidade, morbidade e mortalidade. Após 28 dias, os animais foram sacrificados e o sangue coletado para avaliações hematológicas, bioquímicas e de estresse oxidativo. Não se observaram sinais clínicos de toxicidade, tampouco perda significativa de peso, mortes, ou quaisquer alterações significativas nos parâmetros hematológicos. Biomarcadores do estresse oxidativo e bioquímicos mostraram peroxidação lipídica, danos renais e hepáticos (p < 0,05; ANOVA/Bonferroni) em ratos machos (100 e 150 mg/kg) e a redução (p < 0,05; ANOVA/Bonferroni) nos níveis de glutationa reduzida (GSH) em todos os grupos de machos tratados. Nas fêmeas, não houve indícios de estresse oxidativo, nem alterações bioquímicas. O diferente perfil de toxicidade entre os gêneros sugere influência hormonal nos efeitos de mistura administrada. A associação testada pode alterar o estado oxidativo e promover danos renais e hepáticos.The association of p-synephrine, ephedrine, salicin, and caffeine in dietary supplements and weight loss products is very common worldwide, even though ephedrine has been prohibited in many countries. The aim of this study was to evaluate a 28-day oral exposure toxicity profile of p-synephrine, ephedrine, salicin, and caffeine mixture (10:4:6:80 w/w respectively) in male and female Wistar rats. Body weight and signs of toxicity, morbidity, and mortality were observed daily. After 28 days, animals were euthanized and blood collected for hematological, biochemical, and oxidative stress evaluation. No clinical signs of toxicity, significant weight loss or deaths occurred, nor were there any significant alterations in hematological parameters. Biochemical and oxidative stress biomarkers showed lipid peroxidation, and hepatic and renal damage (p < 0.05; ANOVA/Bonferroni) in male rats (100 and 150 mg/kg) and a reduction (p < 0.05; ANOVA/Bonferroni) in glutathione (GSH) levels in all male groups. Female groups displayed no indications of oxidative stress or biochemical alterations. The different toxicity profile displayed by male and female rats suggests a hormonal influence on mixture effects. Results demonstrated that the tested mixture can alter oxidative status and promote renal and hepatic damages

Fluoroquinolone resistance in Campylobacter jejuni and Campylobacter coli from poultry and human samples assessed by PCR-restriction fragment length polymorphism assay

The objective of this study was to determine fluoroquinolone resistance in Campylobacter spp from poultry and human isolates. Forty-one Campylobacter jejuni isolates (30 of poultry origin and 11 of human origin) and 11 Campylobacter coli isolates (10 of human origin and 1 of poultry origin) were examined for ciprofloxacin, norfloxacin, and nalidixic acid resistance using the minimal inhibitory concentration (MIC) method. Thereafter, the isolates were analyzed by PCR±Restriction Fragment Length Polymorphism (RFLP) assay for detection of Thr-86 mutation. Finally, DNA sequencing was performed for confirmation of gyrA gene mutation. A complete correlation was observed between MICs, PCR-RFLP assay, and sequencing. The results revealed high quinolone resistance rates for C. jejuni (100%) and C. coli (100%) isolates obtained from poultry and moderate resistance for C. jejuni (9.1%) and C. coli (40%) samples of human origin. A mutation in codon 86 of the gyrA gene with a Thr-to-Ile substitution is reported to be the main cause of high resistance to quinolones. This mutation can be analyzed by PCR-RFLP assay, which has been proven to be a simple and fast method for the detection of fluoroquinolone resistance in Campylobacter spp

What is the impact of interventions that prevent fetal mortality on the increase of preterm live births in the State of Sao Paulo, Brazil?

Abstract\ud \ud Background\ud There is a global growing trend of preterm births and a decline trend of fetal deaths. Is there an impact of the decline of fetal mortality on the increase of preterm live births in State of Sao Paulo, Brazil?\ud \ud \ud Methods\ud The time trends were evaluated by gestational age through exponential regression analysis. Data analyzed included the fetal mortality ratio, proportion of preterm live births, fertility rate of women 35 years and over, prenatal care, mother's education, multiple births and cesarean section deliveries. A survival analysis was carried out for 2000 and 2010.\ud \ud \ud Results\ud Preterm births showed the highest annual increase (3.2 %) in the less than 28 weeks of gestation group and fetal mortality ratio decreased (7.4 %) in the same gestational age group. There was an increase of cesarean section births and it was higher in the < 28 weeks group (6.1 %). There was a decreased annual trend of mothers with inadequate prenatal care (6.1 %) and low education (8.8 %) and an increased trend in multiple births and fertility rates of women of 35 years and over. The variables were highly correlated to which other over time. In 2000, 8.2 % of all pregnancies resulted in preterm births (0.9 % in fetal deaths and 7.3 % in live births). In 2010, the preterm birth increased to 9.4 % (0.8 % were preterm fetal deaths and 8.6 % preterm live births).\ud \ud \ud Conclusions\ud The results suggest that 45.2 % could be the maximum contribution of successful interventions to prevent a fetal death on the increase in preterm live births. This increasing trend is also related to changes of the women reproductive profile with the change of the women reproductive profile and access to prenatal care.State Secretary of Health of São PauloPan American Health Organizatio

Effect of polysaccharide sources on the physicochemical properties of bromelainchitosan nanoparticles

Bromelain, a set of proteolytic enzymes potential pharmaceutical applications, was encapsulated in chitosan nanoparticles to enhance enzyme stability, and the effect of different chitosan sources was evaluated. Chitosan types (i.e., low molecular weight chitosan, chitosan oligosaccharide lactate, and chitosan from shrimp shells) produced nanoparticles with different physicochemical properties, however in all cases, particle size and zeta potential decreased, and polydispersity index increased after bromelain addition. Bromelain encapsulation was higher than 84% and 79% for protein content and enzymatic activity, respectively, with low molecular weight chitosan presenting the highest encapsulation efficiency. Nanoparticle suspension was also tested for accelerated stability and rheological behavior. For the chitosan–bromelain nanoparticles, an instability index below 0.3 was recorded and, in general, the loading of bromelain in chitosan nanoparticles decreased the cohesiveness of the final suspension.This research was granted by FAPESP (2016/03444-5,2017/05275-9,and2017/05333-9), CNPq and FAEPEX, and by the Portuguese Science and Technology Foundation, Ministry of Science and Education (FCT/MEC) through national funds, and co-financed by FEDER, under the project reference M-ERA-NET/0004/2015 (PAIRED) Partnership Agreement PT2020.info:eu-repo/semantics/publishedVersio