Defining Chlorophyll-a Reference Conditions in European Lakes

The concept of “reference conditions” describes the benchmark against which current conditions are compared when assessing the status of water bodies. In this paper we focus on the establishment of reference conditions for European lakes according to a phytoplankton biomass indicator—the concentration of chlorophyll-a. A mostly spatial approach (selection of existing lakes with no or minor human impact) was used to set the reference conditions for chlorophyll-a values, supplemented by historical data, paleolimnological investigations and modelling. The work resulted in definition of reference conditions and the boundary between “high” and “good” status for 15 main lake types and five ecoregions of Europe: Alpine, Atlantic, Central/Baltic, Mediterranean, and Northern. Additionally, empirical models were developed for estimating site-specific reference chlorophyll-a concentrations from a set of potential predictor variables. The results were recently formulated into the EU legislation, marking the first attempt in international water policy to move from chemical quality standards to ecological quality targets

A atuação do nutricionista na Atenção Básica à Saúde em um grande centro urbano The participation of the nutritionist in Primary Health Care in a large urban center

O nutricionista é um profissional importante na implementação de ações de promoção, tratamento e reabilitação da saúde. Porém, sua participação na Atenção Básica (AB) é reduzida. A cidade de São Paulo vem passando por um processo desigual de urbanização, produzindo novas situações de insegurança alimentar e nutricional. Este trabalho analisará a atuação do nutricionista na AB em um grande centro urbano. Trata-se de estudo de abordagem quantitativa no qual foram utilizados dados populacionais da Secretaria Municipal de Saúde e um questionário semiestruturado aplicado em entrevistas individuais. Encontraram-se 123 nutricionistas atuando na rede Básica de Saúde e 51 em Núcleos de Apoio à Saúde da Família (NASF). Todas as regiões do município apresentaram-se com menor número de nutricionistas quando comparada à recomendação do Conselho Federal de Nutricionistas. Em 57,3% dos NASF do município identificou-se a presença deste profissional. Cada nutricionista de NASF acompanha, em média, 7,1 equipes de saúde da família. As faixas etárias que correspondem à infância são as atendidas com menor frequência pelos nutricionistas das UBS e dos NASF. Comparando-se as atividades desenvolvidas, observa-se a transição de um modelo de assistência primária centrado no atendimento individual para um que prioriza o atendimento em grupo.<br>Nutritionists are important professionals for ensuring the implementation of health promotion, treatment and rehabilitation. However, their participation in primary healthcare from a quantitative standpoint is limited. The city of São Paulo has experienced an uneven urbanization process triggering new problems of insecurity in terms of food and nutrition. This article analyzes the performance of the primary healthcare nutritionist in a large urban center. It is a quantitative study that used data from the Municipal Health Department, population data of São Paulo and a semi-structured questionnaire applied in individual interviews. All regions of the city are found to have fewer nutritionists than the recommendation of the Federal Council of Nutritionists. There are 123 nutritionists in the basic healthcare network and 51 in the Family Health Support Nuclei (FHSN) (57.3%). Each nutritionist from the FHSN accompanies 7.1 family health strategy teams on average. The age groups corresponding to children are less frequently seen by nutritionists. Comparing the activities, the transition from a model of primary health care focused on individual care to a model that prioritizes group care was observed