Internações por condições sensíveis à atenção primária, Minas Gerais, 2000 e 2010

OBJECTIVE To analyze hospitalization rates and the proportion of deaths due to ambulatory care-sensitive hospitalizations and to characterize them according to coverage by the Family Health Strategy, a primary health care guidance program. METHODS An ecological study comprising 853 municipalities in the state of Minas Gerais, under the purview of 28 regional health care units, was conducted. We used data from the Hospital Information System of the Brazilian Unified Health System. Ambulatory care-sensitive hospitalizations in 2000 and 2010 were compared. Population data were obtained from the demographic censuses. RESULTS The number of ambulatory care-sensitive hospitalizations declined from 20.75/1,000 inhabitants [standard deviation (SD) = 10.42) in 2000 to 14.92/thousand inhabitants (SD = 10.04) in 2010 Heart failure was the most frequent cause in both years. Hospitalizations rates for hypertension, asthma, and diabetes mellitus, decreased, whereas those for angina pectoris, prenatal and birth disorders, kidney and urinary tract infections, and other acute infections increased. Hospitalization durations and the proportion of deaths due to ambulatory care-sensitive hospitalizations increased significantly. CONCLUSIONS Mean hospitalization rates for sensitive conditions were significantly lower in 2010 than in 2000, but no correlation was found with regard to the expansion of the population coverage of the Family Health Strategy. Hospitalization rates and proportion of deaths were different between the various health care regions in the years evaluated, indicating a need to prioritize the primary health care with high efficiency and quality.OBJETIVO Analisar taxas de permanência hospitalar e de proporção de óbitos por internações por condições sensíveis à atenção primária em saúde, caracterizando-as segundo cobertura pela Estratégia de Saúde da Família. MÉTODOS Trata-se de estudo ecológico que teve como unidade de análise os 853 municípios do estado de Minas Gerais, estratificados pelas 28 regionais de saúde. Foram utilizados dados do Sistema de Informação Hospitalar do Sistema Único de Saúde. As internações por condições sensíveis de 2000 foram comparadas às de 2010. Dados populacionais foram obtidos dos censos demográficos. RESULTADOS As internações por condições sensíveis à atenção primária apresentaram queda de 20,75/mil hab (DP = 10,42) em 2000 para 14,92/mil hab (DP = 10,04) em 2010. A insuficiência cardíaca foi a causa mais frequente em ambos os períodos. Houve redução nas taxas de internações por hipertensão arterial, asma e diabetes mellitus, bem como aumento nas internações por angina pectoris, doenças relacionadas ao pré-natal e parto, infecções de rim e trato urinário, além de outras infecções agudas. A permanência hospitalar e a proporção de óbitos por internações por condições sensíveis aumentaram significativamente. CONCLUSÕES A taxa média de internações por condições sensíveis foi significativamente menor em 2010 do que em 2000, mas não foi observada correlação com a expansão de cobertura populacional da Estratégia de Saúde da Família. As taxas de permanência hospitalar e proporção de óbitos entre os anos avaliados comportaram-se de forma distinta entre as diversas regionais de saúde, apontando necessidade de priorização de atenção primária resolutiva e de qualidade

Musculoskeletal disorders in adolescent workers

O trabalho infantil é um fenômeno mundial de grandes proporções, especialmente em países subdesenvolvidos. Estima-se, em todo o mundo, que 352 milhões de crianças e adolescentes com idade inferior a 18 anos são economicamente ativos, incluindo trabalho remunerado, não-pago, ilegal e informal. Assim, o objetivo é descrever a prevalência de desordens no sistema músculo-esquelético em um grupo de adolescentes inseridos no Programa de Formação Profissionalizante na "Casa do Pequeno Jardineiro", na cidade de Juiz de Fora, MG. O método constou de observação, análise e descrição das posturas adotadas durante o processo de trabalho, aplicação de um questionário de identificação das condições de vida e trabalho e a realização do teste de flexão em pé (TFP). A amostra total foi dividida em três grupos, avaliando a ocorrência de dor e/ou desconforto nos ombros, nos cotovelos, nos quadris ou coxas e nos pés, retração dos grupos musculares tríceps sural e isquiotibiais, presença de dor e/ou desconforto nos quadris ou coxas associado à retração dos grupos musculares tríceps sural e isquiotibiais. Em conclusão, os adolescentes submetidos a uma carga de trabalho elevada apresentaram maior freqüência de desordens no sistema músculo-esquelético.Labor in childhood is a world phenomenon of great proportions, especially in under-developed countries. It's estimated, around the world, that 352 million children and adolescents under the age of 18 years old are economically active, including remunerated and unremunerated, illegal and informal work. Thus, the aim is to describe the prevalence of musculoskeletal disorders in a group of adolescents inserted in a professional apprenticeship program at the "Casa do Pequeno Jardineiro" (House of the Little Gardener) in the city of Juiz de Fora, MG. The methodology used was observation; analysis and description of the postures used during the process of labor; administration of a questionnaire to identify the conditions of the lifestyle and work; and the flexion test in standing (FTS). The sample was divided into three groups, evaluating the presence of pain or discomfort on the shoulders, on the elbows, on the hips or thighs and on the feet, retraction of the hamstrings and calf muscles, and presence of pain and/or discomfort on the hips or thighs associated with the retraction of the hamstrings and calf muscles. In conclusion, the adolescents that were submitted to a higher load in work showed a higher frequency of disorders of the musculoskeletal system

Quality of the eggs of commercial layers fed with sugarcane dry yeast

Este trabalho objetivou avaliar o efeito da adição de levedura seca (Saccharomyces cerevisiae) à dieta de poedeiras na qualidade dos ovos. Foram utilizadas 120 poedeiras comerciais com 33 semanas de idade, distribuídas em um delineamento estatístico de blocos ao acaso, com cinco tratamentos (0, 7, 14, 21 e 28% de levedura), quatro repetições e seis aves por unidade experimental. Rações isoprotéicas (18% de proteína bruta), isoenergéticas (2.800 kcal de energia metabolizável/kg), isocálcicas (3,8% Ca) e isofosfóricas (0,38% P disponível) foram formuladas à base de milho e farelo de soja. Os níveis de levedura seca não alteraram o peso do ovo (64,35±0,85 g), a altura do albúmen (7,95±0,22 mm), a unidade Haugh (87,42±1,31), os sólidos totais da gema (50,86±0,20%), o extrato etéreo da gema (30,74±0,26%), a proteína da gema (16,92±0,16%), a gravidade específica do ovo (1,0912±0,001 g/mL), o peso da casca (6,67±0,08 g) e a espessura da casca (0,4671±0,003 mm). Foi observado efeito quadrático na variável cor da gema no terceiro ciclo de postura. A inclusão de até 28% de levedura seca nas rações intensificou a cor da gema e foi considerada uma prática viável pela análise econômica.This work aimed at evaluating the effect of the addition of dry yeast (Saccharomyces cerevisiae) to the laying diet on the quality of the eggs. One hundred and twenty chickens with 33 weeks of age were used in a randomized block design, with five treatments (0, 7, 14, 21 and 28% of dried yeast), four replicates and six birds per pen. Diets similar in protein (18% of crude protein), energy (2,800 kcal of metabolizable energy/kg), calcium (3.8%) and in phosphorus (0.38% of available phosphorus) were formulated based on corn and soybean meal. The levels of dry yeast did not affect egg weight (64.35±0.85 g), albumen height (7.95±0.22 mm), Haugh unit (87.42±1.31), total yolk solids (50.86±0.20%), ether extract of yolk (30.74±0.26%), yolk protein (16.92±0.16%), egg specific gravity (1.0912±0.001 g/mL), shell weight (6.67±0.08 g) and shell thickness (0.4671±0.003 mm). Quadratic effect was observed for the variable yolk color in the third laying cycle. The inclusion of dry yeast up to 28% provided increase on yolk color and proved to be economicaly viable

Análise genética de características produtivas e reprodutivas em populações multirraciais de bovinos leiteiros

The objective of this work was to determine whether the random regression model using linear splines (RRMLS) is suitable to estimate the genetic parameters for productive and reproductive traits of a multiple-breed dairy cattle population, as well as to investigate the effect of the genetic group of the progeny on the genetic merit of the sire. The multiple-trait model (MTM) and the RRMLS with one knot fitted for every genetic group were used to obtain the genetic parameters. Records of 1/2 Holstein + 1/2 Gyr (1/2HG), 5/8 Holstein + 3/8 Gyr (5/8HG), and 3/4 Holstein + 1/4 Gyr (3/4HG) crossbreed dams were considered. The RRMLS showed better fitting. The additive and residual variances estimated by the MTM and the RRMLS were similar. Heritability varied from 0.20 to 0.33 for age at first calving, from 0.09 to 0.22 for first lactation length, and from 0.15 to 0.35 for first lactation 305-day milk yield, according to the genetic composition of the dams. The RRMLS is suitable to estimate the genetic parameters for productive and reproductive traits of multiple-breed dairy cattle populations. The genetic merit of the sires is affected by the genetic group of the progeny by which they are evaluated.O objetivo deste trabalho foi verificar se o modelo de regressão aleatória com polinômios lineares do tipo spline (MRAPLS) é adequado para estimar os parâmetros genéticos de características produtivas e reprodutivas em uma população multirracial de bovinos leiteiros, bem como investigar o efeito do grupo genético da progênie sobre o mérito genético do touro. Foram utilizados o modelo multicaracterístico (Mult) e o MRAPLS com nós ajustados aos grupos genéticos, para obtenção dos parâmetros genéticos. Foram considerados os registros de vacas 1/2 Holandesa + 1/2 Gir (1/2HG), 5/8 Holandesa + 3/8 Gir (5/8HG) e 3/4 Holandesa + 1/4 Gir (3/4HG). O MRAPLS apresentou os melhores ajustes. As variâncias aditivas e residuais estimadas por Mult e MRAPLS foram semelhantes. As herdabilidades variaram de 0,20 a 0,33 para idade ao primeiro parto, de 0,09 a 0,22 para duração da primeira lactação e de 0,15 a 0,35 para produção de leite em até 305 dias na primeira lactação, de acordo com a composição genética das vacas. O MRAPLS é adequado para estimar parâmetros genéticos de características produtivas e reprodutivas em populações multirraciais de bovinos leiteiros. O mérito genético do touro é influenciado pelo grupo genético da progênie por meio do qual ele é avaliado

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Panoramic snapshot of serum soluble mediator interplay in pregnant women with convalescent COVID-19: an exploratory study

IntroductionSARS-CoV-2 infection during pregnancy can induce changes in the maternal immune response, with effects on pregnancy outcome and offspring. This is a cross-sectional observational study designed to characterize the immunological status of pregnant women with convalescent COVID-19 at distinct pregnancy trimesters. The study focused on providing a clear snapshot of the interplay among serum soluble mediators.MethodsA sample of 141 pregnant women from all prenatal periods (1st, 2nd and 3rd trimesters) comprised patients with convalescent SARS-CoV-2 infection at 3-20 weeks after symptoms onset (COVID, n=89) and a control group of pre-pandemic non-infected pregnant women (HC, n=52). Chemokine, pro-inflammatory/regulatory cytokine and growth factor levels were quantified by a high-throughput microbeads array.ResultsIn the HC group, most serum soluble mediators progressively decreased towards the 2nd and 3rd trimesters of pregnancy, while higher chemokine, cytokine and growth factor levels were observed in the COVID patient group. Serum soluble mediator signatures and heatmap analysis pointed out that the major increase observed in the COVID group related to pro-inflammatory cytokines (IL-6, TNF-α, IL-12, IFN-γ and IL-17). A larger set of biomarkers displayed an increased COVID/HC ratio towards the 2nd (3x increase) and the 3rd (3x to 15x increase) trimesters. Integrative network analysis demonstrated that HC pregnancy evolves with decreasing connectivity between pairs of serum soluble mediators towards the 3rd trimester. Although the COVID group exhibited a similar profile, the number of connections was remarkably lower throughout the pregnancy. Meanwhile, IL-1Ra, IL-10 and GM-CSF presented a preserved number of correlations (≥5 strong correlations in HC and COVID), IL-17, FGF-basic and VEGF lost connectivity throughout the pregnancy. IL-6 and CXCL8 were included in a set of acquired attributes, named COVID-selective (≥5 strong correlations in COVID and <5 in HC) observed at the 3rd pregnancy trimester.Discussion and conclusionFrom an overall perspective, a pronounced increase in serum levels of soluble mediators with decreased network interplay between them demonstrated an imbalanced immune response in convalescent COVID-19 infection during pregnancy that may contribute to the management of, or indeed recovery from, late complications in the post-symptomatic phase of the SARS-CoV-2 infection in pregnant women