O discurso dos profissionais sobre a demanda e a humanização

A humanização dos serviços da atenção primária à saúde depende, em grande parte, da resolução das necessidades em saúde e da conseqüente organização da demanda. OBJETIVO: O artigo objetiva conhecer as implicações da demanda sobre a humanização das práticas de atenção primária. METODOLOGIA: Trata-se de uma pesquisa exploratória com abordagem qualitativa. O universo empírico da pesquisa foi composto por 10 trabalhadores de uma Unidade Básica de Saúde: 1 gestora, 1 médica, 1 dentista, 2 enfermeiros, 3 técnicos em enfermagem, 1 atendente da portaria e 1 encarregado do almoxarifado. A coleta de dados aconteceu em 8 reuniões de discussão focal sobre temas como política de humanização, direito à saúde, integralidade, acolhimento, subjetividade em saúde, processos de trabalho. As discussões foram gravadas e transcritas. Os dados foram trabalhados pela análise do discurso. RESULTADOS: Como resultados, apareceram três repertórios lingüísticos ligados à demanda: compreensão das necessidades em saúde; entendimento do acolhimento como triagem e aplicação de protocolo; influência do modelo biomédico na organização dos serviços. A excessiva demanda e a falta de resolubilidade estão ligadas a uma compreensão das necessidades de saúde como o simples acesso à tecnologia, e do acolhimento apenas como triagem de sintomas. Os profissionais da enfermagem reportam como uma causa da excessiva demanda o fato de que os usuários sempre querem ser atendidos pelo médico, o que pode ser explicado pela cultura da atenção criada pelo modelo biomédico no qual eles próprios se encontram quando entendem as necessidades e o acolhimento na perspectiva biomédica.Humanization of Primary Health Care Services depends mostly on the resolution of the health needs and on the consequen organization of demand. OBJECTIVE: The article searches to know the implications of demand to the humanization of Primary Health Care practices. METHODOLOGY: It is an exploratory research with qualitative approach. The empirical universe was formed by 10 professionals: 1 manager; 1 physician; 1 dentist; 2 nurses, 3 nursing technicians; 1 reception attendant; 1 stockroom commissioner. Data were collected through 8 meetings in which discussion focused on themes such as humanization policy, right to health, integrality, users' reception, subjectivity in health, work processes. The discussions have been recorded and a transcription was made. Analysis of data was done through discourse analysis. RESULTS: As results, three linguistic repertories were found linked with the demand: the understanding of health needs; the understanding of users' reception as screening and application of protocols; the influence of the biomedical model in the organization of the services. The excessive demand and the lack of resolution are linked to the understanding of heath needs simply as access to technology, and of users' reception simply as screening of symptoms. Nurses claim that excessive demand is due to users always wanting to be seen by a physician, which can be explained by the health care culture created by the biomedical model which is also adopted by professionals when they understand health needs and the users' reception in the biomedical perspective

Shallow gas seismic structures: forms and distribution on Santa Catarina Island, Southern Brazil

Abstract This paper presents the spatial distribution of shallow gas structures and classifies them on the basis of two different data sets of CHIRP seismic records, one from the Conceição Lagoon (CL) and the other from North Bay (NB), both on Santa Catarina Island, Southern Brazil. Side scan sonar data from the CL were used to facilitate the understanding. The sub bottom (SB) seismic data were processed and interpreted by means of the SeisPrho software, the side scan sonar (SSS) data by SonarWiz5 software and the spatial extension being measured with the help of GIS. The shallow gas structures were defined in accordance with their shapes in the seismic recordings (echo-character). At the CL, shallow gas accumulations were found in the form of seepages and features presenting shallow gas structures between the surface and 8.20 ms (around 12.3 m). Accumulations of gas were found in the form of Acoustic Blanking with Acoustic Plume, and also Black Shadows. Pockmarks were found on the lagoon floor and associated with gas seepages (average size diameter 0.97 ± 0.19 m and density from 54 to 242 units per 50 m2). In the NB three types of shallow gas features were found in the seismic profile, namely Acoustic Blanking, Turbidity Pinnacles and Intra-sedimentary plumes. The depth varied from the surface to 12.10 ms (around 18.15 m). In both environments, the gas is escaping from the sediment into the water column. The Pockmarks in the CL and the Acoustic Plume features and sediment rich in total sulfur in the NB validate these findings

Anticariogenic Activity of Three Essential Oils from Brazilian Piperaceae

The current trend toward using natural food additives, cosmetics, and medicines has motivated industries to substitute synthetic compounds for natural products. Essential oils (EOs) from medicinal plants are a well-known source of chemical compounds that display several interesting biological activities, including antimicrobial action. In this study, we investigated the antibacterial activity of EOs extracted from three Piperaceae species collected in the Brazilian Amazon region against a representative panel of cariogenic bacteria. The minimum inhibitory concentration (MIC) of the essential oils extracted from Peperomia pellucida (PP-EO), Piper marginatum (PM-EO), and Piper callosum (PC-EO) was determined against Streptococcus mutans, S. mitis, S. sanguinis, S. salivarius, S. sobrinus, Enterococcus faecalis, and Lactobacillus casei by using the microplate microdilution method. PM-EO, PC-EO, and PP-EO displayed antibacterial activity against all the tested cariogenic bacteria. PM-EO displayed the best inhibitory activity, with MIC values ranging from 50 to 500 µg/mL. The lowest MIC values were obtained for PM-EO against S. mitis (MIC = 75 μg/mL), Lactobacillus casei (MIC = 50 μg/mL), and S. mutans (MIC = 50 μg/mL). Gas chromatography mass spectrometry (GC-MS) analysis allowed the chemical composition of all the EOs to be identified. The main constituents of PM-EO, PC-EO, and PP-EO were 3,4-(methylenedioxy)propiophenone, α-pinene, and dillapiole, respectively. Finally, the compounds that were exclusively detected in PM-EO are highlighted. Our results suggest that PM-EO may be used in products for treating dental caries and periodontal diseases

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially