O agente de saúde na atenção primária de saúde da teoria à realidade

A estratégia dos cuidados primários de saúde visa dar ao indivíduo, família e comunidade acesso universal a assistência de saúde essencial com baixo custo e com a participação da comunidade. O primeiro contato com os indivíduos e o sistema de saúde é oferecido pela agente de saúde comunitária. Sua função no sistema é fazer funcionar dinamicamente o sistema primário como o elo entre a comunidade e o sistema de cuidado primário de saúde. O estudo foi conduzido para saber o que a comunidade conhece sobre "agentes comunitários de saúde" e sobre o seu trabalho na comunidade e no Centro de Saúde. Depois de seis anos de experiência com o sistema de atuação primária de saúde, em Brasília, na Vila Paranoá, somente 21 % (42) das famílias sabiam sobre o trabalho dos agentes comunitários de saúde. Os resultados deste estudo indicam a necessidade de repensar o papel, os métodos de trabalho e de treinamento dos agentes.Primary Health Care strategy aims to give individuals, families and the Community, universal access to essencial health assistance at low-cost and with community participation. In the inicial contacts between individuals and the health system, primary care is offered by the "Community Health Agent". His function in the primary Health system is to make the basic health services dynamic functioning as the "link" between the Community and the primary health care system. This study was conduct to learn what the Community Knows about the "Community Health Agent" and about their work in the Community and in the Health Center. After six years of experience with a primary Health Care System in Brasilia, in the Paranoá Vila, only 21 % (42) of the families know about the Community Health Agents work. The results of this study indicate a need to rethink the agent's role and methods of work and training

Interoperability: a conceptual framework to bridge the gap between multifunctional and multisystem urban flood management

Urban flood management is increasingly expected to be multifunctional to integrate with the existing functioning of cities. Locally, this led to the development of sustainable urban water drainage designs, while at larger scales, blue‐green or water‐sensitive cities are considered as examples for how cities should function. Upscaling local designs to city‐scale flood resilience is not straightforward, however, due to the complexity of physical infrastructure and socio‐economic interactions within urban systems and requires “system‐of‐systems” thinking. To this end, we introduce the concept “interoperability” to guide transition from local multifunctionality to city‐scale multisystem flood management, through actively managing connections between infrastructure systems to convey, divert, and store flood water. While flood management is already based on these connections, interoperability is about explicitly emphasising them to explore and create opportunities to facilitate the integration of systems for flood management. The main research need arising from this conceptualisation is to determine how spatial data on infrastructure, environment, and social characteristics in urban areas can serve as a basis to identify opportunities and barriers for interoperability. By introducing interoperability and the research needs arising from it, a framework is created to facilitate and encourage practical thinking and discussion about system integration in urban flood management

Ecological Media Reveal Community Structure Shifts in a Municipal Wastewater Treatment Train

Unique ecological/habitat media derived from four phases of a municipal wastewater treatment plant revealed the highest diversity (2.55-2.86) and evenness (0.79-0.87) for the raw sewage (R) medium. Richness was, however, inoculum- and media-dependent hence inocula R and P recorded the highest counts on media A and F, respectively

Glycoprotein IIb/IIIa Inhibitors Use and Outcome after Percutaneous Coronary Intervention for Non-ST Elevation Myocardial Infarction

Aims. We investigate the effect of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors on long-term outcomes following percutaneous coronary intervention (PCI) after non-ST elevation myocardial infarction (NSTEMI). Meta-analyses indicate that these agents are associated with improved short-term outcomes. However, many trials were undertaken before the routine use of P2Y12 inhibitors. Recent studies yield conflicting results and registry data have suggested that GP IIb/IIIa inhibitors may cause more bleeding than what trials indicate. Methods and Results. This retrospective observational study involves 3047 patients receiving dual-antiplatelet therapy who underwent PCI for NSTEMI. Primary outcome was all-cause mortality. Major adverse cardiac events (MACE) were a secondary outcome. Mean follow-up was 4.6 years. Patients treated with GP IIb/IIIa inhibitors were younger with fewer comorbidities. Although the unadjusted Kaplan-Meier analysis suggested that GP IIb/IIIa inhibitor use was associated with improved outcomes, multivariate analysis (including propensity scoring) showed no benefit for either survival (P=0.136) or MACE (P=0.614). GP IIb/IIIa inhibitor use was associated with an increased risk of major bleeding (P=0.021). Conclusion. Although GP IIb/IIIa inhibitor use appeared to improve outcomes after PCI for NSTEMI, patients who received GP IIb/IIIa inhibitors tended to be at lower risk. After multivariate adjustment we observed no improvement in MACE or survival and an increased risk of major bleeding

Linking Sediment Transport and Stratigraphy on the Continental Shelf

The goal of the shelf sediment dynamics component of STRATAFORM is to link sediment transport processes active on the continental shelf to the formation and preservation of event beds in shelf sediment deposits. An approach combining shelf sediment-transport models with high-resolution measurements of water-column and bed properties over periods from several months to several years allows us to make quantitative estimates of bed modification caused by sediment resuspension during episodic transport events. These modifications include erosion and deposition of bed material, formation of graded storm beds, and changes in small-scale bed surface morphology. The characteristics of the resulting “event bed” (thickness, grading, physical structures) are a function of flow and bed properties, depending on both temporal and spatial variations in sediment transport

Desenvolvimento do ensino superior de enfermagem na região Centro-Oeste - indicadores de qualidade para cursos de graduação

Considerando-se que os novos cursos foram criados dentro de uma nova proposta de sistema de saúde em implantação no País, e tendo em vista que a decisão em criar tais cursos implica em igual responsabilidade em acompanhá-los no interesse de sua consolidação, buscou-se obter resposta a algumas indagações de ordem qualitativa, no esforço de explicitar alguns indicadores de desenvolvimento desses cursos de Enfermagem da Região Centro-Oeste

Alimentação de zero a um ano de idade : um desafio aos profissionais de saúde

Analisam-se aspectos da alimentação infantil com respeito ao posicionamento das escolas médicas e Instituições Nacionais e Internacionais. São apresentados dados da alimentação de crianças de zero a um ano de idade de área periurbana e questiona-se a adequação da formação do profissional de saúde quanto à alimentação infantil.This article discusses some aspects of feeding practices for children from zero to one year of age. Also questioned the position of medical school and National and International Institut in this respect of this subject plus the adequacy of the instruction and practices of the health professionals with respect to infant nutrition in low income comunities

The experience of enchantment in human-computer interaction

Improving user experience is becoming something of a rallying call in human–computer interaction but experience is not a unitary thing. There are varieties of experiences, good and bad, and we need to characterise these varieties if we are to improve user experience. In this paper we argue that enchantment is a useful concept to facilitate closer relationships between people and technology. But enchantment is a complex concept in need of some clarification. So we explore how enchantment has been used in the discussions of technology and examine experiences of film and cell phones to see how enchantment with technology is possible. Based on these cases, we identify the sensibilities that help designers design for enchantment, including the specific sensuousness of a thing, senses of play, paradox and openness, and the potential for transformation. We use these to analyse digital jewellery in order to suggest how it can be made more enchanting. We conclude by relating enchantment to varieties of experience.</p