Putting Health at the Heart of Local Planning Through an Integrated Municipal Health Strategy

As a cross-sectoral issue, the promotion of health needs to be addressed across all policies. In Portugal, as more competencies are being transferred to local governments, the integration of health considerations into municipal plans remains a challenge and guidance on how to develop an integrated municipal health strategy is absent. The aim of this study is to describe the conceptual and methodological approach that informed the development of an integrated and multisectoral municipal health strategy in the City of Coimbra. Its design followed a population health approach with a geographic lens, looking at how the population's health outcomes and health determinants were geographically distributed across the municipality, as well as the extent to which policies from multiple sectors can address them. The planning cycle followed an iterative workflow of five actions: assessing, prioritizing, planning, implementing, and monitoring. Following a participatory planning approach, several participatory processes were conducted involving local stakeholders and citizens (e.g., population-based surveys, workshops, Delphi, collaborative sessions) to identify problems, establish priorities, and define measures and actions. The strategic framework for action integrates 94 actions across multisectoral domains of municipal intervention: sustainable mobility and public places, safe and adequate housing, accessible healthcare, social cohesion and participation, education and health literacy, and intersectoral and collaborative leadership. Findings shed light on important aspects that can inform other municipal strategies, such as the adoption of a place-based approach, focused on geographic inequalities, health determinants and stakeholder participation, and the application of a health in all policies framework

A construção da identidade travesti em Foz do Iguaçu-PR

Anais do VI Encontro de Iniciação Científica e II Encontro Anual de Iniciação ao Desenvolvimento Tecnológico e Inovação – EICTI 2017 - 04 a 06 de outubro de 2017 - temática Ciências HumanasNosso projeto de pesquisa busca compreender a construção da identidade de gênero de Travestis e Transsexuais morador@s da cidade de Foz do Iguaçu-PR, cidade que forma uma das tríplices fronteiras brasileira juntamente com Paraguai e Argentina. O cerne de nosso trabalho está em entender como estes sujeitos codificam os valores que constroem suas identidades, e como a forte influência do discurso que constrói a identidade cisgênero (gênero biológico/binário, homem/pênis-mulher/vagina), vista como a única maneira legítima e “normal” de construção da identidade, afeta seus discursos na defesa do direito à livre expressão das identidades sexuais e de gênero e do respeito às diferenças, levando-se em conta aspectos como sexo, gênero, raça e classeUniversidade Federal da Integração Latino-Americana (Unila); Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq); Fundação Araucária; Parque Tecnológico Itaipu (PTI) e Companhia de Saneamento do Paraná (SANEPAR

Avaliação de reforços vacinais contra a coqueluche para adolescentes e adultos na cidade de São Paulo

OBJECTIVE: To develop a model to assess different strategies of pertussis booster vaccination in the city of São Paulo. METHODS: A dynamic stationary age-dependent compartmental model with waning immunity was developed. The "Who Acquires Infection from Whom" matrix was used to modeling age-dependent transmission rates. There were tested different strategies including vaccine boosters to the current vaccination schedule and three of them were reported: (i) 35% coverage at age 12, or (ii) 70% coverage at age 12, and (iii) 35% coverage at age 12 and 70% coverage at age 20 at the same time. RESULTS: The strategy (i) achieved a 59% reduction of pertussis occurrence and a 53% reduction in infants while strategy (ii) produced 76% and 63% reduction and strategy (iii) 62% and 54%, respectively. CONCLUSION: Pertussis booster vaccination at age 12 proved to be the best strategy among those tested in this study as it achieves the highest overall reduction and the greatest impact among infants who are more susceptible to pertussis complications.OBJETIVO: Desarrollar un modelo capaz de acceder resultados de diferentes posibles estrategias de refuerzo vacunal contra la tosferina, en la ciudad de Sao Paulo, Sureste de Brasil. MÉTODOS: El modelo matemático dinámico propuesto es dependiente de la edad y consideró pérdida de la inmunidad vacunal con el avance de la edad. La matriz "who acquire infection from whom" fue utilizada para insertar las diferentes dinámicas de contactos entre los grupos de edad. Diferentes estrategias vacunales fueron evaluadas, añadiendo refuerzos vacunales al actual esquema utilizado, e tres diferentes estrategias fueron reportadas: (i) 35% o (ii) 70% de cobertura vacunal en la edad de 12 años e (iii) coberturas vacunales de 35% a los 12 años y 70% a los 20 años al mismo tiempo. RESULTADOS: La estrategia (i) produjo reducción de 59% en los casos de tosferina y 53% de reducción entre los menores de un año; la estrategia (ii) alcanzó reducción de 76% en los casos y de 63% entre los menores de un año; la estrategia (iii) redujo en 62% el total de casos y 54% entre los menores de un año. DISCUSIÓN: Refuerzo vacunal contra la tosferina a los 12 años es la mejor estrategia entre las evaluadas, pues genera mayor reducción de casos en todas las edades y alcanza mayor impacto entre los menores de un año, los mas vulnerables a las complicaciones de la tosferina.OBJETIVO: Desenvolver um modelo capaz de acessar resultados de diferentes possíveis estratégias de reforço vacinal contra a coqueluche, na cidade de São Paulo. MÉTODOS: O modelo matemático dinâmico proposto é dependente da idade e considerou perda da imunidade vacinal com o avanço da idade. A matriz "who acquire infection from whom" foi utilizada para inserir as diferentes dinâmicas de contatos entre os grupos etários. Diferentes estratégias vacinais foram testadas, acrescentando reforços vacinais ao atual esquema utilizado, e três diferentes estratégias foram reportadas: (i) 35% ou (ii) 70% de cobertura vacinal na idade de 12 anos e (iii) coberturas vacinais de 35% aos 12 anos e 70% aos 20 anos ao mesmo tempo. RESULTADOS: A estratégia (i) produziu redução de 59% nos casos de coqueluche e 53% de redução entre os menores de um ano; a estratégia (ii) alcançou redução de 76% nos casos e de 63% entre os menores de um ano; a estratégia (iii) reduziu em 62% o total de casos e 54% entre os menores de um ano. DISCUSSÃO: Reforço vacinal contra a coqueluche aos 12 anos é a melhor estratégia dentre as testadas, pois gera maior redução de casos em todas as idades e alcança maior impacto entre os menores de um ano, os mais vulneráveis às complicações da coqueluche

Effect Of Aerobic Exercise Training On Regional Blood Flow And Vascular Resistance In Diabetic Rats

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Background: Hyperglycemia has been associated with decreased blood flow in various organs, leading to tissue damage and dysfunctions. Exercise training (ET) is known to promote beneficial changes in the autonomic nervous system and may have effects on circulation. The aim of this study was to evaluate coronary and renal blood flows and vascular resistances after ET in diabetic rats. Methods: Thirty-two rats were divided into four groups (n = 8): sedentary control (SC), trained control (TC), sedentary diabetic (SD), trained diabetic (TD). Diabetes was induced by an injection of streptozotocin (STZ, 50 mg/kg). The ET was performed on a treadmill for 10 weeks. The blood flows were measured using colored microspheres. Results: The diabetic groups presented hyperglycemia (blood glucose >350 mg/dL) and ET did not change this parameter. The SD group showed reduced renal blood flow when compared to SC group, and ET was able to normalize this parameter in TD rats (SC: 4.3 +/- 0.5; TC: 2.9 +/- 0.3; SD: 1.9 +/- 0.4; TD: 3.2 +/- 0.4 mL/min/g). TD group presented increased coronary blood flow in relation to SD group (SC: 2.3 +/- 0.23; TC: 2.8 +/- 0.5; SD: 1.2 +/- 0.4; TD: 3.0 +/- 0.4 mL/min/g). The heart and kidneys vascular resistance were increased in SD group when compared to SC group, and ET was able to reverse these changes. Conclusions: Given the relevance of cardiomyopathy and nephropathy in mortality of diabetics, our results demonstrated that ET is effective in improving coronary and renal blood flows and vascular resistances in STZ-diabetic rats, reinforcing the positive role of this approach in preventing hyperglycemia-induced long-term organ damage.7Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)CAPES [88881.062178/2014-01]FAPESP [2012/20141-5, 2007/52419-4]CNPq [563961/2010-4, 457200/2014-6

O Serviço Social Serviço de Apoio e Orientação Social ao Usuário

TCC (graduação) - Universidade Federal de Santa Catarina, Centro Sócio Econômico, Curso de Serviço SocialO presente Trabalho de Conclusão de Curso apresenta a contextualização das políticas de saúde no Brasil desde os primórdios do século XX até os dias atuais, revelando o processo de construção do Sistema Único de Saúde (SUS) e a trajetória do Serviço Social nesta política. Neste contexto, será enfatizada a intervenção do Serviço Social em unidade de saúde, com as ações sócio-educativas e o trabalho com redes. Em consonância com a teoria, será mostrado a experiência de estágio curricular com a análise da demanda atendida, os óbices e as possibilidades para intervenção do Assistente Social no Serviço de Apoio e Orientação Social ao Usuário da Diretoria do Posto de Assistência Médica (DAME), pertencente a Secretaria Estadual da Saúde (SES) sendo uma unidade ambulatorial que atua em nível secundário e presta assistência de média complexidade, localizada em Florianópoli

Different multidimensional chromatographic approaches applied to the study of Wine Malolactic Fermentation

Different multidimensional analyical techniques applied to the study of malolactic fermentation impact on wine final qualit

Trilha de Aprendizagem para desenvolvimento de competências didático-pedagógicas em docentes do INCA

Propõe plano de ação para criar uma trilha de aprendizagem na modalidade a distância para engajar e promover o desenvolvimento contínuo de competências didáticopedagógicas, analógicas e digitais dos docentes do INCA.28 páginasEducação e DocênciaInovaçãoInovação e Tecnologias na EducaçãoÁrea temática: Nível Meso. Temática: Gestão, organização e tecnologia (desenvolvimento profissional e apoio ao corpo docent

Novel information in estimating loss given default in Brazil

The Basel Accord regulates risk and capital requirements to ensure that a bank holds capital proportional to the exposed risk of its lending practices. Basel II allows banks to develop their own empirical models based on historical data for probability of default (PD), loss given default (LGD) and exposure at default (EAD). Brazil was among the first emerging market countries to release a timetable for the implementation of the Basel II Accord and aimed to apply it uniformly to all Brazilian financial institutions from 2005 to 2011. Within this context, the necessity arises of conducting research that could assist the financial institutions in improving the accuracy of their models. This thesis has three objectives. The first is to develop a macro-economic model to predict the behaviour of the aggregate delinquency in Brazilian consumer loans. The model consists in testing co-integrating relationships and then estimating a short run error correction model. The results based on monthly data from 2000 to 2012 show that the delinquency rate is particularly sensitive to shocks on GDP and to the variation of workers’ income. The analysis then shifts to micro or account level to model the behaviour of borrowers and certain novel types of information that can be used for prediction. Second, customers fail to make loan repayments for a number of reasons, ranging from simple forgetfulness to deliberate attempts. For this reason, the second objective is to investigate the reasons for default and to explore ways of incorporating these variables into Recovery Rate (RR = 1 - LGD) models, since the standard approach overlooks real reasons for default and uses proxies for them such as marital status and length of employment. Customers who failed to repay their loans were interviewed in order to discover the causes for this failure. In addition, the interviews included questions aimed to measure the customer’s personality traits and their financial knowledge in relation to the reasons for default. The empirical results show that the variables proposed in this study, namely, reason for missing payment, financial knowledge and risk taken, improve the prediction of the recovery rate. Thirdly, it is known that recovery depends on the debt collection process and on the different options or actions that collection departments can take. Yet there is practically no literature exploring the impact of the lender’s collection actions on RR/LGD. This work fills this gap by investigating the role of different collection actions at the loan-level for a retail credit product, and by estimating LGD models using Panel Data regressions

Access and adherence to isoniazid preventive therapy and occurrence of active TB in a cohort of people living with HIV: a retrospective cohort study in Sao Paulo, Brazil

Tuberculosis (TB) is still a leading cause of morbidity and mortality among people living with HIV (PLHIV). The diagnosis of latent TB is required for the implementation of prophylactic therapy with isoniazid (PTI). However, low access to diagnosis of latent TB and non-adherence to PTI may hinder potential benefits of this essential intervention. In this study, we addressed the access and adherence to PTI in a cohort of PLHIV with positive tuberculin skin test (TST) in a reference HIV clinic in Sao Paulo, Brazil. We have also analyzed the occurrence of active TB over a median of 131 months after a positive TST among study participants. Our findings revealed that 88.3% of the 238 TST-positive patients had access to PTI, and 196 (93.3%) of those with access adhered to PTI. Active tuberculosis was diagnosed in three of the 196 TST-positive patients who adhered to PTI (1.5%; 95% confidence interval [CI] 0.3-4.4%), whereas seven cases were detected among 42 patients without access or who did not adhere to PTI (16.6%; 95% CI 7.0-31.3%). The apparent beneficial effect of PTI in our cohort is consistent with previous studies including PLHIV, and highlights the importance of reliably delivering each of the steps between screening for latent TB and provision of PTI