Recent immigrants to the USA from Southeast Asia may be at higher risk of exposure to fish-borne contaminants including polychlorinated biphenyls (PCBs), p, p′-dichlorodiphenyldichloroethene (DDE) ...and methylmercury (MeHg) because of their propensity to engage in subsistence fishing.
Exposure to contaminants was assessed in men and women of Hmong descent living in Green Bay, Wisconsin, where the Fox River and lower Green Bay are contaminated with PCBs, and to a lesser extent with mercury. Serum samples from 142 people were analyzed for PCBs and p,p′-DDE by capillary column gas chromatography with electron capture detection (ECD). Whole blood was analyzed for total mercury by cold vapor atomic absorption spectrometry and atomic fluorescence spectroscopy. Lipid-adjusted total PCB concentrations ranged from 8.7 to 3,091ng/g (full range of the data), with a geometric mean of 183.6ng/g (estimated after eliminating one outlier). DDE ranged from 0.3 to 7,083 (full range of the data) with a geometric mean of 449.8ng/g (estimated after eliminating two outliers). Men had higher PCB and DDE concentrations than women. Serum PCB concentrations were significantly correlated with fish consumption (r=0.43, p<0.0001), whereas DDE concentrations were not (r=0.09,p=0.29). Instead, serum DDE was strongly associated with the number of years spent in a Thai refugee camp before immigrating to the USA (r=0.60;p<0.0001). PCB congeners 138, 153, 118 and 180 accounted for a smaller percentage of the total PCBs than has been reported in other fish-eating populations, and several lightly chlorinated congeners were present in relatively large amounts. Mercury exposure was low in this population. In conclusion, Hmong immigrants in northeastern Wisconsin are at risk of elevated PCB exposure from consumption of locally caught fish. The pattern of exposure is somewhat different than patterns in other fish-eating populations, possibly due to use of Aroclor 1242 by the paper industry in this region.
O artigo discute resultados parciais de uma pesquisa em andamento sobre estratégias de internacionalização operadas por escolas brasileiras da rede privada, nos níveis infantil, fundamental e médio. ...Foram investigados 65 estabelecimentos localizados em região de alto favorecimento econômico da cidade de Belo Horizonte, por meio da análise de seu material de divulgação, além de entrevistas semidiretivas realizadas com diretores, coordenadores ou professores. Um investimento particular em recursos internacionais foi detectado em mais da metade das escolas: iniciativas diversificadas em torno de dois objetivos principais - aquisição e domínio de outro idioma; a vivência efetiva dos alunos no estrangeiro.
Este artigo traça um panorama das contribuições de pesquisas estrangeira e nacional sobre o tema das estratégias educativas de internacionalização. São trabalhos que, em geral, versam sobre ...modalidades recentes de investimento por parte de famílias socialmente favorecidas em uma dimensão internacional do capital cultural. A aquisição desses recursos - o acúmulo de competências linguísticas, culturais e sociais, além da própria mobilidade - é interpretada, por esses grupos, como o vetor da constituição de disposições que resultariam em certa desenvoltura de atuação de seus filhos em meios internacionais. A análise do conjunto de resultados fornece pistas importantes, na medida em que permite a visibilidade a estratégias comuns, próprias do momento atual, mas sinaliza também a necessidade de maior compreensão das particularidades que caracterizam ações e valores distintos atribuídos ao capital simbólico internacional por parte de populações de nações diversas. Nesse sentido, o texto realça a relevância sociológica do objeto, em particular, no caso brasileiro. É que o recurso recente a esse capital como estratégia educativa não só das elites, mas também de grupos em ascensão, vem tornar mais complexo, ou mesmo agravar, o quadro de desigualdade de oportunidades escolares que, tradicionalmente, tem marcado a disputa pelas melhores posições na hierarquia social do país. Assim, o interesse renovado pela dimensão internacional do capital cultural parece se constituir, recentemente, em um fator a mais a aprofundar e consolidar fronteiras já existentes entre os que podem se beneficiar da rentabilidade de tal investimento, ao longo de sua escolarização, e aqueles que se limitam aos recursos nacionais.This work gives an overview of the contributions made by national and international studies on the theme of internationalization strategies for education. In general, these studies focus on recent modalities of investment made by socially advantaged families, and on the international dimension of the cultural capital. Acquiring these resources - the sum of linguistic, cultural and social skills, apart from the mobility itself - is interpreted by these groups as the agent of the constitution of aptitudes that would result in a resourceful performance by their children in international environments. The analysis of the collection of results gives important clues insofar as it makes visible common strategies characteristic of the current times, but also signal to the need for better understanding of the peculiarities that characterize distinct actions and values attributed to what is international by segments of the population in several countries. In this sense the text highlights the sociological relevance of the object, particularly in the Brazilian case. What happens is that the recent resorting to what is international as an educative strategy, not only on the part of the elites, but also by socially emerging groups, has contributed to an increased complexity, or even a worsening, of the scenario of inequalities in school opportunities that has traditionally been a hallmark of the struggle for higher positions in the social hierarchy of the country. Thus, the renewed interest by things international seems to constitute in recent times a further factor to deepen and consolidate the already existing boundaries separating those who can benefit from this kind of capital throughout their schooling from those who are limited to the national resources.
Este artigo traça um panorama das contribuições de pesquisas estrangeira e nacional sobre o tema das estratégias educativas de internacionalização. São trabalhos que, em geral, versam sobre ...modalidades recentes de investimento por parte de famílias socialmente favorecidas em uma dimensão internacional do capital cultural. A aquisição desses recursos - o acúmulo de competências linguísticas, culturais e sociais, além da própria mobilidade - é interpretada, por esses grupos, como o vetor da constituição de disposições que resultariam em certa desenvoltura de atuação de seus filhos em meios internacionais. A análise do conjunto de resultados fornece pistas importantes, na medida em que permite a visibilidade a estratégias comuns, próprias do momento atual, mas sinaliza também a necessidade de maior compreensão das particularidades que caracterizam ações e valores distintos atribuídos ao capital simbólico internacional por parte de populações de nações diversas. Nesse sentido, o texto realça a relevância sociológica do objeto, em particular, no caso brasileiro. É que o recurso recente a esse capital como estratégia educativa não só das elites, mas também de grupos em ascensão, vem tornar mais complexo, ou mesmo agravar, o quadro de desigualdade de oportunidades escolares que, tradicionalmente, tem marcado a disputa pelas melhores posições na hierarquia social do país. Assim, o interesse renovado pela dimensão internacional do capital cultural parece se constituir, recentemente, em um fator a mais a aprofundar e consolidar fronteiras já existentes entre os que podem se beneficiar da rentabilidade de tal investimento, ao longo de sua escolarização, e aqueles que se limitam aos recursos nacionais.
This work gives an overview of the contributions made by national and international studies on the theme of internationalization strategies for education. In general, these studies focus on recent modalities of investment made by socially advantaged families, and on the international dimension of the cultural capital. Acquiring these resources - the sum of linguistic, cultural and social skills, apart from the mobility itself - is interpreted by these groups as the agent of the constitution of aptitudes that would result in a resourceful performance by their children in international environments. The analysis of the collection of results gives important clues insofar as it makes visible common strategies characteristic of the current times, but also signal to the need for better understanding of the peculiarities that characterize distinct actions and values attributed to what is international by segments of the population in several countries. In this sense the text highlights the sociological relevance of the object, particularly in the Brazilian case. What happens is that the recent resorting to what is international as an educative strategy, not only on the part of the elites, but also by socially emerging groups, has contributed to an increased complexity, or even a worsening, of the scenario of inequalities in school opportunities that has traditionally been a hallmark of the struggle for higher positions in the social hierarchy of the country. Thus, the renewed interest by things international seems to constitute in recent times a further factor to deepen and consolidate the already existing boundaries separating those who can benefit from this kind of capital throughout their schooling from those who are limited to the national resources.
Essential attributes and qualifiers of primary health care Silvia Walter de Aguiar, Andréa; Martins, Pollyanna
Revista brasileira em promoção da saúde = Brazilian journal in health promotion,
06/2012, Letnik:
25, Številka:
2 Sup
Journal Article
Recenzirano
Odprti dostop
Historically, the primary health care (PHC) has been associated with the first level of care from a health system and characterized by the kind of professional that in it operates, where is expected ...a predominance of specialists in this area. However, the major limitation for this type of characterization is that the profile of professionals engaged in this service may vary from country to country.Several theoretical and conceptual landmarks proposed approaches and indicators to assess and characterize the APS. In 1978, the American Institute of Medicine suggested an approach in which listed its attributes such as accessibility, integrality, coordination, continuity and responsibility. This was an important landmark in an attempt to outline a normative approach to measure it. However, most indicators and specific definition was not suggested. The selected indicators required a high level of performance, were difficult to be achieved, and focused on the capacity of services and not in its concrete realization(1).A 1996 report, from the same institution, defined PHC as the provision of integrated services and accessible by clinicians who are responsible for attending a large majority of personal care needs, developing a continued partnership with patients and working within family and community. This definition does not include the first contact and focuses on individual attention.The Canadian Medical Association, in 1996, considered the APS as a front door of the health system and community interventions included in the definition of the functions of APS. In the same year was published a Charter for General Practice / Family Medicine in Europe (Letter to General Practice / Family Medicine in Europe), which describes 12 characteristics: general, accessible, integrated, continuous, as a team, holistic, personalized, targeted for the family and the community, coordinated, confidential and protectress(2).Donabedian(3) systematized a group of important variables that can assess the quality of a system or health service and rated according to their characteristics in structure, process and outcome. The evaluation of the process includes the quality of services provided by health professionals individually or in groups and refer to professional qualifications, organization and coordination of the work process of teams. The evaluation of the structure includes environmental conditions and equipment in which the services are provided and the results are evaluated starting from the verification of changes in health status of a population that can be attributed to the care process.Among the theoretical and conceptual landmarks of the PHC highlights the publication “Primary Care: Balancing Health Needs, Services, and Technology”, by Professor Barbara Starfield, in 1998, translated into Portuguese and published in Brazil in 2002. The book provides evidence on the role of PHC in health systems, evidence of its impact on population health, and compares the cost-effectiveness between countries with different forms and different degrees of implementation of this strategy, and propose a structure for measure it and set its attributes(1).The views of PHC, centered in the individual and in the population, provided the normative basis for evaluating it in a health system and contributed to the construction of the evaluation framework proposed by Starfield(1).The author also proposed a framework for evaluating the PHC which considered the concepts of the essential attributes and derivative measures of structure (capacity) and process (performance).The essential and exclusive attributes of the PHC include: access / care on first contact, longitudinality, integrality and coordination of care. A high level of reach of essential attributes of the PHC results in three additional aspects, denominated derivatives, which qualify the actions and services at this level of care(1,4).The aspects qualifiers are: centered on the family,cultural competence and community orientation. In most countries, nor centered on the family nor the communityorientation are systems focus. The community orientation is an ideal rather than a reality(1,4).The National Primary Care Policy points out, in its guidelines, the universal and continuing access to health care quality and resolute, featuring primary care as the entry door and preferred care network. This care network should embrace users and promote linking and co-responsibility for the attention to their health needs(5). In the current issue of Brazilian Journal of Health Promotion, the reader can look into the User of the Family Health Strategy: knowledge and satisfaction with embracement, which contains important information that demonstrate mechanisms to ensure accessibility and embracement, from the comprehension of the user.Among the strategies for the development of integrality and coordinated care, now are exalted communities of practice, in which groups are formed around the practice of profession, linked from the need to share experiences so that knowledge can be collective(6). Articles “Community of practice as way of collective learning” and “Development of practices and knowledge in the Family Health Strategy:theoretical study” emphasize the learning derived from the exchange of experiences, sharing of meanings, observations, reflections on PHC.REFERÊNCES1. Starfield B. Atenção primária: equilíbrio entre necessidades de saúde, serviços e tecnologia. Brasília: UNESCO, Ministério da Saúde, 2002.2. World Health Organization - WHO. A Charter for general practice/Family medicine in Europe: working draft, discussion document Acesso em 24 de novembro de 2011 Copenhagen: WHO Regional Office for Europe; 1995. Acesso em: http://whqlibdoc.who.int/ euro/1994 97/EUR_ICP_GPDV_94_01_PB01.pdf3. Donabedian A. The Quality of Medical Care. Science. 1978;200:856–63.http://www.sciencemag.org/ content/200/4344/8564. Ministério da Saúde (BR), Secretaria de Atenção em Saúde, Departamento de Atenção Básica. Manual do instrumento de avaliação da atenção primária à saúde: PrimaryCareAssessment Tool PCATtool. Brasil: Ministério da Saúde; 2010.5. Ministério da Saúde (BR). Portaria GM nº 2488, de 21 de outubro de 2011. Aprova a Política Nacional de Atenção Básica, estabelecendo a revisão de diretrizes e normas para a organização da Atenção Básica, para a Estratégia Saúde da Família (ESF) e o Programa de Agentes Comunitários de Saúde. Diário Oficial da União, v. 204; 2011 Out 24, seção 1, p. 48-55.6. Fleury A, Fleury MA. Competência e aprendizagem organizacional. In: Fleury A, Fleury MA. Estratégias empresariais e formação de competências: um quebracabeça caleidoscópio da industria brasileira. 2ª ed. São Paulo: Atlas; 2001. p. 17-33.
Este texto apresenta o Curso Técnico em Práticas Integrativas e Complementares em Saúde (TPICS), oferecido pela Escola de Saúde da Universidade Federal do Rio Grande do Norte (ESUFRN), com a ...finalidade de analisar os objetivos propostos no seu Projeto Pedagógico, descrevendo como os mesmos estão sendo alcançados ao longo da sua trajetória. As terapias alternativas e complementares vêm sendo gradativamente inseridas no Sistema Único de Saúde, assim, emerge a necessidade de preparar o profissional técnico para atuar com um perfil voltado para terapêuticas mais acessíveis à população que surtam efeitos benéficos sem a exigência de utilizar recursos dispendiosos ao sistema de saúde. O curso TPICS encontra-se na sua sexta turma de alunos, e já formou 96 técnicos desde agosto de 2010. Durante a formação, os alunos desenvolvem, entre outras competências, a noção de corporeidade no saber e fazer profissional para poder lidar com o holismo tão propagado nas políticas de saúde do Brasil, sendo estimulados a protagonizarem o processo de ensino e aprendizagem, estabelecendo uma relação crítica e progressiva ao longo do curso. A avaliação se dá de forma processual, dialógica e comprometida com o desenvolvimento pleno do aluno, nas dimensões humana, cognitiva, política, filosófica e ética. Contudo, observa-se que há a oferta de uma formação sólida considerando os princípios norteadores do Projeto Pedagógico do Curso a partir do pluralismo de ideias e concepções pedagógicas, agregando questões técnicas à formação crítica e humanista, fortalecendo a promoção da saúde através de abordagens integrais de cunho preventivista.
The aim of this study was to evaluate the profile of dental students and its relationship to anxiety levels. The State-Trait Anxiety Inventory was applied to 207 first- to fifth-year undergraduates ...enrolled in the dentistry program at the School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Brazil. Participants were aged 17 to 29 years, and the maiority were women (57.5%). Students had a weekly workload of up to 40 hours and performed at least two complementary activities, in addition to their undergraduate training. Almost all students (95.7%) had attended private high schools and 80.6% lived with their parents or spouses. Regarding parental education, 59.4% of mothers and 55.6% of fathers had a higher education degree. Most students showed medium levels of anxiety according to measurements of state anxiety (53.1%) and trait anxiety (81.6%). It can be concluded that more than 50% of students in the Dentistry graduation course of the Federal University of Ceará showed an average level of anxiety, and that the excessive workload and enrichment activities necessary to obtain the undergraduate degree in Dentistry probably can be influencing the anxiety levels of students, however, more studies and statistical tests should be performed to identify the root causes in order to preserve the mental health of these future dentists.
O Sistema de Licenciamento Ambiental de Propriedades Rurais (SLAPR) foi implantado no estado do Mato Grosso, no ano de 2000, num processo de descentralização da política florestal para os estados. O ...principal objetivo do SLAPR era a redução dos desmatamentos ilegais no estado e causou grande expectativa nos elaboradores/gestores de politica pública na época de sua implantação. Este artigo quantificou e qualificou os resultados dos desmatamentos ocorridos dentro do Sistema, bem como do nível de sua regularização que a política conseguiu provocar no estado até o ano 2007. Para elaborar o trabalho, foram utilizadas ferramentas de Geoprocessamento, extraindo os vetores dos limites das propriedades da base digital da Secretaria de Estado do Meio Ambiente de Mato Grosso (SEMA-MT) até 2006 e da dinâmica de desmatamentos entre 2000 e 2007. Também foram utilizados documentos informando o número de desmatamentos autorizados no período. Entre os resultados, verificou-se que o sistema licenciou, no período, grandes propriedades rurais (média de 1.500 ha) havendo altas taxas de autorização de desmatamentos. A quantidade de 1.420.500,50 hectares foram desmatados em propriedades rurais licenciadas em todo o estado do Mato Grosso, no período de 2000 a 2007, representando um incremento de 32% em relação ao acumulado no período anterior, entre 1995 e 1999. A maior parte desse desmatamento contou com autorização legal. O estudo também concluiu que houve desmatamentos em reserva legal dentro das propriedades licenciadas, apesar de que tal infração tenha sido menor em relação às propriedades fora do sistema. A autorização de desmatamento caiu drasticamente após 2005, mostrando que o sistema funcionou melhor quando todo estado estava com altas taxas de desmatamento e com polígonos maiores de desmatamento. O estudo sinaliza para cuidados na análise dos dados numéricos de desmatamento no SLAPR, indicando em que aspectos a euforia apresentada na época de sua implementação veio ou não a se confirmar, apontando as armadilhas e vicissitudes desse tipo de instrumento de políticas públicas ambientais.
Environmental licensing system of rural property (SLAPR) was implemented in the State of Mato Grosso in 2000, within a process of decentralization of forest policy to subnational states. The main objective of SLAPR was the reduction of illegal deforestation in the State, and this has caused a lot of enthusiasm among public managers at that time. This article analyzed the results of deforestation occurred within the system, as well as the level of its regularization that this policy could cause in the state until 2007. It was used geoprocessing tools, extracting licensed properties data (until 2006) and deforestation dynamics (2000-2007) from SEMA -MT (Secretary of State of Mato Grosso for the Environment). In addition, documents stating the number of authorized deforestation during the period were used. Among the results it was found that system licensed, in that period, mostly large properties (1500 ha average), existing high level of deforestation allowances. A total of 1,420,500.50 hectares were cleared on farms throughout the state of Mato Grosso in the period 2000 to 2007, representing an increase of 32% accumulated in the previous period, from 1995 to 1999. Most of this deforestation had legal authorization. Also was concluded that there was deforestation in legal reserve within the licensed properties, even though such breach was minor in relation to properties outside the system. The deforestation allowance fell down drastically after 2005, showing that system was most effective when the whole state had performed high levels of deforestation and higher deforestation polygons. The study addressed to the necessity of being careful on numerical data analysis about the deforestation control by SLAPR, indicating in which aspects that enthusiasm could be confirmed or not, and addressing the traps and difficulties of this kind of instrument of environmental public policies.
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