Analysis of the impact of health interventions on vaccination coverage for children under two years of age in municipalities of Minas Gerais.

OBJECTIVE: To evaluate the impact of the state action-research project on vaccination coverage in children under two years of age in the state of Minas Gerais, according to the size of the municipalities, comparing the years 2021 and 2022. METHODS: This is a study nested within the state action-research project, a before-after community clinical trial carried out in 212 municipalities in the state of Minas Gerais. This study used secondary data on Vaccination Coverage (VC), Homogeneity of Vaccines (HVC) and Abandonment rate of multi-dose vaccines. After classifying municipalities by size and vaccination coverage rates were equitably classified, an analysis of secondary data on 12 immunobiologicals indicated for the age group in question and their abandonment rate of multi-dose vaccines was carried out. RESULTS: There was an increase in the proportion of municipalities classified as small that reached the vaccination coverage target set by the National Immunization Program (PNI) after the action-research project was carried out. There was an increase in the proportion of small municipalities classified as having a low abandonment rate for the rotavirus vaccine, in the adequate homogeneity of vaccination coverage and in the classification of risk as very low risk and low and medium risk, all with a statistically significant difference. CONCLUSION: There was an influence of municipal size on the effectiveness of the actions applied to increase vaccination coverage, explaining that proposing individualized actions for each municipality is essential to improve vaccination coverage.

A Covid-19 não é democrática: determinação social do processo saúde-doença numa análise de gêneroraça-classe-sexualidade

A disseminação da COVID-19 no Brasil se estabeleceu em um cenário político de importantes retrocessos democráticos e de desmonte da seguridade social. A fim de investigar mais profundamente esse contexto, o campo da saúde possui, historicamente, formulações de modelos teóricos que buscam as compreensões de saúde e doença. Ademais, para explicar as condições de saúde da população através de uma noção mais completa, torna-se fundamental debater sobre o processo de saúde doença e sua determinação social em uma episteme de gênero-raça-classe-sexualidade, visto que a saúde entendida como amplo desenvolvimento das potencialidades humanas em certo momento histórico, choca-se com as limitações estabelecidas pela estrutura para o alcance dessas capacidades através das desigualdades que marcam a realidade nacional. Os desdobramentos cotidianos e os impactos diretos na vida da população negra, nas mulheres, na população LGBTQIA+ e, de forma geral, na classe trabalhadora na pandemia, com maior número de mortes, afetando em maior grau a saúde mental, as relações de trabalho e familiares, validam de forma concreta a determinação social do processo de saúde-doença. Portanto, o projeto e concepção de saúde precisa se posicionar na disputa de percepção crítica da realidade, e de ação para construir uma sociedade emancipada.

Corrupção na educação superior pública? Estudo das Ifes de Minas Gerais / ¿Corrupción en la educación superior pública? Estudio de las Ifes de Minas Gerais / Is there corruption in public higher education institutions? Study of the HEIs of Minas Gerais

Resumo A corrupção na administração pública brasileira vem adquirindo maior centralidade graças aos sucessivos escândalos desvendados no país. As instituições públicas federais de ensino superior (Ifes) não passaram incólumes por esse contexto, chamando a atenção por se tratar de organizações voltadas à promoção da formação intelectual e cidadã. Este artigo analisa de que forma o ambiente organizacional se configura para o combate à corrupção por meio de um estudo de caso nas 17 Ifes de Minas Gerais. Para isso, verificam-se as características relacionadas com a corrupção em processos disciplinares administrativos (PADs), instaurados de 2015 a 2019, e entrevistam-se servidores que participavam da condução desses processos. A despeito de a maioria dos entrevistados não ter uma percepção clara do fenômeno da corrupção nas Ifes, os achados da pesquisa indicam que os principais fatores do ambiente organizacional referentes à integridade que contribuem para o combate à corrupção correspondem aos canais para manifestação de denúncia, aos mecanismos de controle externo e interno, aos instrumentos de promoção da ética e às regras de conduta, transparência e acesso à informação. Em termos de estrutura, constata-se que o corporativismo é o principal empecilho do ambiente organizacional no combate à corrupção. Para isso, sugere-se o desenvolvimento de pesquisas futuras voltadas a verificar a institucionalização das medidas da integridade nas Ifes como estratégia de combate à corrupção.

Resumen La corrupción en la administración pública brasileña ha ido adquiriendo mayor centralidad debido a los sucesivos escándalos develados en el país. Las instituciones públicas federales de educación superior (Ifes) no permanecieron indemnes a este contexto, llamando la atención por tratarse de organizaciones orientadas a promover la educación intelectual y ciudadana. Este artículo analizó cómo se configura el entorno organizacional para combatir la corrupción a través de un estudio de caso en las 17 Ifes de Minas Gerais. Para ello, se verificaron las características relacionadas con la corrupción en los procesos administrativos disciplinarios (PAD) instaurados de 2015 a 2019 y se entrevistó a los funcionarios que participaron en la conducción de estos procesos. A pesar de que la mayoría de los entrevistados no tuviera una percepción clara del fenómeno de la corrupción en las Ifes, los hallazgos de la investigación indicaron que los principales factores del entorno organizacional relacionados con la integridad que contribuyen a la lucha contra la corrupción corresponden a los canales para la manifestación de denuncias, mecanismos de control externo e interno, instrumentos de promoción de la ética y reglas de conducta, transparencia y acceso a la información. En términos de estructura, se encontró que el corporativismo era el principal obstáculo del entorno organizacional en la lucha contra la corrupción. Se sugiere desarrollar investigaciones futuras orientadas a verificar la institucionalización de las medidas de integridad en las Ifes como estrategia de combate a la corrupción.

Abstract: Corruption in the Brazilian public administration has gained centrality due to the successive scandals unveiled in the country. The public higher education institutions (HEIs) did not go unscathed, bringing attention to the fact that they are organizations aimed at promoting citizenship and intellectual education. This article analyzed how the organizational environment is configured to fight corruption through a case study of the 17 HEIs in Minas Gerais. We verified characteristics related to corruption in administrative disciplinary proceedings established between 2015 and 2019 and interviewed civil servants who participated in the conduction of these processes. Although most interviewees did not have a clear perception of corruption in the HEIs, the research findings indicated the main factors related to integrity that contribute to fighting corruption in the organizational environment. These factors are the complaints channels, external and internal control mechanisms, instruments for promoting ethics and rules of conduct, transparency, and access to information. In terms of structure, it was found that corporatism was the main obstacle to fight corruption in the organizational environment. The study points out the need for future research to verify the institutionalization of integrity measures in the HEIs as a strategy to combat corruption.

Alcohol Consumption and Risk of Liver Cirrhosis: A Systematic Review and Meta-Analysis.

OBJECTIVES: To systematically summarize the risk relationship between different levels of alcohol consumption and incidence of liver cirrhosis. METHODS: MEDLINE and Embase were searched up to March 6, 2019, to identify case-control and cohort studies with sex-specific results and more than 2 categories of drinking in relation to the incidence of liver cirrhosis. Study characteristics were extracted and random-effects meta-analyses and meta-regressions were conducted. RESULTS: A total of 7 cohort studies and 2 case-control studies met the inclusion criteria, providing data from 2,629,272 participants with 5,505 cases of liver cirrhosis. There was no increased risk for occasional drinkers. Consumption of one drink per day in comparison to long-term abstainers showed an increased risk for liver cirrhosis in women, but not in men. The risk for women was consistently higher compared to men. Drinking ≥5 drinks per day was associated with a substantially increased risk in both women (relative risk [RR] = 12.44, 95% confidence interval [CI]: 6.65-23.27 for 5-6 drinks, and RR = 24.58, 95% CI: 14.77-40.90 for ≥7 drinks) and men (RR = 3.80, 95% CI: 0.85-17.02, and RR = 6.93, 95% CI: 1.07-44.99, respectively). Heterogeneity across studies indicated an additional impact of other risk factors. DISCUSSION: Alcohol is a major risk factor for liver cirrhosis with risk increasing exponentially. Women may be at higher risk compared to men even with little alcohol consumption. More high-quality research is necessary to elucidate the role of other risk factors, such as genetic vulnerability, body weight, metabolic risk factors, and drinking patterns over the life course. High alcohol consumption should be avoided, and people drinking at high levels should receive interventions to reduce their intake.

Alcohol, microbiome, life style influence alcohol and non-alcoholic organ damage.

This paper is based upon the "8th Charles Lieber's Satellite Symposium" organized by Manuela G. Neuman at the Research Society on Alcoholism Annual Meeting, on June 25, 2016 at New Orleans, Louisiana, USA. The integrative symposium investigated different aspects of alcohol-induced liver disease (ALD) as well as non-alcohol-induced liver disease (NAFLD) and possible repair. We revealed the basic aspects of alcohol metabolism that may be responsible for the development of liver disease as well as the factors that determine the amount, frequency and which type of alcohol misuse leads to liver and gastrointestinal diseases. We aimed to (1) describe the immuno-pathology of ALD, (2) examine the role of genetics in the development of alcoholic hepatitis (ASH) and NAFLD, (3) propose diagnostic markers of ASH and non-alcoholic steatohepatitis (NASH), (4) examine age and ethnic differences as well as analyze the validity of some models, (5) develop common research tools and biomarkers to study alcohol-induced effects, 6) examine the role of alcohol in oral health and colon and gastrointestinal cancer and (7) focus on factors that aggravate the severity of organ-damage. The present review includes pre-clinical, translational and clinical research that characterizes ALD and NAFLD. Strong clinical and experimental evidence lead to recognition of the key toxic role of alcohol in the pathogenesis of ALD with simple fatty infiltrations and chronic alcoholic hepatitis with hepatic fibrosis or cirrhosis. These latter stages may also be associated with a number of cellular and histological changes, including the presence of Mallory's hyaline, megamitochondria, or perivenular and perisinusoidal fibrosis. Genetic polymorphisms of ethanol metabolizing enzymes and cytochrome p450 (CYP) 2E1 activation may change the severity of ASH and NASH. Other risk factors such as its co-morbidities with chronic viral hepatitis in the presence or absence of human deficiency virus were discussed. Dysregulation of metabolism, as a result of ethanol exposure, in the intestine leads to colon carcinogenesis. The hepatotoxic effects of ethanol undermine the contribution of malnutrition to the liver injury. Dietary interventions such as micro and macronutrients, as well as changes to the microbiota have been suggested. The clinical aspects of NASH, as part of the metabolic syndrome in the aging population, have been presented. The symposium addressed mechanisms and biomarkers of alcohol induced damage to different organs, as well as the role of the microbiome in this dialog. The microbiota regulates and acts as a key element in harmonizing immune responses at intestinal mucosal surfaces. It is known that microbiota is an inducer of proinflammatory T helper 17 cells and regulatory T cells in the intestine. The signals at the sites of inflammation mediate recruitment and differentiation in order to remove inflammatory inducers and promote tissue homeostasis restoration. The change in the intestinal microbiota also influences the change in obesity and regresses the liver steatosis. Evidence on the positive role of moderate alcohol consumption on heart and metabolic diseases as well on reducing steatosis have been looked up. Moreover nutrition as a therapeutic intervention in alcoholic liver disease has been discussed. In addition to the original data, we searched the literature (2008-2016) for the latest publication on the described subjects. In order to obtain the updated data we used the usual engines (Pub Med and Google Scholar). The intention of the eighth symposia was to advance the international profile of the biological research on alcoholism. We also wish to further our mission of leading the forum to progress the science and practice of translational research in alcoholism.

Comparison of High Performance Liquid Chromatography with Fluorescence Detector and with Tandem Mass Spectrometry methods for detection and quantification of Ochratoxin A in green and roasted coffee beans

Two analytical methods for the determination and confirmation of ochratoxin A (OTA) in green and roasted coffee samples were compared. Sample extraction and clean-up were based on liquid-liquid phase extraction and immunoaffinity column. The detection of OTA was carried out with the high performance liquid chromatography (HPLC) combined either with fluorescence detection (FLD), or positive electrospray ionization (ESI+) coupled with tandem mass spectrometry (MS-MS). The results obtained with the LC-ESI-MS/MS were specific and more sensitive, with the advantages in terms of unambiguous analyte identification, when compared with the HPLC-FLD.

Determination of PAHs: a practical example of validation and uncertainty assessment.

The objective of this study was to present a reliable and practical example of method validation and uncertainty assessment with an analytical method for the determination of polycyclic aromatic hydrocarbons (PAHs) in urban dust. The method was gas chromatography-mass spectrometry in combination with isotope dilution principle to achieve better accuracy for the results. The method performance parameters for five PAHs were determined (phenanthrene, fluoranthene, benzo[a]anthracene, benzo[a]pyrene and benzo[ghi]perylene); this method was used in the key comparison of CCQM-K50b for PAHs in particulate matter. The limits of detection and quantification were lower than 0.075 and 0.250 µg/g, respectively. The linear correlation coefficients were greater than 0.99. The major uncertainty contributions resulted from the accuracy of each analyzed PAH and the repeatability of the process. Certified reference material (National Institute of Standards and Technology SRM 1649a, urban dust) was used to determine the accuracy and precision of the method. The obtained results were satisfactory and agreed with all evaluated performance parameters.

Avaliação de crioprotetores na produção de material de referência para enumeração de coliformes em leite em pó a ser utilizado em ensaio de proficiência / Evaluation of cryoprotectants in the production of reference material for coliforms counting in milk powder to be used for proficiency testing

O desafio na produção de materiais de referência (MR) destinados a ensaios microbiológicos é ainstabilidade natural dos micro-organismos. A liofilização é indicada para criopreservação de culturasbacterianas quando o número de células deve ser resguardado. Agentes protetores podem ser adicionadosantes do congelamento para aumentar a estabilidade do material. Neste trabalho foram avaliados oscrioprotetores na produção de MR liofilizados a serem utilizados em ensaio de proficiência para contagemde coliformes. Foram produzidos quatro lotes utilizando-se diferentes crioprotetores: solução de leitedesnatado a 10 % (EC1), a mesma solução contendo glicerol (EC2), sacarose (EC3) e trealose (EC4). Umacepa de Escherichia coli foi empregada no preparo dos materiais. A homogeneidade foi avaliada conforme oProtocolo Internacional Harmonizado. A estabilidade foi estudada durante quatro meses à ≤ -70 ºC (longaduração) e às temperaturas de -20 ºC, 4 ºC, 25 ºC e 35 ºC durante cinco dias (curta duração), segundo aISO/GUIDE 35. Apenas EC1 foi considerado não homogêneo. Os lotes permaneceram estáveis à ≤ -70 ºCdurante quatro meses. EC2 apresentou resultados insatisfatórios na estabilidade de curta duração. EC3 eEC4 foram homogêneos e estáveis nas temperaturas estudadas. A sacarose e a trealose foram consideradascrioprotetores adequados para o preparo do MR em questão.

Desenvolvimento de material de referência para ensaio de proficiência em microbiologia de alimentos / Development of reference materials for proficiency tests in food microbiology

Ensaios de proficiência (EP) são considerados importantes ferramentas para a condução de programas controle de qualidade, que possibilitam efetuar a avaliação da habilidade de laboratórios em obter resultados precisos. No Brasil é restrita a oferta de EP na área de microbiologia de alimentos. Além disso, os altos custos diminuem a participação regular de laboratórios nacionais nesses ensaios. O presente estudo teve como objetivo realizar a avaliação da técnica de liofilização no preparo de materiais de referência (MR) para EP destinados ao ensaio de detecção de Salmonella spp. em leite. Foi determinada a concentração do inóculo utilizado no preparo de dois lotes e, também, foi padronizado o procedimento de contaminação da matriz. Para monitorar a qualidade dos MR produzidos foram estabelecidos ensaios de controle, dentre eles o teste da homogeneidade e da estabilidade em longo e curto prazo. A técnica de liofilização mostrou ser adequada para a produção de MR de qualidade e aplicável para EP. Os MR apresentaram estabilidade à temperatura de estoque (-20ºC) durante os três primeiros meses, porém foi observada perda de viabilidade após doze meses de armazenamento. Na estabilidade em curto prazo, os MR foram estáveis a 4°C, contudo apresentaram redução significativa no número de células quando mantidos a temperaturas de 25ºC e 37ºC durante sete dias.

Proficiency tests are considered relevant tools of quality control programs used to monitor the laboratory performance and to assess the reliability of tests results. In Brazil, the provision of proficiency testing (PT) is restricted to food microbiology area. Furthermore, high costs reduce the regular participationof national laboratories in these tests. This study evaluated the freeze-drying technique employed forpreparing reference materials (RM) to be used in the PT schemes for detecting Salmonella spp. in milk.The concentration of inoculums used for preparing two batches of RM was determined, and the proceduresfor matrix contamination were standardized. The control trials were established in order to monitor thequality of the produced RM, and among them, there are long and short-term homogeneity and stability assays. The freeze-drying technique proved to be a suitable procedure for producing RM for PT. The RM were stable for the first three months when stored at -20ºC, nevertheless, viability loss could be observed after 12-month storage. The RM were stable at 4°C at short-term stability, although when the products were kept at 25°C and 37°C for seven days, a significant reduction in the number of cells could be observed.