Beached seabirds as plastic biomonitors in Brazil from the Beach Monitoring Project of the Santos Basin (PMP-BS).

Bioindicator species are useful to monitor wildlife exposure to plastic pollution, and responses to plastic leakage and policy interventions. Here we explore the biomonitoring potential of different seabird and shorebirds species across six years of monitoring in Brazil. Using the necropsy stranding database of the Beach Monitoring Project of the Santos Basin (PMP-BS), we evaluated i) the frequency of birds-plastic interactions in Brazil; ii) whether plastic interactions have changed through time and in different coastal regions; and iii) potential bioindicators for monitoring the exposure of seabirds to plastic in the nearshore South Atlantic Ocean. We found 37 species that had ingested plastic, including ten new records, found that the rates of tube-nosed seabirds increased through time, and suggested two potential species. We discuss the potential for biomonitoring marine pollution in the South Atlantic Ocean using PMP-BS, providing a scheme for a better plastic pollution monitoring in Brazil.

From molecules to ecosystems: Insights into a network of interactions for a Chagas disease outbreak using Triatoma brasiliensis as natural samplers.

Exploring the dynamics of disease transmission involves an understanding of complex interactions within the eco-epidemiologic framework. In the context of Chagas disease (CD), elements are mainly represented by the interactions among the pathogen, insect vector, host, humans and the environment. We performed quantitative and qualitative analyses on a dataset derived from 98 Triatoma brasiliensis infected by trypanosomatids, which were linked to a CD outbreak in the semi-arid region of northeastern Brazil. We extracted invertebrate-derived DNA (iDNA) from these insects, comprising 18 populations around the outbreak area, each indicative of various strata of anthropogenic influence. Food source (FS) diversity, representing potential parasite reservoirs, was determined through mitochondrial gene (cyt b) sequencing of vertebrates, and parasite genotyping was accessed using fluorescent amplified fragment barcodes (FFLB) of trypanosomatids. We also assessed the residents' awareness of breeding sites for CD vectors in the inspected houses. The quantification of Trypanosoma cruzi was estimated via real-time PCR and is denominated here as the average parasite load (PL) per insect (T. cruzi/intestinal unit). We aimed to address vector-parasite-host-environment interactions that were discussed based on their significance among the components. Notably, among the significant interactions, we observed that the PL in the insects was significantly influenced by FS. Infected insects that fed on the classic reservoir, Didelphis albiventris, and Galea spixii exhibited higher PLs, compared to those that fed on Kerodon rupestris (p < 0.04)-a primary host. While D. albiventris is already recognized as a synanthropic species, we propose that G. spixii may also be undergoing a synanthropic process. Conversely, domestic cats are frequently identified as FS in infected insects from the sylvatic environment, suggesting a possible change in their behavior towards a wild state. Therefore, we propose that neglected anthropogenic actions have facilitated the reciprocal (sylvatic-peridomestic) circulation of T. cruzi-especially noted for TcI because it was predominant in insects found in peridomestic environments. Residents are often unaware of the existence of insect breeding grounds near their homes, particularly when it involves the storage of materials without planning for use, such as piles of tiles, bricks and wood. Although indirect inferences about the interaction among vector-parasite-host-environment are still incipient, we highlight the potential use of vectors as natural samplers of biological and ecological components in transmitting the disease.

Experimental Hybrids of the Triatoma brasiliensis Species Complex Show Higher Susceptibility to the Trypanosoma cruzi Infection Than Their Parentals.

The Triatoma brasiliensis species complex is a monophyletic group encompassing two subspecies and six species. Recently, a hybrid zone of members of this complex was recorded in the state of Pernambuco. Questions concerning the capability of the hybrids to become infected with Trypanosoma cruzi have been raised. This study aimed to compare the susceptibility of Triatoma b. brasiliensis, Triatoma juazeirensis, and their experimental hybrids to infection with T. cruzi. We infected the parentals and their experimental hybrids (obtained through reciprocal crosses) through artificial feeding with citrated rabbit blood, to which the TcI 0354 strain of T. cruzi had been added. The insects were weighed before and after feeding on the rabbit blood, and then they were dissected on the 10th, 20th, and 30th day after infection. Both the hybrids and the parentals remained infected throughout the experiment. The parasite was mostly found in the epimastigote form. The number of epimastigotes was significantly lower in the stomach and small intestine of T. juazeirensis than in the hybrids or in T. b. brasiliensis. A significantly higher percentage of metacyclic trypomastigotes was detected in the small intestine and rectum of the hybrids. Hybrids demonstrated higher susceptibility to the TcI 0354 strain than their parentals, opening up new avenues to be investigated.

Unraveling the Sexual Dimorphism of First Instar Nymphs of the Giant Stick Insect, Cladomorphus phyllinus Gray, 1835, from the Atlantic Forest, Brazil.

The first instar nymphs, both male and female, of the giant stick insect Cladomorphus phyllinus Gray, 1835 were carefully described and measured, revealing a remarkable sexual dimorphism that is considered rare among insects and is poorly explored in the order Phasmida. The studied F1 nymphs originated in captivity from eggs laid by a coupled female specimen collected in the Atlantic Forest in the vicinity of Petrópolis city, state of Rio de Janeiro, Brazil. The first instar nymphs of C. phyllinus were measured and illustrated in high-resolution photographs to show the general aspects and details of sexually dimorphic traits, making clear the phenotypic differences in the sexes. A total of 100 nymphs were kept alive until morphological sexual dimorphism was confirmed and quantified. All recently hatched first instar nymphs were separated based on the presumed male and female characteristics, i.e., the presence and absence of the suture in the metanotum in the males and females, respectively, had their sexes confirmed in 100% of the specimens as previously assigned. These results confirm this new morphological trait, which here is named "alar suture" as sex-specific in the first instar nymphs, a novelty in this stage of development of sexual differentiation. In addition, the distinct conformations of the last three abdominal sternites of both sexes were recorded.

Functional Response and Parasitism rate of Trichogramma galloi Zucchi (Hymenoptera: Trichogrammatidae), a Parasitoid of Eggs of Sugarcane Borer.

The evaluation of parameters such as functional response and parasitism rates is essential for the choice and use of a control agent, which contributes to a positive or negative outcome of Biological Control. Diatraea saccharalis (Fabricius, 1794) (Lepidoptera: Crambidae), commonly called sugarcane borer, is the main pest of the sugarcane crop and its management can be done by the parasitoid Trichogramma galloi Zucchi, 1988 (Hymenoptera: Trichogrammatidae), which attacks the egg stage of the pest before damage is done to the crop. To better understand this host/parasitoid relationship, the functional response and parasitism rate of T. galloi in 0.4:1 and 1.6:1 (parasitoid:egg) proportions on D. saccharalis eggs were evaluated, the second proportion being carried out in clutch deposited on sugarcane leaves. Trichogramma galloi presented a type II functional response, common among the parasitoids of the Trichogrammatidae family. Although the rate of parasitism on sugarcane borer eggs ranged from 43.36 to 53.77%, there was no significant difference between the evaluated proportions, 0.4:1 and 1.6:1 (parasitoid/egg).

Refuge distributions and landscape connectivity affect host-parasitoid dynamics: Motivations for biological control in agroecosystems.

Species distributions are affected by landscape structure at different spatial scales. Here we study how the interplay between dispersal at different spatial scales and landscape connectivity and composition affect local species dynamics. Using a host-parasitoid model, we assessed host density and host occupancy on the landscape, under different parasitoid dispersal ranges and three local distributions of non-crop habitats, areas where hosts are unable to grow but parasitoids are provided with alternative hosts and food resources. Our results show distinct responses of host density to increases in non-crop area, measured by differences in slopes for different distributions of non-crop habitats, and that the effect of local landscape composition on species dynamics depends on the landscape connectivity at the regional scale. Moreover, we show how host density and occupancy are affected by increasing parasitoid dispersal ranges depending on landscape structure. Our results demonstrate the role of local and regional scales on species distributions and the importance of the combined effects of species biological parameters and landscape structure on species dynamics. Finally, we highlight the relevance of these aspects for the development of better strategies of biological control.

"Avançado" ou "precipitado"? Sobre o Modelo de Acesso Avançado/Aberto na Atenção Primária à Saúde / "Advanced" or "precipitate"? About the Advanced/Open Access Model in Primary Health Care / ¿"Avanzado" o "apresurado"? Sobre el Modelo de Acceso Avanzado/Abierto en Atención Primaria de Salud

Resumo O modelo de Acesso Avançado ou Aberto (Advanced/Open Access) vem sendo estimulado por gestores e valorizado pela medicina de família e comunidade brasileira como modelo de gestão da clínica na Equipe de Saúde da Família. Este artigo de revisão integrativa discute como essa tecnologia pode qualificar ou prejudicar a Atenção Primária à Saúde. Embora ajude a promover mudanças necessárias em agendas tradicionalmente voltadas para ações programáticas, o modelo tem um forte viés gerencialista. Ao desconsiderar premissas básicas, sua implantação pode resultar em sofrimento do profissional e em sua alienação perante o território e o cuidado integral em saúde, além de reforçar o modelo biomédico e a medicalização social. Apontamos caminhos para que 'avançado' não signifique 'precipitado', destacando que uma implantação com base no diálogo entre trabalhadores, gestores e usuários parece mais coerente com a própria literatura sobre Acesso Avançado e com a produção nacional sobre Acolhimento no Sistema Único de Saúde.

Abstract The Advanced/Open Access model has been encouraged by managers and valued by Brazilian family and community medicine as a model of clinical management in the Family Health Team. This integrative review article discusses how this technology can qualify or hinder Primary Health Care. Although it helps to promote necessary changes in agendas traditionally focused on programmatic actions, the model has a strong managerialist bias. By disregarding basic premises, its implementation may result in professional suffering and alienation from the territory and integral health care, besides reinforcing the biomedical model and social medicalization. We point out ways for 'advanced' not to mean 'precipitate', highlighting that an implementation based on dialogue among workers, managers, and users seems more coherent with the literature on Advanced Access and with the national production on Welcoming in the Unified Health System.

Resumen El modelo de Acceso Avanzado o Abierto (Advanced/Open Access) ha sido estimulado por los gestores y valorado por la medicina de familia y por la comunidad brasileña como modelo de gestión de la clínica en el Equipo de Salud de la Familia. Este artículo de revisión integradora analiza cómo esta tecnología puede calificar o perjudicar la Atención Primaria de Salud. Si bien ayuda a promover cambios necesarios en agendas tradicionalmente enfocadas en acciones programáticas, el modelo tiene un fuerte sesgo administrativista. Al desconocer premisas básicas, su implementación puede resultar en sufrimiento del profesional y en su alienación ante el territorio y del cuidado integral en salud, además de reforzar el modelo biomédico y la medicalización social. Señalamos caminos para que 'avanzado' no signifique 'apresurado', destacando que una implementación basada en el diálogo entre trabajadores, gestores y usuarios parece más coherente con la literatura sobre Acceso Avanzado y con la producción nacional sobre Acogida en el Sistema Único de Salud.

Cheating interactions favor modularity in mutualistic networks / Las interacciones de engaño favorecen la modularidad en las redes mutualistas / Interações de trapaceiros favorece modularidade em redes de mutualismos

A fundamental fact about mutualisms is they are often explored by species that explore resources and services provided by individuals without providing any benefit. The role of these cheaters on the evolutionary dynamics of mutualisms has long been recognized, but cheaters may not only affect the species they explore. Because mutualisms form networks that often involve dozens to hundreds of species in a given site, indirect effects generated by cheaters may cascade through the network, reshaping trait evolution. Here, we study how harboring cheating interactions can influence coevolution in mutualistic networks. We combine a coevolutionary model, data on empirical networks of mutualisms, and numerical simulations to show that the higher frequency of cheating interactions can lead to the formation of groups of species phenotypically similar to each other but distinct from other groups of species, leading to higher trait disparity. The clustered trait patterns generated by cheaters, in turn, change the patterns of interaction in simulated networks, fostering the formation of modules of interacting species. Our results indicate that cheaters of mutualisms can contribute to generate phenotypic clusters in mutualisms, counteracting selection for convergence imposed by mutualistic patterns, and favoring the emergence of modules of interacting species.

Un hecho fundamental sobre los mutualismos es que muchas veces son explorados por especies que exploran recursos y servicios proporcionados por individuos sin proporcionar ningún beneficio. El papel de estos tramposos en la dinámica evolutiva de los mutualismos se ha reconocido desde hace mucho tiempo, pero es posible que los tramposos no solo afecten a las especies que exploran. Debido a que los mutualismos forman redes que muchas veces involucran decenas a cientos de especies en un sitio determinado, los efectos indirectos generados por los tramposos pueden caer en cascada a través de la red, remodelando la evolución de los rasgos. Aquí, estudiamos cómo albergar interacciones de engaño puede influir en la coevolución en redes mutualistas. Combinamos un modelo coevolutivo, datos sobre redes empíricas de mutualismos y simulaciones numéricas para mostrar que la mayor frecuencia de interacciones engañosas puede conducir a la formación de grupos de especies fenotípicamente similares entre sí pero distintos de otros grupos de especies, lo que conduce a mayores disparidad de rasgos. Los patrones de rasgos agrupados generados por los tramposos, a su vez, cambian los patrones de interacción en redes simuladas, fomentando la formación de módulos de especies que interactúan. Nuestros resultados indican que los tramposos de los mutualismos pueden contribuir a generar agrupaciones fenotípicas en mutualismos, contrarrestando la selección por convergencia impuesta por patrones mutualistas y favoreciendo la aparición de módulos de especies interactuantes.

Um fato fundamental sobre os mutualismos é que eles são frequentemente explorados por espécies que exploram recursos e serviços fornecidos por indivíduos sem fornecer qualquer benefício. O papel desses trapaceiros na dinâmica evolutiva dos mutualismos foi reconhecido há muito tempo, mas os trapaceiros podem não apenas afetar as espécies que exploram. Como os mutualismos formam redes que geralmente envolvem dezenas a centenas de espécies em um determinado local, os efeitos indiretos gerados por trapaceiros podem se espalhar pela rede, remodelando a evolução de características. Aqui, estudamos como considerar interações de trapaça pode influenciar a coevolução em redes mutualísticas. Combinamos um modelo coevolucionário, dados sobre redes empíricas de mutualismos e simulações numéricas para mostrar que a maior frequência de interações de trapaça pode levar à formação de grupos de espécies fenotipicamente semelhantes entre si, mas distintos de outros grupos de espécies, levando a disparidade de traço. Os padrões de características agrupados gerados por trapaceiros, por sua vez, alteram os padrões de interação em redes simuladas, promovendo a formação de módulos de espécies em interação. Nossos resultados indicam que trapaceiros de mutualismos podem contribuir para gerar grupos fenotípicos em mutualismos, contrariando a seleção para convergência imposta por padrões mutualísticos e favorecendo o surgimento de módulos de espécies interagentes.

Liderança feminina: relato do primeiro encontro de mulheres Médicas de Família e Comunidade do Brasil / Women leadership: report of the first meeting of Female Family Physicians in Brazil

RESUMO Este relato situa-se no campo do protagonismo das mulheres Médicas de Família e Comunidade (mMFC) e em sua articulação nacional por meio do Grupo de Trabalho Mulheres na Medicina de Família e Comunidade (GT-MMF), fundado em 2016 no bojo da Sociedade de Medicina de Família e Comunidade (SBMFC), entidade científica que representa a especialidade no País. Descreve a organização do I Encontro do GT-MMFC, em 2019, intitulado 'Liderança feminina em saúde' e discute seus desdobramentos, com foco na equidade de gênero nos domínios: profissional, acadêmico, de gestão, de ensino e pesquisa; assim como na própria instituição, a SBMFC. O artigo se debruça, ainda, sobre questões relacionadas com as causas de mulheres no âmbito da especialidade e da medicina. O evento foi aberto a estudantes e profissionais de outras áreas e ofertou discussões contemporâneas, como: protagonismo feminino; autocuidado; interseccionalidades; maternidade e trabalho; inserção da mulher e diferenças de gênero na política. O Encontro reuniu mulheres de quatro regiões do Brasil, aprofundou as relações e o apoio interpares e permitiu a ampliação das pautas para o fortalecimento da consciência de gênero e sua influência no cotidiano das mMFC, na sua prática acadêmica, científica, assistencial e de gestão.

ABSTRACT This report is situated in the scope of Female Family Physicians' protagonism and their national organization through the Women's Working Group on Family and Community Medicine, which was founded in 2016 under the Brazilian Society of Family and Community Medicine, a scientific entity that represents this medical specialty in the country. It describes the organization of the first Meeting of this Working Group, in 2019, named 'Female Leadership in Health' and discusses its unfoldings, focusing on gender equity in spheres such as: professional, academic, management, educational, and research, as well as permeating the institution itself. This article also focuses on women's issues surrounding both the specialty and medicine in general. The event welcomed students and professionals from other fields and offered contemporary debates, for example: female protagonism, self-care, intersectionality, maternity and work, participation of women in politics, and gender inequities. The Meeting gathered women from four regions of Brazil, deepened peer bonds and support, and enabled the expansion of the agenda of gender consciousness and its influence in women family physicians' daily life in their experience in management, university, science, and assistance.

Potencialidades e limitações da visita domiciliar realizada por estudantes de medicina na disciplina de Saúde da Família e Comunidade / Potentialities and limitations of the home visit performed by students of medicine in the course of Family and Community Health

Foram analisadas experiências vivenciadas nas visitas domiciliares realizadas pelos estudantes de Medicina, com objetivo de identificar e discutir as potencialidades e as limitações dessas. A partir disso, são descritas e avaliadas crítica e qualitativamente tais experiências, a fim de demonstrar a sua contribuição na área de atuação. O estudo teve como base a análise temática dos portfólios realizados por estudantes que cursavam a disciplina Saúde da Família e Comunidade, entre agosto de 2015 e outubro de 2016, e que, no presente, são membros da Liga Acadêmica de Atenção Básica à Saúde (LAABS). Diante de tais análises, destacam-se como potencialidades a importância do trabalho em equipe, aproximação entre profissional de saúde e a realidade do paciente, avaliação da situação de saúde e das condições de vida da população, além do desenvolvimento de vínculos com a população, o que facilita a continuidade do cuidado. Por outro lado, o pouco tempo disponível para a visita, o horário inadequado escolhido em algumas situações e a frustração quando o estudante não percebia adesão instantânea à mudança do estilo de vida pelo paciente foram algumas das limitações encontradas. Por fim, diante do exposto, embora a visita domiciliar apresente limitações, as potencialidades superam, visto que por auxiliar concretamente na melhoria da relação médico paciente, ela torna possível a realização de um trabalho contínuo e que propicia um melhor seguimento com a população.

Medical students' practices experienced in home visits were analyzed, aiming to identify and to discuss their potentialities and limitations. From this, these experiences are described and evaluated critically and qualitatively, in order to demonstrate their contribution in the area of performance. The study was based on the thematic analysis of the portfolios carried out by students who attended the Family and Community Health course, between August 2015 and October 2016, and who are currently members of the Academic League for Basic Health Care (ALBHC). Faced with such analyzes, the potentialities and the importance of teamwork are highlighted. as well as the approximation between health professional and patient reality; the evaluation of the health situation and the living conditions of the population and the development of ties with the population, which facilitates the continuity of care. On the other hand, some of the limitations were found like short time available for the visit; the inappropriate time chosen in some situations; the frustration when the student did not notice instant adherence to the lifestyle change by the patient. Finally, as described above, although the home visit presents limitations, the potentialities outweigh them, since they help concretely in the improvement of the patient-doctor relationship, which makes possible the accomplishment of a continuous work and allows a better follow-up with the population.

Dynamics of food sources, ecotypic distribution and Trypanosoma cruzi infection in Triatoma brasiliensis from the northeast of Brazil.

Innovative approaches used to combat Chagas disease transmission tend to combine a set of comprehensive efforts to understand the ecology of local vectors. In this work we identified molecularly the blood meal of 181 Triatoma brasiliensis, distributed in 18 populations (8 sylvatic and 10 peridomestic), which were collected across a range of 240 km (East-West) and 95 km (North-South) in the semi-arid region of northeastern, Brazil. We used the vertebrate mitochondrial gene (cytochrome B) sequencing applied to DNA isolated from bug midgut to identify the insect blood meal sources via the BLAST procedure. The peridomestic populations were classified according to two main hypotheses of site-occupancy for T. brasiliensis: the first says that the infestation is mainly driven by structures that resemble its natural habitat (stony-like ecotopes) and the second assumes that it is associated with key-hosts (rodents and goats). Rodents of the Caviidae family (Galea spixii and Kerodon rupestris) were identified as the key-host of T. brasiliensis, but also the potential Trypanosoma cruzi reservoir-able to connect the sylvatic and domestic T. cruzi cycle. Cats also deserve to be studied better, as potential T. cruzi reservoirs. By modeling the food sources + site-occupancy + T. cruzi natural infection, we identified man-made ecotopes suitable for forming dense triatomine infestations with high rates of T. cruzi natural infection, which may be taken into account for vector control measures.

A generalized transition model for grouped longitudinal categorical data.

Transition models are an important framework that can be used to model longitudinal categorical data. They are particularly useful when the primary interest is in prediction. The available methods for this class of models are suitable for the cases in which responses are recorded individually over time. However, in many areas, it is common for categorical data to be recorded as groups, that is, different categories with a number of individuals in each. As motivation we consider a study in insect movement and another in pig behaviou. The first study was developed to understand the movement patterns of female adults of Diaphorina citri, a pest of citrus plantations. The second study investigated how hogs behaved under the influence of environmental enrichment. In both studies, the number of individuals in different response categories was observed over time. We propose a new framework for considering the time dependence in the linear predictor of a generalized logit transition model using a quantitative response, corresponding to the number of individuals in each category. We use maximum likelihood estimation and present the results of the fitted models under stationarity and non-stationarity assumptions, and use recently proposed tests to assess non-stationarity. We evaluated the performance of the proposed model using simulation studies under different scenarios, and concluded that our modeling framework represents a flexible alternative to analyze grouped longitudinal categorical data.

O uso do SUS como estigma: a visão de uma classe média / The use of SUS as a stigma and a threat to life: the vision of a middle class

Resumo Acesso é um conceito central para a efetivação da universalidade do SUS, mas pouco valorizado nas publicações oficiais do Ministério da Saúde. Talvez por isso, o acesso no SUS ainda seja visto como excludente. Desde a implantação da Estratégia Saúde da Família, houve importante melhora no acesso percebido pelos usuários, embora as classes médias permaneçam excluídas do SUS, atraídas pela compra de planos de saúde privados. Esse fenômeno foi observado no território de uma equipe de Saúde da Família do bairro do Grajaú, cidade do Rio de Janeiro, tradicionalmente de classe média, cujos moradores sistematicamente recusavam cadastro e acompanhamento pela equipe. O trabalho teve o objetivo de levantar e analisar as narrativas de recusa desses indivíduos, através de análise temática e de conteúdo. Percebeu-se um estigma associado ao uso do SUS e seus profissionais, e maior confiança na compra do serviço de saúde, justificada pelo medo da falta de leitos para internação e atendimento de emergência. Além disso, as entrevistadas não se apropriaram do SUS como direito. O Brasil atravessa grave crise política, e o SUS, que sempre resistiu sob ameaça, corre ainda maior risco. É necessário que a população possa enxergar um SUS que funciona e apropriar-se dele.

Abstract Access is a central concept for achieving the universality of SUS, but little valued in the official publications of the Ministry of Health. Perhaps because of this, access in the SUS is still seen as excluding. Since the implementation of the Family Health Strategy, there has been an important improvement in perceived access by users, although the middle classes remain excluded from SUS, attracted by the purchase of private health insurance plans. This phenomenon was observed in the territory of a Family Health team in the Grajaú neighborhood, Rio de Janeiro, traditionally middle class, whose residents systematically refused registration and follow up by the team. This paper aimed to analyze the narratives of refusal of these individuals, through thematic and content analysis. It was noticed a stigma associated to the use of SUS and its professionals, and greater confidence in the purchase of the health service, justified by the fear of the lack of beds for hospitalization and emergency care. In addition, the interviewees did not appropriate SUS as a right. Brazil is under serious political crisis and the SUS, which has always resisted under threat, is even more at risk. It is necessary that the population can see a functioning SUS and take ownership of it.

Repensando acesso, qualificando o cuidado: relato do trabalho em duas equipes de saúde da família / Rethinking access, qualifying care: a report of the work in two family health care teams / Repensar el acceso, mejorar la atención: un informe del trabajo en dos equipos de atención primaria

Em março de 2015, a residência em medicina de família e comunidade foi incorporada a duas equipes de um centro de saúde: uma com população vulnerável e grande rotatividade de médicos, e outra com população principalmente da classe média. Após três meses, percebemos que os profissionais estavam sobrecarregados na maioria dos turnos de atendimento, não tinham horário de almoço e saíam da unidade após o fechamento. Na avaliação 360° pela preceptora, os pacientes aprovavam o atendimento, mas reclamavam do tempo de espera para a consulta. O objetivo foi reavaliar o processo de trabalho e melhorar a satisfação dos pacientes e profissionais. Para tal, levantamos os nós críticos nas agendas diárias e adaptamos a capacidade das agendas às necessidades das populações, e optamos pelo acesso avançado, além de outros acordos entre a equipe para organizar a demanda. Toda a equipe participou do processo de planejamento e incorporação das ações. Logo nas primeiras duas semanas, os profissionais perceberam diminuição na sobrecarga de trabalho. Nossos próximos passos são aumentar participação popular e melhorar vigilância sobre a população, evitando a lei de cuidados inversos.

En marzo del 2015, la residencia en medicina familiar se ha unido a dos equipos de un centro de salud: uno equipo con una población vulnerable y una alta rotación de médicos, e otro con una población mayoritariamente de la clase media. Después de tres meses, nos dimos cuenta de que los profesionales estaban sobrecargados en la mayoría de los turnos de servicio, sin la hora del almuerzo y dejaban la clínica después del cierre. En la evaluación de 360° por la preceptora, los pacientes aprobaron la atención médica, pero se quejaron del tiempo de espera para la consulta. El objetivo era volver a evaluar el proceso de trabajo y mejorar la satisfacción de los pacientes y de los profesionales. Para ello, analizamos los nodos críticos en los horarios diarios para adaptar la capacidad de los programas a las necesidades de la población, y optamos por el acceso avanzado, además de otros acuerdos entre el personal para organizar la demanda. Todo el equipo participó en la planificación y el proceso de incorporación de acciones. Durante las dos primeras semanas, los médicos se dieron cuenta de la disminución de la carga de trabajo. Nuestros próximos pasos son aumentar la participación popular y mejorar la vigilancia de la población, evitando la ley de atención inversa.

In March 2015, the residence in family medicine was incorporated into two teams at a health center: one which has existed for eight years, attends a vulnerable population and has a high turnover of doctors, and another with a population mostly from middle class. After three months, we observed that professionals were overwhelmed in most service shifts, had no lunch break, and left after closing time. At the 360 review conducted by the preceptor, patients approved the consultations with residents, but complained of the waiting time. Our objective was to re-evaluate the work process and improve the satisfaction of patients and professionals. To this end, we studied each team, determined the key critical nodes in daily schedules, adapted the capacity of the teams to the needs of the populations, and opted for advanced access, in addition to other agreements between the staff to organize and optimize service. The whole team participated in planning and implementing these actions. During the first two weeks, practitioners were able to take their lunch breaks, leaving the center on time, and there was an increase in satisfaction. For our next step, we intend to raise popular participation and avoid the inverse care law by searching actively for patients who do not attend the clinic.

Laboratory Performance Predicts the Success of Field Releases in Inbred Lines of the Egg Parasitoid Trichogramma pretiosum (Hymenoptera: Trichogrammatidae).

In this study we assessed the relationship between the laboratory and field performance of different isofemale lines of Trichogramma pretiosum Riley. In comparative assays, we used three rare mitochondrial haplotypes as genetic markers of the isofemale lines, and by introgressing these mitochondrial haplotypes into each of 15 genetically different nuclear lines, also tested the assumption that mitochondria are neutral markers. In a laboratory trial, 45 isofemale lines (15 nuclear genotypes x three mitochondrial haplotypes) were ranked in three categories (best, intermediate and worst) according to the mean offspring production and the proportion of female offspring. Subsequently, lines from each of the three categories were selected for field releases to quantify field parasitism on Ephestia kuehniella. Temporally separate releases were done in a transgenic Bt cornfield, with four plots, each with 50 points of recapture. The points of recapture consisted of trap cards with eggs of E. kuehniella collected daily. The trap cards were maintained in the laboratory at 25°C until the adult wasps emerged, and the maternal identity of the wasps was determined using qPCR and high-resolution melt curve analysis to determine the mitochondrial haplotype. The results showed that these measures of laboratory performance (fecundity and offspring sex ratio) were good predictors of field success in T. pretiosum. We also report strong evidence discrediting the assumption that mitochondria are neutral, in view of the correlation between performance and mitochondrial haplotype.

Comunicação e percepções sobre saúde: o olhar dos usuários na estratégia saúde da família / Communication and perceptions of health: the point of view of patients in the family health strategy

A comunicação, em sua essência polissêmica, aciona sentidos diversos para usuários e profissionais de saúde, especialmente nas concepções que envolvem saúde, cuidado e processo de trabalho. O objetivo deste artigo é o de analisar a percepção de usuários de uma favela do município do Rio de Janeiro sobre o conceito de saúde e processo de trabalho ofertado pela equipe da Estratégia Saúde da Família localizada na mesma. Trata-se de um estudo qualitativo de abordagem sócioantropológica que utilizou entrevistas semiestruturadas com os usuários adscritos. Percebeuse que a disparidade entre as concepções abordadas movimentaram implicações diretas no processo de trabalho da equipe, gerando entre a população e os profissionais de saúde menos potência e mais desencontro.

Communication, in a polysemic aim, has engaged several meanings to users and healthcare professionals, especially in issues that involves health, care and work process. The objective of this article is to analyze the perception of slum dwellers patients at Rio de Janeiro on the concept of health and work process offered by the Family Health Strategy team responsible by them. This is a socio-anthropological approach qualitative study which applied semi-structured interviews in the patients. It was noticed that the difference between the concepts addressed had direct implications at the work process, culminating in less power and more disagreement between the population and healthcare professionals.

Metapopulation dynamics on ephemeral patches.

A challenge for conservation management is to understand how population and habitat dynamics interact to affect species persistence. In real landscapes, timing and duration of disturbances can vary, and species' responses to habitat changes will depend on how timing of dispersal and reproduction events relate to the landscape temporal structure. For instance, increasing disturbance frequency may promote extinction of species that are unable to appropriately time their reproduction in an ever-changing habitat and favor species that are able to track habitat changes. We developed a mathematical model to compare the effects of pulsed dispersal, initiated by shifts in habitat quality, with temporally continuous dispersal. We tested the effects of habitat (and population) turnover rates on metapopulation establishment, persistence, and long-term patch occupancy. Pulsed dispersal reduced patch occupancy and metapopulation longevity when habitat patches are relatively permanent. In such cases, demographic extinction was the primary form of local extinction. Conversely, when habitat patches are short-lived and new ones are frequently formed, pulsed dispersal promoted rapid colonization, increased occupancy, and prolonged metapopulation persistence. Our results show that species responsiveness to habitat disturbance is critical to metapopulation persistence, having profound implications for the species likely to persist in landscapes with altered disturbance regimes.

Does active Crohn's disease have decreased intestinal antioxidant capacity?

BACKGROUND AND AIMS: Oxidative stress is presumed to play an important role in Crohn's disease (CD) pathogenesis. Nevertheless, the evaluation of the intestinal antioxidant capacity through the analysis of glutathione peroxidase activity in CD remains to be determined. METHODS: 20 CD outpatients and 16 volunteers going through colonic cancer screening were enrolled. Colonoscopy with biopsies was performed in all individuals. Samples from inflamed and non-inflamed mucosa were taken when there was CD endoscopic activity. Spectrophotometric assays were performed to measure tissue glutathione peroxidase (GPx) activity, and total (GSHT) and oxidized (GSSG) glutathione in all samples. Demographics and clinical characteristics were collected from clinical charts. RESULTS: Inflamed CD mucosa presented reduced GPx activity compared to non-inflamed CD mucosa (42.94mU/mg protein vs 79.62mU/mg protein, P<0.05) and control mucosa (42.94mU/mg protein vs 95.08mU/mg protein, P<0.001). GSHT concentration was reduced in inflamed mucosa when compared to non-inflamed CD mucosa (0.78µmol/g vs 1.98µmol/g, P<0.01) and the control group (0.78µmol/g vs 2.11µmol/g, P<0.001). A significant correlation was detected between GPx activity and GSSG (r=-0.599), disease duration (r=0.546), and thiopurine treatment (r=-0.480) in non-inflamed CD mucosa. CONCLUSION: Our findings suggest that reduced GPx activity is present in inflamed CD mucosa. In addition, endoscopic activity, disease duration and thiopurine therapy could be associated with mucosal decreased antioxidant activity.

Survival of submerged blowfly species and their parasitoids: implications for postmortem submersion interval.

Pupal survival of three blowfly species, Chrysomya albiceps, Chrysomya megacephala, and Chrysomya putoria (Diptera: Calliphoridae) and the parasitoid species Nasonia vitripennis (Hymenoptera: Pteromalidae) was studied after the pupae were experimentally submerged in water. Non-parasitized pupae at different developmental stages, 0, 24, 48, and 72 h, and parasitized pupae after 3, 8, 10, and 12 days of development were submerged for 6, 24, 48, or 72 h. Control groups for each pupal developmental stage (parasitized or not), which were not submerged, were also observed in order to compare the adult emergence rates. The survival of white pupae (0 h/age) decreased with time of submergence for all three blowfly species, showing the lowest rates compared with other experimental pupa groups. For the three blowfly species, non-parasitized pupae at 24 and 48 h of age showed survival rates above 60%. However, for pupae at 72 h of age, the survival rates decreased with increased underwater time, with less than 30% survival after 72 h in C. putoria and C. albiceps. The survival of parasitoids inside blowfly pupae that were submerged during their larval stage (3 days/age) decreased with the increase of submergence time. After the parasitoids reached the pre-pupal life stage, the survival was higher for all underwater periods. These observations can be useful in investigations of the decomposition of partially submerged bodies, or in cases of pupae found adhering to decaying flesh, hair, or clothes of corpses that were submerged after the larvae had developed and pupated.

Seasonal fecundity and body size in Chrysomya megacephala (Fabricius) (Diptera: Calliphoridae)

In this study the seasonal variation of fecundity, wing and tibia size was investigated in natural populations of Chrysomya megacephala (Fabricius) aiming at determining the variations in life history of the species as a function of seasonality. A relative constant temporal trajectory was found for fecundity, wing and tibia size over twelve months. Strong positive correlations between wing size and temperature, tibia size and temperature and between wing and tibia sizes were observed. The implications of the results for population dynamics of C. megacephala were discussed.

Neste estudo a variação sazonal da fecundidade, tamanhos de asa e tíbia, foi investigada em populações naturais de Chrysomya megacephala (Fabricius) a fim de determinar variações nas características bionômicas da espécie em função da sazonalidade. Uma trajetória temporal relativamente constante foi encontrada para fecundidade, tamanhos de asa e tíbia durante doze meses. Correlações positivas e significativas entre tamanho da asa e temperatura, tamanho da tíbia e temperatura e tamanhos da asa e tíbia foram observadas. As implicações desses resultados para a dinâmica populacional de C. megacephala foram discutidas.