A territorialidade da Atenção Básica à Saúde do SUS: a difusão das clínicas médicas populares na Região Metropolitana de Belém, Pará, Brasil / The territorial nature of the Primary Health Care of Brazil's Unified Health System (SUS): the proliferation of community medical clinics in the Metropolitan Region of Belém, State of Pará, Brazil

Resumo O artigo apresenta uma análise sobre a difusão das clínicas médicas populares nos municípios que compõem a Região Metropolitana de Belém (RMB). Com o propósito de compreender as razões e as origens do avanço do setor de saúde popular, promoveu-se uma investigação sobre a atuação da rede de atenção básica à saúde (ABS) do Sistema Único de Saúde (SUS). A discussão se fundamenta na revisão de dados primários e secundários, captados via trabalho de campo nas 119 clínicas populares da RMB e via informações do DATASUS. Constatou-se que o setor das clínicas de saúde popular foi beneficiado amplamente nos últimos anos, mediante a intensificação do subfinanciamento do SUS, em particular da rede de ABS, que passa por um processo de fragmentação, responsáveis pela redução e pela desarticulação das equipes multiprofissionais de ABS, além das perdas apresentadas no setor de saúde suplementar. As clínicas populares seguem um modelo assistencial inacabado e contraditório, criado pela própria iniciativa privada para o preenchimento da demanda reprimida do SUS em razão de o acesso a essas instituições não garantir uma assistência universal e gratuita ou assegurar um tratamento continuo, motivo pelo qual uma ampla parcela destes usuários é devolvida ao SUS.

Abstract The scope of this article is an analysis of the proliferation of community medical clinics in the municipalities that comprise the Metropolitan Region of Belem. An investigation was conducted into the performance of the primary health care network of Brazil's Unified Health System, with a view to getting a better understanding of the reasons for, and origins of, the proactive stance of the community health sector. The discussion is based on the review of primary and secondary data, obtained via fieldwork in 119 community clinics in the Metropolitan Region of Belem, and information from Brazil's Unified Health System data center. It was revealed that the community health clinic sector has benefited extensively in recent years from the intensification of underfunding of Brazil's Unified Health System, especially the primary health care network, which is undergoing a process of fragmentation. This is directly responsible for the reduction and disruption of multiprofessional primary health care teams, in addition to the losses suffered in the supplementary health sector. The community clinics adopt an spontaneous and contradictory care model created by the private sector to meet the repressed demand of Brazil's Unified Health System

Changes in the seroprevalence and risk factors between the first and second waves of COVID-19 in a metropolis in the Brazilian Amazon.

In Brazil, the coronavirus disease 2019 (COVID-19) epidemic spread rapidly in a heterogeneous way, mainly due to the different socioeconomic and behavioral characteristics of different regional populations and different evaluation periods. We performed a cross-sectional study including 1,337 individuals (first wave = 736/second wave = 601) after the first two waves of COVID-19 in the city of Belém, the capital of the state of Pará. The detection of IgG anti-SARS-CoV-2 antibodies was performed using an enzyme-linked immunosorbent assay test followed by statistical analysis using the RStudio program. Our results showed an increase in the seroprevalence (first wave= 39.1%/second wave= 50.1%) of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibodies in the population of Belém from the first to the second pandemic wave. Advanced age, primary or secondary education level, lack of social isolation, and a low frequency of protective mask use were considered risk factors for SARS-CoV-2 infection during the first wave compared to the second wave. This study is one of the firsts to provide important information about the dynamics of virus circulation and the groups vulnerable to exposure in the two major periods. Our data emphasize the socioeconomic characteristics of the affected population and that nonpharmacological prevention measures are crucial for combating the pandemic.

The Global Report on Adult Learning and Education (GRALE): Strengths, weaknesses and future directions.

One of the core outcomes of the Sixth International Conference on Adult Education (CONFINTEA VI) held in 2009 was the Belém Framework for Action (BFA). Its signatories committed to monitoring the most recent development stages of adult learning and education (ALE) worldwide on a regular basis, and to present and assess results in a global report. Coordinated by the UNESCO Institute for Lifelong Learning, surveys have been conducted and documented in four GRALE reports over the past decade. A fifth report is currently being prepared for CONFINTEA VII, to be held in June 2022. This article critically analyses the project of compiling a Global Report on Adult Learning and Education (GRALE) at roughly three-year intervals. Drawing on an evaluative framework for research quality developed by Pär Mårtensson and colleagues, the authors of this article investigate to what extent the GRALE approach to monitoring and reporting on ALE so far has been (1) credible (e.g. based on rigorous research methodologies and methods); (2) contributory (e.g. relevant and applicable to practice, generalisable); (3) communicable (e.g. accessible, understandable and readable in terms of report structure); and (4) conforming (e.g. with ethical standards). The purpose of this evaluation is for it to serve as a contribution to enhancing the quality of monitoring approaches in the field of ALE. This is vital for working towards future directions of ALE which are shaped by a high-quality evidence base. Ultimately, this will not only make ALE more accessible, fair, diverse and effective, but will also add to insights on how to achieve the Sustainable Development Goals in a similar way, especially since ALE indirectly but fundamentally affects the success of all 17 goals.

Le Rapport mondial sur l'apprentissage et l'éducation des adultes (GRALE) : points forts, points faibles et orientations futures ­ Le Cadre d'action de Belém est l'un des aboutissements principaux de la sixième Conférence internationale sur l'éducation des adultes (CONFINTEA VI) organisée en 2009. Ses signataires s'étaient engagés à procéder régulièrement au suivi des toutes dernières évolutions de l'apprentissage et de l'éducation des adultes (AEA) dans le monde entier, et à présenter et évaluer les résultats obtenus dans un rapport mondial. Des études, coordonnées par l'Institut de l'UNESCO pour l'apprentissage tout au long de la vie (UIL), ont été menées et présentées dans quatre GRALE ces dix dernières années. Un cinquième rapport est en préparation pour la CONFINTEA VII qui se tiendra en juin 2022. Cet article procède à une analyse critique du projet qui consiste à rédiger un Rapport mondial sur l'apprentissage et l'éducation des adultes (GRALE) environ tous les trois ans. S'appuyant sur un cadre d'évaluation de la qualité de la recherche développé par Pär Mårtensson et collègues, les auteurs du présent article examinent dans quelle mesure, pour procéder au suivi de l'apprentissage et de l'éducation des adultes et à la rédaction de rapports sur ce thème, l'approche du GRALE a été jusqu'à présent (1) crédible (p. ex. en s'appuyant sur des méthodes et procédés de recherche rigoureux) ; (2) contributive (c'est-à-dire qu'elle a joué un rôle, p. ex. en étant pertinente et praticable, généralisable) ; (3) communicable (p. ex. en étant accessible, compréhensible et lisible en tant que rapport) et (4) conforme (p. ex. aux normes éthiques). Cette évaluation a pour objet de contribuer à améliorer la qualité des approches de suivi dans le domaine de l'apprentissage et de l'éducation des adultes, ce qui est crucial pour œuvrer en vue de donner à l'AEA des orientations futures reposant sur un socle de preuves fondées. Enfin, cela rendra non seulement l'apprentissage et l'éducation des adultes plus accessibles, justes, divers et efficaces, mais cela fournira aussi des idées supplémentaires pour atteindre de la même manière les Objectifs de développement durable, du fait notamment que l'apprentissage et l'éducation des adultes influent, certes indirectement mais de façon fondamentale, sur l'atteinte des 17 objectifs.

The Relevance of a Diagnostic and Counseling Service for People Living With HTLV-1/2 in a Metropolis of the Brazilian Amazon.

Introduction: To identify the prevalence of infection in the urban area of the capital city of Belém, Brazil, the Laboratory of Virology of the Federal University of Pará implemented, as a public service, serological screening for human T-lymphotropic viruses 1 and 2 (HTLV-1/2) infection and, if necessary, counseling service and referral to specialized medical care. The project is funded by the National Council of Science and Technology, the Ministry of Health of Brazil and the Pan American Health Organization. Methods: From January 2020 to June 2021, 1,572 individuals of both sexes were approached to answer a questionnaire and were tested using an enzyme immunoassay (Murex HTLV-I+II, DiaSorin, Dartford, UK). Seropositive samples were confirmed as HTLV-1 and HTLV-2 infection by line immunoassay (INNO-LIA® HTLV I/II Score, Fujirebio, Japan) and/or by real-time polymerase chain reaction. G and Fisher's exact tests were applied to identify the association between epidemiological characteristics and HTLV-1/2 infection. Results: Of the 1,572 screened individuals, 63.74% were females between the ages of 30 and 59 years (49.04%). Infection was confirmed in six individuals (0.38%), among whom three (0.19%) were infected with HTLV-1 and three with HTLV-2 (0.19%). Blood transfusion before 1993 was the main risk factor associated with the route of exposure to the virus (p = 0.0442). The infected individuals were referred to a counseling session with a nursing professional, and two patients who manifested signs and symptoms suggestive of myelopathy associated with HTLV were referred to a neurologist. Conclusion: The implementation of the screening service revealed the occurrence of moderate endemicity of HTLV-1/2 in Belém, reinforcing the importance of continuing the service as a means of establishing an early diagnosis and providing counseling as a measure to prevent and control viral transmission in the general population.

Molecular characterization of the gastrointestinal eukaryotic virome in elderly people in Belem, Para, Brazil.

Acute gastroenteritis is one of the main causes of mortality and morbidity worldwide, affecting mainly children, the immunocompromised and elderly people. Enteric viruses, especially rotavirus A, are considered important etiological agents, while long-term care facilities are considered favorable environments for the occurrence of sporadic cases and outbreaks of acute gastroenteritis. Therefore, it is important to monitor the viral agents present in nursing homes, especially because studies involving the elderly population in Brazil are scarce, resulting in a lack of available virological data. As a result, the causative agent remains unidentified in a large number of reported acute gastroenteritis cases. However, the advent of next-generation sequencing provides new opportunities for viral detection and discovery. The aim of this study was to identify the viruses that circulate among elderly people with and without acute gastroenteritis, living in residential care homes in Belém, Pará, Brazil, between 2017 and 2019. Ninety-three samples were collected and screened by immunochromatography and qPCR. After, the samples were analyzed individually or in pools by next generation sequencing to identify the viruses circulating in this population. In 26 sequenced samples, members of 13 eukaryotic virus families were identified. The most abundantly present virus families were Parvoviridae, Genomoviridae and Smacoviridae. Contigs displaying similarity to pegiviruses were also detected. Furthermore, a near-complete rotavirus A genome was obtained and could be classified as G3P[8] genotype with the equine DS-1-like genetic background. Complete sequences of the VP4 and VP7 genes of a rotavirus C were also detected, belonging to G4P[2]. This study demonstrates the first characterization of the gastrointestinal virome in elderly in Northern Brazil. A diversity of viruses was found to be present in patients with and without diarrhea, reinforcing the need to monitor elderly people residing in long-term care facilities, especially in cases of acute gastroenteritis.

A resposta à AIDS na construção do SUS em Belém do Pará: o caso da ONG Paravidda (1992-2003) / The response to AIDS in the construction of the SUS in Belém of Pará: the case of the NGO Paravidda (1992-2003)

A assistência para Aids e a implementação do Sistema Único de Saúde (SUS) aparecem na literatura como processos desconectados durante os anos 1990. Sendo assim, o objetivo do trabalho é analisar as reivindicações da ONG ­ Paravidda em relação às necessidades de saúde das pessoas com HIV em Belém (1992 ­ 2003), argumentando que esse processo a enquadra na implementação do SUS na capital paraense. Para tal, nos munimos de discussões em História das Doenças e do campo das Políticas de Saúde referentes ao SUS e Aids para considerarmos o Paravidda como integrante desse processo. A pesquisa é de base documental que, em perspectiva histórica, faz uso de documentos institucionais e literatura periódica, bem como depoimentos de atores-chave. Partindo disso, discorremos sobre a construção das bases do SUS nos anos 1980 e sua implantação no Pará na década de 1990, descrevemos as múltiplas atuações das ONGs e o Programa Nacional de Aids. Em meio a esses processos que favoreceram o campo de atuação do Paravidda e as respostas das gestões locais de saúde, a ONG e um conjunto de setores sociais articulados levavam suas necessidades aos seminários municipais de Belém, sendo os jornais Diário do Pará e O liberal os principais canais de divulgação dos debates. Além disso, o grupo utilizava destes canais para denunciar a falta de medicamentos e leitos para Aids em Belém, tornando-se um meio estratégico de chamar atenção das autoridades locais de saúde. Desta forma, o trabalho conclui que as denúncias do Paravidda através da imprensa se interligam às seguintes bases do SUS: participação social através da composição nos debates públicos à Aids em Belém; e universalidade como direito, pois a ONG buscou respostas estatais que contemplassem as suas múltiplas necessidades de saúde: ações preventivas à distribuição de medicamentos e ampliação da assistência à organização da rede

The healthcare for Aids and the implementation of the Sistema Único de Saúde (SUS) appearead disjointed in scientific literature through the 1990. Thus, the objective of this essay analyse the claims of the NGO Paravidda in relation to the healthcare needs of people with HIV in Belém (1992-2003), arguing this process frames it in SUS´s implementation in Belém. For such, we will be using discussions in History of Diseases and of Health Politics referred to SUS and Aids. The research is of documental base in wich, in historic perspective, has made use of intitutional documents and scientific paper literature, as well as testimony of main activists. Along the essay, it is discussed the process of construction of SUS´s foundations by the end of the 1980 and through the 1990 and its implementations on the state of Pará, in wich shall be described the multiples actuations of the Aids-NGO´s and the National Aids Program. In the midsts of these processes, that favoured Paravidda´s field of acting and the institutional responses of local health managements, the NGO and an assemble of articulated social sectors took their needs to municipal seminars of Belém, having the journals Diário do Pará and O Liberal as their main means of debate disclosure.Besides, Paravidda would use the journal to dennouce the lack of medicine and hospital beds for Aids in Belém, becoming a strategic mean to seek the attention of local health authorities. Thus, the essay concludes that the complaints of Paravidda through the press interconnect to the following foundations of SUS: social participation, through its presence in the public debate regarding Aids in Belém; universality as a right, through wich the NGO sought answers answes from the state that contemplated its multiple health needs: preventive actions of medication distribution and enlargementof healthcare in its network organization

A new species of Pontoscolex earthworm (Rhinodrilidae, Clitellata) from the Gurupi Biological Reserve, along with records of earthworm species from the Amazon region of Maranhão, Brazil.

We describe a new species of the genus Pontoscolex from the Amazon region of Maranhão State in Brazil. The region is the most deforested and degraded in the biome, with only 25% of the original forest cover left. Pontoscolex awa sp. nov. has regular setae, very small spermathecae, and tubercula pubertatis band-shaped extending to AB line in XIX-XII. Common and genital setae are of similar length and without ornamentations; these features are new in the genus, although unknown in several species. The Gurupi Biological Reserve where the new species was found is the only integral protection area within the Belém Endemism Area and therefore of crucial importance for conservation of earthworms and other endemic organisms.

Phlebotomines (Diptera: Psychodidae) from a Urban Park of Belém, Pará State, Northern Brazil and Potential Implications in the Transmission of American Cutaneous Leishmaniasis.

In urban ecotourism parks, the life cycle of American cutaneous leishmaniasis (ACL) agents can remain established, where phlebotomines may comprise potential risks for visitors. The present study aimed to survey the phlebotomine fauna of a forest park 'Bosque Rodriques Alves-Jardim Botânico da Amazônia' (BRAJBA), in the urban area of Belém, Brazil. The park was monthly surveyed in 2018 using CDC light traps placed in ground and canopy strata. Leishmania spp. isolated from dissected females were characterized by polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP) analysis. Fluctuations in specimen capture were correlated with rainfall. Nyssomyia antunesi (Coutinho, 1939) was predominant for all surveyed ecotopes and capture methods in both areas. Females of Ny. antunesi resting on tree bases were observed attempting to bite researchers during early morning. One Bichromomyia flaviscutellata (Mangabeira, 1942) and one Trichophoromyia brachipyga (Mangabeira, 1942) were found naturally infected by flagellates. Only the strain from Th. brachipyga was isolated and characterized as Leishmania (Viannia) lainsoni Silveira, Shaw, Braga and Ishikawa, 1987. Monthly fluctuations of the three most abundant species, Ny. antunesi, Trichophoromyia ubiquitalis (Mangabeira, 1942) and Th. brachypiga, had statistically significant negative correlations with rainfall. The present study provided further information to better understand ACL ecology in the Belém urban area, where the urban parks surveyed appeared to offer potential risk of contracting the disease, thus requiring environmental management. These observations highlighted the need for including Ny. antunesi, Bi. flaviscutellata, Th. ubiquitalis, and Th. brachypiga in the priority list for continuous entomological surveillance.

Depositional history of polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs) and polycyclic aromatic hydrocarbons (PAHs) in an Amazon estuary during the last century.

The sources and depositional history of OCPs (organochlorine pesticides), PCBs (polychlorinated biphenyls) and PAHs (polycyclic aromatic hydrocarbons) over the last 100years were determined in two sediment cores collected in the Amazon region. It was possible to distinguish two depositional periods along the cores. The first period occurred before extensive anthropogenic effects were registered in the sediments. During this time interval, the concentrations of all OCPs and PCBs were below the detection limits (DL), and the PAH concentrations were low and essentially constant (58.19-124.28ngg-1). The second period starts in the mid-1960s and reflects the increased human influence in the area. The concentrations of OCPs, PCBs, and PAHs increased towards the top of the cores, varying between

Entre a engenharia militar e a arquitetura médica: representações de Alexandre Rodrigues Ferreira sobre a cidade de Belém no final do século XVIII / Between military engineering and medical architecture: representations by Alexandre Rodrigues Ferreira about the city of Belém in the late eighteenth century

Resumo O artigo analisa as concepções de Alexandre Rodrigues Ferreira sobre a urbanização de Belém, fundamentadas na história natural e na medicina social, sintetizadas na obra de Antônio Nunes Ribeiro Sanches. Primeiramente, destaca-se a influência da engenharia militar na constituição do núcleo seiscentista da cidade e na irradiação da cidade-fortaleza, ressaltando as críticas de Ferreira à centralidade geoestratégica na constituição urbana. Num segundo momento, as reformas urbanas setecentistas realizadas sob preceitos da arquitetura médica, como a construção do Hospital Real Militar e os projetos de abastecimento de água. Por fim, é pensado um conceito de cidade-civilidade, expresso nas reformas urbanas com a construção de símbolos de poder estatal e de áreas de lazer e sociabilidade, incluindo as observações sobre as moradias.

Abstract This paper discusses Alexandre Rodrigues Ferreira's conceptions about the urbanization of Belém, rooted in natural history and social medicine, as expressed in the work of Antônio Nunes Ribeiro Sanches. The influence of military engineering on its constitution in the 1600s and the spread of this fortress town are investigated, emphasizing Ferreira's criticisms of the geostrategic centrality in the development of the city. The urban reforms of the 1700s under the precepts of medical architecture are then presented, such as the building of the Royal Military Hospital and the water supply system. The concept of the civil city is presented, as expressed in the urban redevelopments, with the building of symbols of state power, areas for leisure and conviviality, and housing.

Método multicriterial para avaliação do risco ambiental no comércio de combustíveis na primeira légua patrimonial de Belém (Pará) / Multi-criteria method for environmental risk assessment of fuel trade within the first urban mile of Belém (Pará)

RESUMO Este artigo apresenta um modelo simplificado de análise sobre o potencial de risco associado à existência de postos de comércio de combustíveis no contexto urbano, que considera três critérios de análise: operacional, normativo e ambiental. Esses critérios estão distribuídos entre oito variáveis de controle, internas e externas, as quais são valoradas a partir de informações quantitativas e qualitativas facilmente disponibilizadas, e que foram empregadas na determinação das notas de risco de 67 postos de combustíveis existentes na primeira légua patrimonial (PLP) da cidade de Belém, Pará, o primeiro rossio da cidade, demarcado pela coroa Portuguesa em 1616, com o fim de obtenção da Nota de Risco de Postos de Combustível e produção do Mapa de Potencial de Risco dos bairros da PLP. Os resultados demonstram que a maioria dos postos de combustíveis existentes na PLP possui risco alto e poucos impõem risco grave e médio.

ABSTRACT This paper introduces a simple model to assess potential risk of gas stations in urban areas, which takes into account three dimensions of analysis: operational, normative, and environmental. These dimensions are distributed in eight internal and external control variables, which, in turn, are valued by qualitative and quantitative interpretation of easily available local data. The proposed model was applied to evaluate 67 gas stations located within the first urban mile of Belém, Pará, Brazil, which is characterized as the first demarcation of land granted by the Portuguese crown in the foundation of Belém, in 1616, in order to obtain the risk rating for gas station and also to produce the potential risk map for first urban area districts. Results show that most of the gas stations in the first urban mile presents high risk, whereas only a few possesses important and medium risk.

Dos imaginários sobre a iniciação sexual: intersecções de gênero, raça/cor e sexualidade entre jovens de camadas populares em Belém, Pará / The imaginary about sexual initiation: intersections of gender, race/color and sexuality between young people of the lower classes in the city of Belém (Pará), Brazil / Los imaginarios sobre la iniciación sexual: intersecciones de género, raza/color y sexualidade entre los jóvenes de las clases bajas en la ciudad de Belém (Pará), Brazil

Resumo Este texto propõe uma exposição sobre o “roteiro sexual” de mulheres e homens jovens (heterossexuais e homossexuais) residentes em regiões “centrais” e “periféricas” da capital paraense, tendo como base material oriundo do projeto “‘Para entrar no mundo que não é meu’: a iniciação sexual a partir de entrevistas com as(os) jovens pobres e de camadas médias de Belém do Pará”. Neste sentido, concentramos nossas incursões na Casa do Estudante Universitário do Pará (CEUP), localizada no bairro de classe média/média alta Batista Campos, e no bairro Guamá - “periferia” de Belém. Enfatizamos, assim, o importante papel das famílias de origem na reprodução de práticas de conduta social e sexual, além das distintas maneiras de as(os) entrevistadas(os) agenciarem suas iniciações sexuais a partir de convenções e imaginários acionados na interseção com gênero, sexualidade e raça/cor.

Abstract: This paper proposes an analysis, based on interviews conducted in the project “‘To enter into a world that is not mine’: sexual initiation in interviews with poor young people and middle classes in the city of Belém (Pará), Brazil”. It analyzed the “sexual scripts” of young women and men (heterosexual and homosexual), residing in “central” and “peripheric” areas in Belém, the capital of Pará, Brazil. Our locus of research was the institution Casa do Estudante Universitário do Pará (CEUP), with locations in a middle class/upper middle class neighborhood, and in the Guamá suburb, a “periphery” of Belém. We emphasize the significant role of families of origin in the reproduction of social and sexual conduct, and the different ways interviewees manage sexual initiation according to beliefs and imaginaries situated at the intersection of gender, sexuality and race/color.

Resumen Este texto propone una exposición, desde las entrevistas realizadas en el proyecto “‘Para entrar en el mundo que no es el mío’: la iniciación sexual desde las entrevistas con los jóvenes pobres y de las clases medias de Belém do Pará”, sobre lo “guión sexual” de las mujeres y los hombres jóvenes (heterosexuales y homosexuales) residentes en regiones “centrales” y “periféricas” de la capital del estado de Pará. En este sentido, centramos nuestras incursiones en la Casa del Estudiante Universitario de Pará (CEUP), ubicada en el barrio de clase media/media alta Batista Campos, y el barrio “periférico” Guamá. Por tanto, tenemos especialmente en cuenta el importante papel de las familias de origen en la reproducción de las prácticas de comportamiento social y sexual, y las diferentes formas de las(los) entrevistadas(os) agenciarem sus iniciaciones sexuales desde las convenciones y los imaginarios desencadenados en la intersección con el género, la sexualidad y la raza/color.

Herpetofauna of the Northwest Amazon forest in the state of Maranhão, Brazil, with remarks on the Gurupi Biological Reserve.

Understanding the biodiversity of an area is the first step for establishing effective interventions for conservation, especially when it comes to herpetofauna, since 4.1% and 9.2%, respectively, of Brazilian amphibians and reptiles are endangered. The aim of this study is to identify the composition of the herpetofauna occurring in the Northwest Amazonian state of Maranhão, with a focus on the Gurupi Biological Reserve and surrounding areas. Samples were collected between May 2012 and October 2013 (18 months), through pitfall traps, time constrained active search, and opportunistic encounters, and these records were supplemented by specimens collected by third parties and by bibliographic records. A total of 131 species were recorded: 31 species of amphibians and 100 species of reptiles (six testudines, 30 lizards, two amphisbaenas, 60 snakes and two alligators), including some species new to the state of Maranhão and the northeast region of Brazil. This inventory contributes to the knowledge of the herpetofauna for the Belém Endemism Center, the most devastated region of the Brazilian Amazon, and considered poorly sampled.

Da Belle époque à cidade do vício: o combate à sífilis em Belém do Pará, 1921-1924 / From the Belle Époque to the city of vice: the fight against syphilis in Belém, Pará, 1921-1924

O artigo analisa o combate à sífilis em Belém do Pará entre 1921 e 1924. A partir da fundação do Instituto de Profilaxia e Doenças Venéreas, administrado pelo médico Heraclídes de Souza Araújo, muitas restrições foram feitas à prática do meretrício, visando transformar as prostitutas em aliadas da política de higienização da cidade. A documentação produzida pelo Instituto de Profilaxia, bem como jornais da época, revela os vários embates que ocorreram entre médicos, polícia civil e meretrizes, destacando as atitudes destas contra a intervenção do Estado em seu ofício.

This article analyzes the fight against syphilis in Belém, capital of the Brazilian state of Pará, between 1921 and 1924. When Instituto de Profilaxia e Doenças Venéreas (Institute for Prophylaxis and Venereal Diseases) was founded, headed by Dr. Heraclídes de Souza Araújo, many restrictions were imposed on prostitution in a bid to make prostitutes partners in the city’s sanitation reform. The documents produced by the institute and published in newspapers of the day reveal the various clashes that occurred between doctors, the civil police force, and prostitutes, highlighting the prostitutes’ attitudes to state intervention in their activities.

Perfil clínico-epidemiológico de pacientes infectados pelo HTLV-1 em Belém/Pará / Clinical-epidemiological profile of HTLV-1 infected patients in Belém, Pará state, Brazil

ResumoObjetivoInvestigar o perfil clínico-epidemiológico de pacientes portadores do HTLV-1 em Belém, no Estado do Pará, Brasil, descrevendo as características de indivíduos infectados e atendidos no Laboratório de Clínica e Epidemiologia de Doenças Endêmicas (LCEDE) do Núcleo de Medicina Tropical (NMT) da Universidade Federal do Pará (UFPA).MetodologiaFoi um estudo descritivo de corte transversal, com coleta em prontuários de pacientes infectados pelo HTLV-1, matriculados no LCEDE do NMT da UFPA entre os anos 2000 a 2012. Foi aplicada a análise descritiva pelo programa Epi Info 3.2.5.ResultadosDos 182 prontuários, 35,2% eram do sexo masculino, e 64,8%, do sexo feminino. Houve predomínio de indivíduos casados (47,8%). A maioria (73,6%) tinha procedência do município de Belém-PA. Dentre os pacientes sintomáticos, 51% apresentavam sintomas neurológicos, 21%, queixas dermatológicas, 18%, queixas reumatológicas, e 10%, queixas autonômicas. Com relação aos pacientes com sintomas neurológicos, 16 (39,0%) foram diagnosticados com PET/MAH.ConclusõesHouve o predomínio do sexo feminino, na faixa etária entre 40 e 49 anos, casado, trabalho informal, procedentes de Belém, com queixas neurológicas e com retorno regular as consultas médicas.

AbstractObjectiveThe clinical-epidemiological profile of patients with HTLV-1 in Belém, Pará state, Brazil was investigated describing the characteristics of these patients at an outpatient service of the Clinical and Epidemiologic Laboratory of Endemic Diseases - LCEDE from the Tropical Medicine Center - NMT of the Federal University of Pará - UFPA.MethodologyIt was a descriptive, cross-sectional study with data collected from the records of HTLV-1 patients from 2000 to 2012. Descriptive analysis used Epi Info 3.2.5 software.ResultsOf the 182 patients, 35.2% were male and 64.8% female, with a predominance of married individuals (47.8%), approximately 73.6% were from Belém. Among the symptomatic patients, 51% presented neurological symptoms, 21% dermatological complaints, 18% rheumatologic complaints, and 10% autonomic complaints. Among the patients with neurological symptoms, 16 (39%) were diagnosed with HAM/TSP.ConclusionThere is predominance of females, aged 40-49 years, married, with informal jobs, from Belém, with neurological sings and regular return to medical visits.

Rotavirus strain surveillance for three years following the introduction of rotavirus vaccine into Belém, Brazil.

The monovalent human rotavirus (RV) vaccine, RIX4414 (Rotarix™, GlaxoSmithKline Biologicals) was introduced into Brazil's Expanded Program on Immunization in March 2006. One year after vaccine introduction, the G2P[4] strain was found to be predominant, with an apparent extinction of many non-G2 strains. This study investigated the diversity of circulating strains in the three years following RIX4414 introduction. Between May 2008 and May 2011, stool samples were collected from children aged ≥12 weeks who were hospitalized for severe lab confirmed RV-gastroenteritis (≥3 liquid or semi-liquid motions over a 24-h period for <14 days, requiring ≥1 overnight hospital stay and intravenous rehydration therapy) in Belém, Brazil. RV-gastroenteritis was detected by ELISA and the G- and P-types were determined by RT-PCR assays. During the first year of surveillance nucleotide sequencing was used for typing those samples not previously typed by RT-PCR. A total of 1,726 of 10,030 severe gastroentertis hospitalizations (17.2%) were due to severe RVGE. G2P[4] was detected in 57.2% of circulating strains over the whole study period, however it predominated during the first 20 months from May 2008 to January 2009. G1P[8] increased in the last part of the study period from May 2010 to May 2011 and represented 36.6% (112/306) of the circulating strains. G2P[4] was the predominant RV strain circulating during the first 20 months of the study, followed by G1P[8]. These findings probably reflect a natural fluctuation in RV strains over time, rather than a vaccine-induced selective pressure.

Casa preta: uma etnografia de um espaço de sociabilidade da juventude grafiteira de Belém / House black: ethnography of a space of sociability youth graffitt of Belém / Casa negra: una etnografía de un espacio de sociabilidad de la juventud gratitera de Belén

o objetivo desse artigo é apresentar o resultado de uma etnografia sobre a Casa Preta, um dos espaços de sociabilidade da juventude grafiteira de Belém. Essa pesquisa é fruto da dissertação de mestrado em antropologia. A Casa Preta é considerada um espaço cultural de produção do hip hop como de outros movimentos, por exemplo,o Movimento Negro. A metodologia aqui utilizada foram a etnografia, a história de vida e a antropologia visual com observação, entrevistas e depoimentos que possibilitaram conhecer o que levou a formação do Coletivo Casa Preta e a organização da casa enquanto um local de moradia e de arte. A Casa preta como um espaço de arte é um dos espaços onde a juventude grafiteira se reúne se mobiliza e realiza contatos com sua rede de sociabilidade(AU)

the objective of this article is to present the results of ethnography in House Black during the master's degree in anthropology. The House Black is a of the existing cultural spaces in the city of Belém, where sociability between graffitt youth takes place. The same is also regarded as a cultural space by enabling the production of hip hop and aggregate subjects belonging to other social movements, such as the black movement. The methodological tools used were: the ethnographic record, life history, visual anthropology, interviews and testimonials. Knowing and understanding that enabled the formation of collective House and the organization as a place of residence and art. The House Black as an art space is where graffitt mobilizing youth meets and making contacts with its network of sociability.(AU)

el objetivo de este trabajo es presentar los resultados de una etnografía sobre la Casa Negra, uno de los espacios de sociabilidad juvenil que hace grafiteira en Belén. Esta investigación es el resultado de una disertación de maestría en antropología. La Casa Negra es considerada un espacio cultural para la producción de hip hop así como de otros movimientos, por ejemplo, el Movimiento Negro. La metodología utilizada aquí fue la etnografía, la historia de la vida y la antropología visual con observación, entrevistas y testimonios que permitieron conocer lo que llevó a la formación del Colectivo Casa Negra y la organización de la casa como lugar de residencia y de arte. La Casa Negra como un espacio de arte es un espacio donde los jóvenes que hacen grafito se reúnen, se movilizan y realizan contactos con su red de sociabilidad.(AU)

Spatio-temporal distribution of fish larvae in relation to ontogeny and water quality in the oligohaline zone of a North Brazilian estuary / Distribuicao espaco-temporal das larvas de peixes em relacao a ontogenia e qualidade da agua na zona oligohalina de um estuario norte brasileiro

Larval fish assemblage in Guajará Bay was studied through four quarterly field campaigns and discussed in relation to individuals' development stages and exposure to contaminants poured out by the Pará State Capital City, Belém. Larval densities were low and diversity extremely poor with a strong dominance of clupeids, engraulids and, to a lower extent, sciaenids. The main spawning season was registered at the onset of the rainy period. Pre-flexion and flexion clupeiforms remained in the farmost stations from the city while post-flexion larvae were found near urban activity centres. Unlikely, pre-flexion and flexion sciaenids were scattered along the city waterfront. Post-flexion larvae were rare; it is suggested that sciaenids use the bay as a transitory route between their spawning grounds and more distant nursery grounds. The waters around the city of Belém showed signs of contamination. However, based on the literature, Guajará Bay environmental quality at the time of the study was suitable for fish larvae life. Nitrate with pH best explained larval distribution.

O padrão de distribuição das larvas de peixes na Baía do Guajará foi estudado através de coletas trimestrais e discutido em relação aos estágios de desenvolvimento dos indivíduos e a exposição dos mesmos aos contaminantes despejados pela Capital do Estado do Pará, Belém. A densidade e a diversidade larval foram baixas com forte dominância dos clupeídeos, engraulídeos e, em menor grau, os cianídeos. O principal período de reprodução foi definido no início do período chuvoso. Larvas de Clupeiformes em pré-flexão e flexão foram encontradas nos pontos de coletas mais afastados da cidade, enquanto aquelas em pós-flexão prevaleceram nas margens da cidade. Por outro lado, os cianídeos em pré-flexão e flexão foram capturados perto dos centros de atividade urbana, enquando aqueles em pós-flexão foram pouco abundantes. É sugerido que a baía se encontra na rota migratória dos cianídeos entre a área de desova e os berçários mais distantes. Apesar das águas no entorno da cidade de Belém mostraram sinais de contaminação, a qualidade ambiental na Baía do Guajará no momento do estudo estava apropriada para a vida das larvas de peixes. Nitrato com pH foram as variáveis que melhor explicaram a distribuição larval.

The status of conservation of urban forests in eastern Amazonia / Status de conservação das florestas urbanas da Amazônia oriental

This study aims to identify the remnant tree flora in six forest fragments in the metropolitan area of Belém and to analyze these fragments in terms of biological conservation, species richness and diversity in the local urban landscape. The fragments and their respective sampling areas were as follows: Amafrutas reserve (15 ha), Trambioca Is. reserve (2 ha), Bosque Rodrigues Alves city park (15 ha), Combu Is. reserve (10 ha), Gunma Park reserve (10 ha) and Mocambo reserve (5 ha). Inventories were built from lineal plots of 250 m² and included trees with DBH equal to or greater than 10 cm at a height of 1.3 m above ground. Sixty-nine families and 759 species, of which eight were officially listed as endangered (Brazilian National Flora: Ministry of Environment, Normative Instruction of September, 2008; Pará State Flora: Decree Nº. 802 of February 2008) were recorded. These endangered species are: Aspidosperma desmanthum Benth. ex Müll. Arg. (Apocynaceae), Cedrela odorata L. (Meliaceae), Eschweilera piresii S.A Mori (Lecythidaceae), Euxylophora paraensis Huber (Rutaceae), Hymenolobium excelsum Ducke (Leguminosae), Manilkara huberi (Ducke) Chevalier (Sapotaceae), Tabebuia impetiginosa (Mart. ex DC.) Standl. (Bignoniaceae), Mezilaurus itauba (Meisn.) Taub. ex Mez (Lauraceae) and Qualea coerulea Aubl. (Vochysiaceae). Emergency actions such as implementing management plans for already existing Conservation Units, the creation of new such units in areas of primary forest fragments (as in the case of the Amafrutas reserve), as well as the intensification of actions of surveillance and monitoring, should be undertaken by Federal, State, and Municipal environmental agencies so as to ensure the conservation of these last primary forest remnants in the metropolitan area of Belém.

O presente estudo teve o objetivo de identificar a flora arbórea remanescente em seis fragmentos florestais da região metropolitana de Belém-PA, além de analisar esses fragmentos em termos de conservação, riqueza e diversidade no cenário urbano da região. Os fragmentos, com respectivas áreas amostradas, foram: Amafrutas (15 ha), Ilha Trambioca (2 ha), Bosque Rodrigues Alves (15 ha), Ilha do Combu (10 ha), Gunma (10 ha) e Mocambo (5 ha). Os inventários foram realizados utilizando-se parcelas lineares de 250 m², com inclusão de árvores com diâmetro a 1,3 m do solo (DAP) igual ou acima de 10 cm. Foram registradas 69 famílias e 759 espécies, sendo que oito destas estão em listas oficiais de espécies ameaçadas de extinção (Flora Nacional: Instrução Normativa do MMA de setembro de 2008; Flora do Pará: Decreto 802, de fevereiro de 2008). As espécies ameaçadas são: Aspidosperma desmanthum Benth. ex Müll. Arg. (Apocynaceae), Cedrela odorata L. (Meliaceae), Eschweilera piresii S.A Mori (Lecythidaceae), Euxylophora paraensis Huber (Rutaceae), Hymenolobium excelsum Ducke (Leguminosae), Manilkara huberi (Ducke) Chevalier (Sapotaceae), Tabebuia impetiginosa (Mart. ex DC.) Standl. (Bignoniaceae), Mezilaurus itauba (Meisn.) Taub. ex Mez (Lauraceae) e Qualea coerulea Aubl. (Vochysiaceae). Ações emergenciais, como a implementação dos planos de manejo das Unidades de Conservação (UCs) já existentes, a criação de novas UCs em áreas de fragmentos de florestas primárias (como é o caso da área da Amafrutas), bem como o fortalecimento dos serviços de vigilância e fiscalização, devem ser tomadas pelos órgãos ambientais (municipal, estadual e federal), de forma a assegurar a conservação desses últimos remanescentes de florestas primárias da região metropolitana de Belém-PA.

O médico da Estratégia de Saúde da Família em Belém, Boa Vista, Manaus e Rio Branco / The doctor of the Family Health Strategy in Belém, Boa Vista, Manaus and Rio Branco, Brazil

INTRODUÇÃO: Esta pesquisa integra uma das linhas de investigação do ObservaRH da Universidade de Brasília, vinculado ao Núcleo de Estudos de Saúde Pública do Centro de Estudos Avançados Multidisciplinares da Universidade. Tem como foco a análise do processo de trabalho em saúde da família e visa contribuir para o fortalecimento dessa estratégia adotada pelos gestores do Sistema Único de Saúde (SUS) como eixo para a mudança no processo de produção dos serviços do setor público no país. Incluído no elenco de interesses permanentes da equipe de pesquisa do ObservaRH/UnB, este trabalho é o terceiro de uma série iniciada com o Distrito Federal e seguida de estudo nas demais capitais do Centro-Oeste e Palmas (TO). OBJETIVO: A pesquisa atual perseguiu o mesmo objetivo geral ­ identificar perfil socioprofissional, aspectos institucionais, do emprego e da atividade dos médicos das equipes de saúde da família ­, mas, desta vez, focando os médicos de família de quatro capitais da Região Norte (Belém, Boa Vista, Manaus e Rio Branco). Ao disponibilizar os resultados desta pesquisa, a expectativa do ObservaRH/UnB é, mais uma vez, possibilitar o intercâmbio de experiências e de contribuições teóricas e metodológicas sobre o processo de trabalho nos contextos de modelos assistenciais calcados na estratégia de saúde da família. Entre os fundamentos considerados na estruturação do conjunto de pesquisas destacam-se o compromisso do setor público com a implantação dessa estratégia como instrumento de justiça e inclusão social no campo da saúde, as demandas por capacidade organizacional e operacional dos serviços públicos de saúde e o aporte à literatura de estudos e informações sobre as características do processo de trabalho dos profissionais médicos no atual modelo de atenção, aspecto este particularmente importante para as instituições educacionais e contratadoras de recursos humanos. MATERIAL E MÉTODO: O estudo está organizado no sentido de oferecer, inicialmente, uma visão geral da atenção primária e da estratégia de saúde da família no conjunto de municípios estudados. Segue-se a descrição da metodologia. A terceira e quarta partes apresentam respectivamente a análise dos resultados obtidos e as considerações finais. Após a relação das referências utilizadas estão aneadas as tabelas geradas pelas informações contidas nos questionários preenchidos pelos médicos das equipes de saúde da família, assim como o modelo do questionário utilizado e o parecer da Comissão de Ética em Pesquisa da Faculdade de Ciências da Saúde da UnB. Artigos sobre a evolução da atenção básica e do Programa de Saúde da Família compõem o apêndice do estudo. CONCLUSÃO: Esses artigos, de autoria de colaboradores vinculados aos municípios em estudo, têm como proposta complementar a pesquisa de campo e contextualizar informações sobre o desenvolvimento da atenção primária e, em particular, do Programa de Saúde da Família nas capitais que fizeram parte da pesquisa.