ABSTRACT Two triatomine genera (Panstrongylus and Triatoma) have essentially been recorded in Rio Grande do Sul State, Brazil. Panstrongylus megistus should be highlighted since this species is one of the main vectors of Trypanosoma cruzi in Brazil, due to its wide geographical distribution and the high susceptibility to this protozoan. This study aimed to present not only the occurrence and distribution of P. megistus in the Porto Alegre city’s metropolitan area (PAMA), Rio Grande do Sul State, Brazil, but also the rates of T. cruzi infection, from 2009 to 2020. The PAMA, which comprises 34 cities and 4.4 million habitants, extends across the transition area in two biomes – Pampa and Mata Atlantica – found in the state. Results showed that P. megistus was recorded in 76.5% of cities (i.e., 26 out of 34), mainly in Porto Alegre city, where the vector was found in 11 out of the 12 years that were monitored. Three hundred and nineteen specimens were captured. Two hundred and sixty-seven specimens (83.7%) were located intradomicile (p < 0.0001), while 52.3% positivity for T. cruzi was found. Thus, P. megistus is important in the PAMA, because it invades and colonizes the households. Moreover, the high rates of T. cruzi infection have drawn attention.

SUMMARY OBJECTIVE: Cancer imposes a profound burden on low- and middle-income countries where 65% of the global cancer deaths occurred in 2020. The objective of the present review was to describe female cancer epidemiology in Brazil, barriers to prevention, screening, and treatment, and to propose strategies to a better control. METHODS: For the process of literature search and scientific acquisition, we have utilized the terms “female cancer” AND “breast cancer,” AND “cervical cancer” AND “endometrial cancer” AND “ovarian cancer” AND “Brazil” in PubMed. References of the articles included in this review were manually searched in order to identify relevant studies on the topic. The official Brazilian epidemiology data were extensively analyzed at the governmental site www.inca.gov.br. RESULTS: Considering cases of breast and gynecologic cancers together, 105,770 new cases are expected to be diagnosed yearly, positioning female cancer as the highest cancer incidence in Brazil. Female breast cancer is the most common and the leading cause of death from cancer in the female population in all regions of Brazil, except in the North, where cervical cancer ranks first. Cervical cancer, a preventable disease, corresponds to the third-most common neoplasia in women, with higher incidences in the North and Northeast regions of Brazil. An upward trend has been observed in endometrial cancer incidence, a tendency that follows the increase of its two most common risk factors: population aging and obesity. Ovarian cancer currently occupies the eighth position among female cancers in Brazil, but it is the most lethal gynecologic cancer. The main strategies to reduce female cancer mortality rates are the reduction of inequalities in healthcare services and the early diagnosis of cases. The lack of a specific national cancer program results in a reactive and unplanned approach to healthcare provision, ultimately leading to suboptimal resource utilization and higher expenditure. CONCLUSION: Analyzed together, breast and gynecologic cancers correspond to the leading cause of cancer in Brazil. A heterogeneous group, female cancer includes diseases with a high primary and secondary prevention potential. The organization of a female cancer program in Brazil prioritizing primary and secondary prevention strategies, such as adequate mammography screening and human papillomavirus vaccination coverage, could significantly improve female cancer control in the country.

ABSTRACT Objective: The aim of this study was to evaluate the frequency of hypoglycemia and the treatment satisfaction in patients with type 1 diabetes (T1D) using insulin analogues. Subjects and methods: This observational retrospective study included 516 adult patients with T1D from 38 cities in Southern Brazil. Demographics and clinical data were collected using a self-report questionnaire. Hypoglycemia was defined as an event based on either symptoms or self-monitored blood glucose < 70 mg/dL. Treatment satisfaction was evaluated using the Diabetes Treatment Satisfaction Questionnaire status version (DTSQs) and with a specific question with scores ranging from 0–10. Common mental disorders were assessed using the General Health Questionnaire (GHQ-12). Results: Overall, the mean age was 38 ± 14 years and 52% of the participants were women. The median diabetes duration was 18 years. The scores for insulin analogue treatment satisfaction were higher than those for previous treatments. DTSQ scores had a median value of 32 (interquartile range 29–35) and remained unchanged over time. The percentage of patients with hypoglycemia (including severe and nocturnal) was comparable across groups divided according to duration of use of insulin analogues. Most patients (n=395, 77%) screened positive for common mental disorders. Conclusions: Patient satisfaction with insulin analogue treatment was high and remained unchanged with time. Episodes of hypoglycemia also remained unchanged over time among patients using insulin analogues.

ABSTRACT This is a retrospective report of the frequency of severe hypoglycemia and the association between common mental disorders and type 1 diabetes mellitus treated with insulin analogues. Patients with severe hypoglycemia compared with those without this complication had a higher prevalence of positive screening for common mental disorders (88% vs.77%, respectively, p = 0.03).

RESUMO Este artigo apresenta uma reflexão sobre as especificidades do processo de ocupação territorial do centro e sudoeste paulista em meados do século XIX, buscando identificar como as formas de expansão econômica e ocupação territorial envolveram tanto políticas oficiais para concentrar indígenas em áreas específicas quanto ações de violência, tendo por fim a apropriação territorial realizada, geralmente, de maneira ilegal. Estado e iniciativa privada construíram e subverteram direitos territoriais indígenas em um duplo movimento que se mostrou essencial à construção de estruturas de privilégios e padrões de posse de terra.

ABSTRACT This article presents a reflection on the specificities of the process of territorial occupation of the Center and Southwest of São Paulo in the mid-nineteenth century, seeking to identify how the forms of economic expansion and territorial occupation involved both official policies to concentrate Indigenous people in specific areas and the use of violence with a view to territorial appropriation, which was usually carried out in illegal way. The Imperial State and private enterprises built and subverted Indigenous territorial rights, in a double movement that proved essential to the construction of structures of privilege and land tenure standards.

RESUMO Copaifera multijuga, ou copaíba, é utilizada popularmente como chá para o tratamento de diversas afecções, o que se deve à presença de substâncias antioxidantes em sua composição, que protegem as células contra danos causados pelos radicais livres. O óleo-resina da árvore é usado como antiinflamatório e antitumoral. O presente estudo avaliou o efeito antioxidante do extrato etanólico da casca da copaíba sobre camundongos Swiss machos inoculados com tumor sólido de Ehrlich. Os camundongos foram inoculados subcutaneamente com 1x106 células de tumor de Ehrlich e foram tratados, via gavagem durante 30 dias, com doses de extrato etanólico de copaíba variando de 100 a 200 mg kg-1. Realizou-se análise bioquímica dos antioxidantes enzimáticos [superóxido dismutase (SOD), catalase (CAT), glutationa-S-transferase (GST)], antioxidantes não-enzimáticos [glutationa reduzida (GSH) e ácido ascórbico (ASA)], substâncias reativas ao ácido tiobarbitúrico (TBARS) e carbonilação proteica (carbonil) em diferentes tecidos e apresentando resultados significativos. O extrato administrado na concentração de 200 mg kg-1 apresentou melhor capacidade antioxidante no fígado, aumentando a CAT, GST, GSH e diminuindo TBARS, além de aumentar a atividade da CAT e da carbonilação proteica no tecido cerebral. Os resultados mostram que o extrato de copaíba foi capaz de reverter o estresse oxidativo causado pelo tumor sólido de Ehrlich, provavelmente por conter compostos antioxidantes, e possivelmente teve um efeito antineoplásico após 30 dias de tratamento.

ABSTRACT Copaifera multijuga, commonly known as copaiba, is popularly used in the form of tea for various conditions due to the presence of antioxidant substances in its composition, which protect cells against damage caused by free radicals. Its oleoresin is also used as an anti-inflammatory and antitumoral agent. The present study investigated the antioxidant effect of the ethanolic extract of copaiba stem bark on Swiss mice inoculated with solid Ehrlich tumors. Mice were inoculated subcutaneously with 1x106 Ehrlich’s tumor cells and treated via gavage with ethanolic extract of copaiba for thirty days, with doses varying between 100 and 200 mg kg-1. Biochemical analyses of enzymatic antioxidants [superoxide dismutase (SOD), catalase (CAT), glutathione-S-transferase (GST)], non-enzymatic antioxidants [reduced glutathione (GSH) and ascorbic acid (ASA)], substances reactive to thiobarbituric acid (TBARS) and protein carbonylation (carbonyl) in different tissues were significantly affected. The extract administered at 200 mg kg-1 presented higher antioxidant capacity in the liver, increased CAT, GST, GSH and decreased TBARS, as well as increased CAT activity and protein carbonylation in brain tissue. The results showed that the copaiba extract was able to reverse the oxidative stress caused by solid Ehrlich tumor, probably due to the presence of antioxidant compounds, and had potential antineoplasic effect after a 30-day treatment.

ABSTRACT Human visceral leishmaniasis is a growing anthropozoonosis in Brazil, and particularly in the southern region of the country. It is an infectious disease transmitted to humans, dogs and other animals in urban and rural areas of the Americas, mainly due to the bite of Lutzomya longipalpis infected with Leishmania infantum. This article aims to portray the current epidemiological situation of the human visceral leishmaniasis arrival in Porto Alegre city, located in the southern region of Brazil. It is a descriptive study, a case series and a critical review. Six human cases with human visceral leishmaniasis were notified by the date of conclusion of the study, all human visceral leishmaniasis cases were diagnosed at late stage, leading to four deaths.

RESUMO Este artigo trata de um tema ainda muito pouco explorado na historiografia, o trabalho indígena no Brasil imperial, principalmente posterior à década de 1840, a partir das alterações da legislação indigenista de 1845 (Regulamento acerca das Missões de Catequese e Civilização de Índios) e imperial de 1850 (Lei de Terras). Em desacordo com a falácia já em voga no século XIX, de que os índios não se prestavam ao trabalho, observamos como essas populações atuaram nos mais diversos ramos econômicos: agricultura, pecuária, atividades extrativistas, serviços domésticos, abertura de estradas e realização de obras públicas, eles prestaram serviços de navegação, foram guias e soldados, entre tantas outras atividades. Sua cooptação nem sempre ocorreu com observância aos critérios legais, e essas populações muitas vezes foram submetidas à escravidão ou a formas análogas de coerção. Essa verdade era conhecida pelas autoridades do período e, também, pelos diversos grupos indígenas do Império, que negociaram e procuraram impor, na medida do possível, suas condições para as relações de trabalho.

ABSTRACT This article casts new light on indigenous work in Brazil’s Second Empire in the wake of the Indigenous legislation of 1845 (Regulation on the Missions of Catechesis and Indigenous Civilization) and the Land Law of 1850. Contrary to the widespread belief in the nineteenth century that Indians did not lend themselves to work, these populations’ labor weighed upon the most varied economic branches: agriculture, cattle raising, extractive activities, domestic services, opening of roads, public works, and navigation services. Indians served as guides, soldiers, sailors, and servants, among many other roles. Yet, their co-optation did not always occur in compliance with legal criteria, which led to these populations’ subjection to slavery and other forms of coercion. This was a fact known by the authorities of the period, but also by the Empire’s different indigenous groups, who negotiated and sought to impose, as far as possible, their own conditions for labor relations.

RESUMO As propriedades do óleo-resina da copaíba, Copaifera multijuga são comumente citadas na literatura, mas há poucos estudos sobre extratos da casca do caule. Avaliamos os efeitos antioxidantes de extratos brutos etanólico (EE) e acetato de etila (EA) da casca do caule da copaíba e os comparamos à rutina no modelo de estresse oxidativo induzido por paracetamol (PCM) em camundongos. Todas as comparações de teste diferiram significativamente. A atividade da catalase hepática (CAT) e da glutationa-S-transferase (GST) diminuiu no grupo PCM, e houve um aumento de proteínas carboniladas no fígado, rim e cérebro. No entanto, as proteínas carboniladas diminuíram no fígado no fígado para o grupo PCM + EE, nos rins para os grupos PCM + EA e PCM + rutina, e no cérebro para todos os tratamentos. A GSH hepática diminuiu no grupo PCM e aumentou no grupo PCM + EE. Os extratos mostraram um efeito positivo sobre o ácido ascórbico (ASA), uma vez que foram capazes de restaurar os níveis dos parâmetros que foram alterados pelo PCM. Houve um aumento da atividade de ALT e AST no plasma dentro do grupo PCM. Embora a ALT tenha diminuído nos grupos PCM + rutina, PCM + EE e PCM + EA, EE e EA não afetaram a AST. O efeito antioxidante mais forte foi observado para o EE, provavelmente devido à presença dos compostos fenólicos epicatequina e epiafzelequina, assim como à maior concentração de fenóis totais e um excelente potencial antioxidante observado no teste DPPH·.

ABSTRACT The properties of oil-resin of copaiba, Copaifera multijuga are commonly mentioned in the literature, but there are few studies on extracts from its stem bark. We evaluated the antioxidant effects of ethanolic (EE) and ethyl acetate (EA) crude stem bark extracts from copaiba and compared them to rutin in a paracetamol (PCM)-induced oxidative stress model in mice. All test comparisons differed significantly. Hepatic catalase (CAT) and glutathione-S-transferase (GST) activity decreased in the PCM group, and there was an increase of protein carbonyls in the liver, kidney and brain. However, the protein carbonyls decreased in the liver for the PCM + EE group, in the kidneys for the PCM + EA and PCM + Rutin groups, and in the brain for all treatments. Hepatic GSH decreased in the PCM group and increased in the PCM + EE group. The extracts showed a positive effect on ascorbic acid (ASA), since they were able to restore the levels of parameters that had been changed by PCM. There was an increase of ALT and AST activity in the plasma within the PCM group. Even though ALT decreased in the PCM + Rutin, PCM + EE and PCM + EA groups, EE and EA did not have an effect on AST. The strongest antioxidant effect was observed for EE, due to the presence of the phenolic compounds epicatechin and epiafzelechin, as well as the highest concentration of total phenols and an excellent antioxidant potential observed in the DPPH· test.

RESUMO Capirona decorticans (Rubiaceae) é popularmente usada para tratar verrugas, feridas, micoses e sarna, e como um componente do chá de Ayahuasca. Apesar do uso popular, são limitadas as pesquisas fitoquímicas e farmacológicas sobre a espécie. Portanto, este estudo quantificou compostos fenólicos no extrato etanólico (EE) e na fração hidrometanólica (FM) (406 e 293 mgEAG g-1, respectivamente) de folhas de C. decorticans. Identificamos flavonoides por LC-MS / MS-MMR-ESI (apigenina, rutina, luteolina, miricetina, quercetina, quercetina-3-β-D-glicosídeo, quercetrina), e avaliamos o estresse oxidativo e o efeito mutagênico/antimutagênico de EE e FM em um experimento in vivo utilizando camundongos Swiss e ciclofosfamida (CP) como um indutor de danos no DNA e estresse oxidativo. Os camundongos foram pré-tratados por 15 dias consecutivos com EE ou FM (250 mg kg-1) e injetados intraperitonealmente com CP (25 mg kg-1). Proteínas carboniladas, ácido ascórbico, catalase e substâncias reativas ao ácido tiobarbitúrico foram dosadas em tecidos hepáticos e renais. O efeito mutagênico/antimutagênico foi avaliado através do Teste de Micronúcleo. Houve carbonilação protéica no fígado de animais expostos à CP, que foi reduzida pela FM. Não houve efeito significativo sobre outros marcadores de estresse oxidativo. Os grupos tratados com os extratos apresentaram uma redução percentual significativa (EE = 96% e FM = 71%) na frequência de eritrócitos policromáticos micronucleados induzidos pela PC. O EE também apresentou mutagenicidade quando utilizado isoladamente. O EE e FM das folhas de C. decorticans apresentaram potencial antioxidante equivalente ao observado em outras espécies, não causaram estresse oxidativo, nem toxicidade, e tiveram efeito protetor e antimutagênico, embora a EE tenha apresentado mutagenicidade.

ABSTRACT Capirona decorticans (Rubiaceae) is popularly used to treat warts, wounds, mycoses and scabies, and is also a component of the Ayahuasca tea. Despite its popular use, the phytochemical and pharmacological research on this species is limited. Therefore, this work quantified phenolic compounds in the ethanolic extract (EE) and hydromethanolic fraction (FM) (406, 293 mgEAG g-1, respectively) from leaves of C. decorticans. We identified flavonoids by LC-MS/MS-MMR-ESI (apigenin, rutin, luteolin, miricetin, quercetin, quercetin-3-β-D-glucoside, quercetrin), and evaluated oxidative stress and mutagenic/antimutagenic effect of EE and FM through an in vivo experiment using Swiss mice and cyclophosphamide (CP) as an inducer of DNA damage and oxidative stress. Mice were pretreated for 15 consecutive days with EE or FM (250 mg kg-1) and then intraperitoneally injected with CP (25 mg kg-1). Carbonylated proteins, ascorbic acid, catalase and thiobarbituric acid-reactive substances were measured in hepatic and renal tissues. The mutagenic/antimutagenic effect was evaluated through the Micronucleus Test. Protein carbonylation in the liver of animals exposed to CP was reduced by FM. There was no significant effect on other markers of oxidative stress. The groups treated with the extracts showed a significant percentage reduction (EE = 96% and FM = 71%) in the frequency of micronucleated polychromatic erythrocytes induced by CP. EE showed mutagenicity when used alone. The EE and FM of C. decorticans leaves showed antioxidant potential equivalent to that observed in other species, did not cause oxidative stress, nor toxicity, and had a protective and antimutagenic effect, although the EE showed signs of mutagenicity.

Marco contextual: Las barreras arquitectónicas asumen un peso importante en la realización de las actividades de la vida diaria de las personas con movilidad reducida. Objetivos: Comprender las fragilidades y/o potencialidades de las respuestas de los ayuntamientos locales para abolir barreras arquitectónicas para personas con movilidad condicionada cuando se encuentran en su contexto social y habitacional. Metodología: Estudio descriptivo, exploratorio, con una muestra de 21 presidentes de junta de dos municipios, a partir de un muestreo no probabilístico accidental. Resultados: De la muestra, el 76,2% de los presidentes de junta no sabe cuántas personas con discapacidad viven en su barrio. La eliminación de barreras arquitectónicas incidió sobre paseos y zonas peatonales accesibles (80%), pasos de peatones (75%), acceso a parques y jardines públicos (70%) y a cementerios y mercados (70%). Los restantes equipamientos, incluso los educacionales, tienen representaciones por debajo del 50%. Conclusión: Subsisten espacios de uso público con barreras arquitectónicas. Hay poca articulación entre los profesionales de la salud y la sociedad para promover la accesibilidad.

Enquadramento: As barreiras arquitetónicas assumem um peso importante na prossecução das atividades de vida diária para pessoas com mobilidade condicionada. Objetivos: Compreender as fragilidades e/ou potencialidades das respostas das autarquias locais para abolir barreiras arquitetónicas para pessoas com mobilidade condicionada quando inseridas no seu contexto social e habitacional. Metodologia: Estudo descritivo, exploratório, com uma amostra de 21 presidentes de junta de dois municípios, a partir de uma amostragem não probabilística acidental. Resultados: Da amostra, 76,2% presidentes de junta não sabem quantas pessoas com deficiência vivem na sua freguesia. A eliminação de barreiras arquitetónicas incidiu sobre passeios e percursos pedonais acessíveis (80%), passadeiras (75%), acesso a parques e jardins públicos (70%) e a cemitérios e mercado (70%). Os restantes equipamentos, mesmo os educacionais, têm representações abaixo de 50%. Conclusão: Subsistem espaços de uso público com barreiras arquitetónicas. Existe pouca articulação entre profissionais de saúde e a sociedade para a promoção da acessibilidade.

Background: Architectural barriers have a significant impact on the daily activities of people with reduced mobility. Objectives: To understand the weaknesses and/or opportunities in the responses of local authorities to eliminate the architectural barriers for people with reduced mobility in their social and residential context. Methodology: A descriptive, exploratory study was conducted with a sample of 21 parish council presidents from two municipalities using an accidental non-probabilistic sampling method. Results: In this sample, 76.2% of parish council presidents do not know how many people with disabilities live in their parish. The elimination of architectural barriers focused on accessible sidewalks and pedestrian routes (80%), pedestrian crossings (75%), access to public parks and gardens (70%), and access to cemeteries and markets (70%). Other equipment, even educational ones, represent less than 50%. Conclusion: Some public spaces still have architectural barriers. There is little cooperation between health professionals and society to promote accessibility.

Resumo A Eugenia dysenterica DC é uma espécie de frutífera endêmica do Cerrado, pertence à família Myrtaceae e é popularmente conhecido como cagaiteira. Apresenta propriedades medicinais e antifúngicas, e tem função importante no ecossistema. No entanto, existem poucos estudos sobre a manutenção da espécie. O objetivo deste estudo foi avaliar o crescimento, a nutrição, a qualidade e a fisiologia de mudas E. dysenterica cultivadas em substratos à base de vermiculita fina e casca de arroz carbonizada, nas seguintes combinações: 1:0; 3:1; 1:1 e 1:3, além do substrato comercial Trimix® e apenas vermiculita. Avaliaram-se os atributos físicos dos substratos (densidades seca e úmida, água disponível, água remanescente, espaço de aeração e porosidade total), a porcentagem de emergência de plântulas, o índice de velocidade de emergência, as trocas gasosas, a fluorescência da clorofila a, o teor relativo de água das mudas, o teor de umidade relativa do substrato, as características biométricas de crescimento de plantas, o acúmulo de massa seca e o estado nutricional através do conteúdo de macronutrientes nas folhas, após 128 dias da emergência. O incremento na proporção de casca de arroz misturada com vermiculita reduziu as densidades seca e úmida, a água disponível, a água remanescente, a porosidade total e o teor de umidade, e aumentou o espaço de aeração nos substratos. O substrato vermiculita pura promoveu o maior índice de qualidade de Dickson, bem como o maior diâmetro de colo, apesar de ser o substrato no qual as plantas apresentaram menor índice de velocidade de emergência. As plantas crescidas no substrato vermiculita pura apresentaram maior teor de N e K nas folhas, e as crescidas no subtrato Trimix® apresentaram maior teor foliar de Mg. Os substratos não alteraram os atributos fisiológicos das mudas.

Abstract Eugenia dysenterica DC is a fruiting species endemic to the Brazilian Cerrado, belonging to the Myrtaceae family and popularly known as Cagaiteira. It has medicinal and antifungal properties, and has an important function in the ecosystem. Nevertheless, there are few studies about the maintenance of this species. The aim of this study was to evaluate the growth, nutrition, quality and physiology of E. dysenterica seedlings grown in fine vermiculite and rice husk-based substrates in the following combinations: 1:0, 3:1, 1:1, and 1:3, in addition to Trimix® commercial substrate and vermiculite only. The physical attributes of substrates (dry and moist densities, available water, remaining water, aeration space and total porosity), seedling emergence percentage, emergence speed index, gas exchange, chlorophyll a fluorescence, relative seedling water content, relative substrate moisture content, plant biometric growth characteristics, accumulated dry weight and nutritional status were evaluated through leaf macronutrient content 128 days after emergence. The increase in the proportion of rice husk mixed with vermiculite resulted in reduction of the dry and moist densities of substrates, available water, remaining water, total porosity and moisture content, and increased the aeration space in substrates. The fine vermiculite substrate promoted the highest Dickson’s quality index and the greatest stem diameter of plants. Seedlings grown on vermiculite substrate presented higher N and K content in leaves, and those grown in Trimix® substrate showed higher leaf Mg content. Substrates did not alter the physiological attributes of seedlings.

Abstract Introduction Tinnitus is a symptom that affects mainly the elderly and can negatively influence their quality of life. Objective The objective of our study is to evaluate the existence of a relationship between the quality of life and the impact caused by tinnitus in elderly individuals, considering the age and gender variables. Method We conducted a cross-sectional study in elderly people of both genders who participate in the extension activities at the university. The evaluation was composed of anamnesis and WHOQOL-OLD instruments, to evaluate the quality of life, and Tinnitus Handicap Inventory (THI) for the evaluation of the tinnitus impact. Result We evaluated 36 elderly individuals with an average age of 68.6 ± 6.8 years old, 72.2 % of them were women. We verified that most of the subjects classified their tinnitus as weak (44.4%) ormedium (36.1%). The score average in the THI was 20 points, with predominant classification of tinnitus impact as negligible (41.7%) or mild (30.6%). In the WHOQOL-OLD, the average score was 15.6 ± 1.6 points (total score). The negative correlation between the THI score and the WHOQOL-OLD score was found in the sensory domain operation and total score. Conclusion The results obtained in the study prove that the quality of life of the elderly individuals evaluated is related to a discomfort caused by the tinnitus.

RESUMO Para a adequada oferta de serviços de reabilitação no Brasil é preciso conhecer a disponibilidade de acesso existente na Rede Assistencial de Saúde (RAS) e desenvolver práticas que atendam às necessidades de saúde. Buscou-se estimar a tendência da distribuição de recursos humanos de reabilitação na RAS 2007-2015, especificamente na Atenção Primária à Saúde (APS) e conhecer a prática de Clínica Ampliada (CA), Projeto Terapêutico Singular (PTS) e Apoio Matricial (AM) para fonoaudiólogos, fisioterapeutas e terapeutas ocupacionais. Buscou-se profissionais na Rede Assistencial pelo Cadastro Nacional de Estabelecimentos de Saúde (CNES). A tendência mensal foi construída por modelos de regressão linear Prais-Winsten. Para conhecer as práticas de CA, PTS e AM, construiu-se discursos do sujeito coletivo a partir de entrevistas de 12 profissionais. Média complexidade teve a maior concentração de profissionais, exceto em hospitais na cidade de São Paulo. A APS, por sua vez, teve a menor possibilidade de acesso. Mesmo tímido, houve crescimento dos três profissionais na assistência, com ênfase para os fisioterapeutas em hospital de São Paulo, em relação ao estado (0,73%) e cidade (0,95%). Na APS, o crescimento maior foi do terapeuta ocupacional em São Paulo-cidade e do fisioterapeuta no Brasil. Para AM, CA e PTS, além da dificuldade do fazer, destacaram-se, respectivamente, ideias de “pluralidade de concepções”, “visão biopsicossocial” e “possibilidade de adaptação” do cuidado. Embora crescente, a disponibilidade de profissionais é baixa e desigual, concentrada na especialidade e enfatizando ampliação de fisioterapeutas no hospital e terapeutas ocupacionais na APS.

ABSTRACT For adequate rehabilitation service offer in Brazil, it is necessary to understand the availability of access to Rede Assistencial de Saúde (RAS) [Brazilian Health Care Network (HCN)] and develop practices to meet health needs. The objective was to estimate the distribution trend of rehabilitation human resources in HCN between 2007 and 2015, especially in Primary Health Care (PHC) and get to know the practice of Clínica Ampliada (CA) [Extended Clinical Care (ECC)], Projeto Terapêutico Singular (PTS) [Singular Therapeutic Project (STP)], and Apoio Matricial (AM) [Matrix Support (MS)] of speech therapists, physical therapist, and occupational therapists. We searched for professionals from the Health Care Network using Cadastro Nacional de Estabelecimentos de Saúde (CNES) [Brazilian National Register of Health Establishments (NRHE)], and the monthly trend was elaborated through Prais-Winsten linear regression models. Aiming at knowing the practices of ECC, STP, and MS, “Discourses of the Collective Subject” were made from interviews held with 12 professionals. Medium complexity services had higher concentration of professionals, except for the hospitals in São Paulo city, and PHC had the lower possibility of access. Though shy, healthcare increased for all three professionals, with emphasis on physical therapists in hospitals in São Paulo city, in a comparison between the state (0.73%) and city (0.95%). In PHC, the highest raises were for occupational therapists of São Paulo city and physical therapists in Brazil. For MS, ECC and STP, besides the difficulty of the working process itself, ideas such as “plurality of concepts,” “biopsychosocial perspective,” and “possibility of adaptation” of care were predominant. Despite the growing numbers, the availability of professionals is still low and uneven, concentrated in specialty, and emphasising the expansion of physical therapy in hospitals and occupational therapy in PHC.

RESUMEN Para que se tenga una adecuada oferta de servicios de rehabilitación en Brasil es necesario conocer el acceso disponible en la Red Asistencial de Salud (RAS) y desarrollar prácticas que abarcan las necesidades de la atención de salud. Se intentó estimar la distribución de los recursos humanos de rehabilitación en la RAS 2007-2015, en especial en la Atención Primaria de Salud (APS) y conocer la práctica de la Clínica Ampliada (CA), del Proyecto Terapéutico Singular (PTS) y de la Ayuda Matricial (AM) de fonoaudiólogos, fisioterapeutas y terapeutas ocupacionales. La búsqueda por estos profesionales de la Red Asistencial se dio a través del Registro Nacional de Establecimientos de Salud (RNES). Se estableció la tendencia mensual mediante modelos de regresión lineal Prais-Winsten. A fin de conocer las prácticas de los CA, PTS y AM se constituyeron discursos de sujeto colectivo desde entrevistas con 12 profesionales. La media complejidad concentró la mayoría de los profesionales, excepto en los hospitales de la ciudad de São Paulo. Pero la accesibilidad a la APS fue menor. Aunque no fue muy alta, se observó evolución de estos tres profesionales en la atención sanitaria, con énfasis en los fisioterapeutas del hospital de São Paulo, referente al estado (0,73%) y ciudad (0,95%). En la APS, el mayor incremento fue del terapeuta ocupacional en la ciudad de São Paulo y del fisioterapeuta por todo el país. En la AM, CA y PTS, además de la dificultad en la práctica, se encontraron respectivamente ideas de “pluralidad de conceptos”, “perspectiva biopsicosocial” y “posibilidad de adaptarse” al cuidado. Aunque esté aumentando, la disponibilidad de estos profesionales todavía es pequeña y desigual, concentrada en la especialidad, lo que señala la necesidad de ampliar el número de fisioterapeutas en hospitales y de terapeutas ocupacionales en la APS.

RESUMO Streblidae é uma família de moscas hematófagas, encontradas em maior riqueza em regiões tropicais e subtropicais, ectoparasitas obrigatórias de morcegos. Um grande número de espécies é encontrado na Mata Atlântica, no entanto, não há muita informação a respeito de seus descritores quantitativos. Neste trabalho nós descrevemos a prevalência, intensidade média e as infracomunidades de moscas estréblidas em morcegos filostomídeos do Parque Estadual da Ilha do Cardoso, estado de São Paulo, Brasil. Capturas foram realizadas de julho de 1990 até julho de 1991 em diferentes localidades da ilha, de forma que 454 moscas de 30 espécies foram coletadas de 132 morcegos de 15 espécies. Com isso, encontramos 44 associações parasito-hospedeiro e 31 infracomunidades que sofreram variação em virtude de associações acidentais ou contaminações. Com os nossos resultados o número de espécies de Streblidae para o estado de São Paulo aumentou de 31 para 36.

ABSTRACT Streblidae is the family of bloodsucking flies, mostly tropical and subtropical, that are obligate ectoparasites of bats. A high number of these fly species are found in the Atlantic Forest, but there is little information about their quantitative descriptors. In this paper, we describe the prevalence, mean intensity, and infracommunities of streblid bat flies on phyllostomid bats from the Parque Estadual da Ilha do Cardoso, São Paulo state, Brazil. Surveys were conducted from July 1990 to July 1991 in distinct places of the island, with a total of 454 flies of 30 species collected from 132 bats of 15 species. From those, we found 44 host-parasite associations and 31 infracommunities that suffered variations due to accidental associations or contaminations. With our results, the number of Streblidae species increased from 31 to 36 in São Paulo State.