Abstract Working with an interprofessional focus is increasingly necessary, in view of the growing complexity of the population’s health needs. This study aims to assess interprofessional collaboration and the teamwork climate in primary health care (PHC) and determine whether there is a relationship between these two variables. The AITCS-II instrument was used to measure interprofessional collaboration, while to diagnose teamwork climate, the ECTE instrument was used, a version adapted to the SUS context of the Teamwork Climate Inventory instrument. These two instruments were applied online together with a questionnaire for the sociodemographic characterization of the 544 participants, who belonged to 97 Family Health Strategy (FHS) teams in a Brazilian municipality. The obtained data were submitted to a multilevel analysis. A positive correlation was observed between interprofessional collaboration and three of the four teamwork climate factors. The better the work climate, the better the interprofessional collaboration in the corresponding team, and this characteristic stands out in relation to other individual analyzed characteristics.

Resumo Trabalhar com foco interprofissional é cada vez mais necessário, tendo em vista a crescente complexidade das necessidades de saúde da população. Este estudo tem como objetivo avaliar a colaboração interprofissional e o clima de trabalho em equipe na atenção primária à saúde (APS) e verificar possível relação entre estas duas variáveis. Para mensurar a colaboração interprofissional foi utilizado o instrumento AITCS-II, enquanto para o diagnóstico do clima de trabalho em equipe foi utilizado o instrumento ECTE, versão adaptada para o contexto SUS do instrumento Teamwork Climate Inventory. Esses dois instrumentos foram aplicados on-line juntamente com um questionário para caracterização sociodemográfica dos 544 participantes, pertencentes a 97 equipes da Estratégia Saúde da Família (ESF) de um município brasileiro. Os dados obtidos foram submetidos a uma análise multinível. Foi observada uma correlação positiva entre a colaboração interprofissional e três dos quatro fatores do clima de trabalho em equipe. Quanto melhor o clima de trabalho, melhor a colaboração interprofissional na equipe correspondente, e essa característica se destaca em relação às demais características individuais analisadas.

Abstract Working with an interprofessional focus is increasingly necessary, in view of the growing complexity of the population’s health needs. This study aims to assess interprofessional collaboration and the teamwork climate in primary health care (PHC) and determine whether there is a relationship between these two variables. The AITCS-II instrument was used to measure interprofessional collaboration, while to diagnose teamwork climate, the ECTE instrument was used, a version adapted to the SUS context of the Teamwork Climate Inventory instrument. These two instruments were applied online together with a questionnaire for the sociodemographic characterization of the 544 participants, who belonged to 97 Family Health Strategy (FHS) teams in a Brazilian municipality. The obtained data were submitted to a multilevel analysis. A positive correlation was observed between interprofessional collaboration and three of the four teamwork climate factors. The better the work climate, the better the interprofessional collaboration in the corresponding team, and this characteristic stands out in relation to other individual analyzed characteristics.

Resumo Trabalhar com foco interprofissional é cada vez mais necessário, tendo em vista a crescente complexidade das necessidades de saúde da população. Este estudo tem como objetivo avaliar a colaboração interprofissional e o clima de trabalho em equipe na atenção primária à saúde (APS) e verificar possível relação entre estas duas variáveis. Para mensurar a colaboração interprofissional foi utilizado o instrumento AITCS-II, enquanto para o diagnóstico do clima de trabalho em equipe foi utilizado o instrumento ECTE, versão adaptada para o contexto SUS do instrumento Teamwork Climate Inventory. Esses dois instrumentos foram aplicados on-line juntamente com um questionário para caracterização sociodemográfica dos 544 participantes, pertencentes a 97 equipes da Estratégia Saúde da Família (ESF) de um município brasileiro. Os dados obtidos foram submetidos a uma análise multinível. Foi observada uma correlação positiva entre a colaboração interprofissional e três dos quatro fatores do clima de trabalho em equipe. Quanto melhor o clima de trabalho, melhor a colaboração interprofissional na equipe correspondente, e essa característica se destaca em relação às demais características individuais analisadas.

ABSTRACT Objective To analyze the karyotype test and myeloid panel with next-generation sequencing findings in patients with myelofibrosis, and to compare transplant characteristics in patients referred for bone marrow transplantation. Methods Retrospective, single-center study with patients diagnosed with myelofibrosis treated at Hospital Israelita Albert Einstein between 2010 and 2020. Results A total of 104 patients with myelofibrosis were examined. Patients who had not been submitted to tests in our service were excluded. The final sample comprised 69 patients. Of these 69, 56 were submitted to karyotyping and 22 to myeloid panel with next-generation sequencing. Karyotype was normal in 60% of the patients and altered in 40%. The prevalence of high-risk molecular mutations was higher in patients referred for bone marrow transplantation (100% versus 50%). The median follow-up of transplant patients was 2.4 years and the overall survival at 2 years was 80% (95%CI: 62-100%). Conclusion The molecular analysis enables estimating the patient’s risk and thus instituting more aggressive treatment such as bone marrow transplant for patients at higher risk, being a relevant tool to guide therapy. Given the significance of molecular analysis for therapeutic decision-making in myelofibrosis, collection and disclosure of data on the prevalence of cytogenetic changes and findings of next-generation sequencing in affected patients is important.

ABSTRACT Background: The number of tuberculosis (TB) cases in prisons is higher than that in the general population and has been reported as the most common cause of death in prisons. This study evaluated the delay in the diagnosis and treatment of TB in Brazilian prisons. Methods: A retrospective cohort study was conducted between 2007 and 2015 using data from the five largest male prisons in Mato Grosso do Sul, Brazil. TB case data was collected from the National Database of Notifiable Diseases (SINAN), GAL-LACEN, and prison medical records. The following variables were recorded: prison, year of diagnosis, age, race, education, HIV status, smoking status, comorbidities, number of symptoms, percentage of cures, delay in diagnosis, patient delay, provider delay, laboratory delay, and delay in treatment. Descriptive statistics were used for the variables of interest. Results: A total of 362 pulmonary TB cases were identified. The average time between the first symptom and reporting of data was 94 days. The mean time between symptom onset and laboratory diagnosis was 91 days. The average time from symptom onset to first consultation was 80 days. The time between diagnosis and treatment initiation was 5 days. Conclusions: Delays were significant between reporting of the first symptoms and diagnosis and significantly smaller from the time between notification and start of treatment. Control strategies should be implemented to diagnose cases through active screening, to avoid delays in diagnosis and treatment, and to reduce TB transmission.

ABSTRACT Tomato fruits are highly perishable. In this sense, adopting techniques to maintain and extend its shelf life is essential. Recent studies have used microalgae as an edible coating for fruit, as it is a nutrient-rich alternative and reduces fruit mass loss and respiration, delaying senescence. The aim of this study was to evaluate the application of microalgae-based coatings with or without the use of modified atmosphere packaging, polyvinyl chloride (PVC), in post-harvest tomato conservation. The design used was completely randomized, in a 4x2 factorial arrangement, with four coatings (no coating, coating composed of Spirulina platensis sp., Chlorella sp. and Scenedesmus sp.) and two conditions (with and without PVC), totalizing 8 treatments, with four replicates, consisting of one fruit each. Stored for 7 days at 10±2ºC and 55±5% UR and evaluated at harvest and on the last day of storage. The fruits coated with Chlorella sp. without PVC and Scenedesmus sp. associated with PVC, showed the lowest mass losses, representing a reduction of 73.79% and 78.47%, respectively, in relation to the control. In addition to mass loss, the levels of ascorbic acid (18.91 and 16.97 mg/100 g), citric acid (4.02 and 4.01), respectively, and the SS/AT ratio also stood out. The microalgae Chlorella sp. and Scenedesmus sp. can be used in coating ‘Santa Clara’ tomato fruits to maintain their physicochemical characteristics over 7 days of storage. The use of PVC film coating helped maintain these characteristics, reducing the perishability of the fruits.

RESUMO Os frutos do tomateiro têm alta perecibilidade havendo a necessidade da adoção de técnicas que mantenham e prolonguem sua vida útil pós-colheita. Estudos recentes têm utilizado microalgas como recobrimento comestível em frutos, por ser uma alternativa rica em nutrientes e reduzir perda de massa e respiração do fruto e assim retardar a senescência. Objetivou-se avaliar a aplicação de revestimentos a base de microalgas com ou sem o uso de embalagem com atmosfera modificada (policloreto de vinila) na conservação pós-colheita de tomate. O delineamento utilizado foi inteiramente casualizado, em arranjo fatorial 4x2, com quatro revestimentos (sem revestimento, revestimento com Spirulina platensis sp., Chlorella sp. e Scenedesmus sp.) e duas condições [com e sem PVC (policloreto de vinila)], totalizando 8 tratamentos, com quatro repetições, constituída por um fruto cada. Armazenados por 7 dias a 10±2ºC e 55±5% UR e avaliados na colheita e no último dia de armazenamento. Os frutos recobertos com Chlorella sp. sem o PVC e Scenedesmus sp. associado ao PVC, tiveram as menores perdas de massa, representando redução de 73,79% e 78,47%, respectivamente, em relação ao controle. Além da perda de massa, também tiveram destaque nos teores de ácido ascórbico (18,91 e 16,97 mg/100 g). As microalgas Chlorella sp. e Scenedesmus sp. podem ser utilizadas no revestimento de frutos do tomateiro ‘Santa Clara’ para manter suas características físico-químicas ao longo de 7 dias de armazenamento. A utilização do recobrimento com filme PVC auxilia na manutenção dessas características, diminuindo a taxa de perecibilidade dos frutos.

The Michelson-Morley interferometer has been used in the most diverse applications since its construction in 1887 by Albert Michelson and Edward Morley to measure the speed of the earth with regard to the ether. Despite the simplicity of its assembly, the instrument still finds relevant applications nowadays. In this work, we present the computational simulation and construction of a variant of the Michelson-Morley interferometer using the air-water diopter as a beam splitter. The proposed modification shows significance in promoting the discussion about many concepts related to physics and engineering. The assembly employed a red laser centered at 630 nm, with linear polarization oriented at an angle of about 45∘ from the plane of incidence, as an excitation source and two first surface mirrors to reflect the beams reflected and refracted at the diopter – a CCD camera captured the circular interference images on the screen. The analysis of the wave intensities employed the Finite Element Method.

Desde sua construção em 1887 por Albert Michelson e Edward Morley, com o objetivo de medir a velocidade da terra em relação ao éter, o interferômetro de Michelson-Morley passou a ser utilizado nas mais diversas aplicações de interferometria. Apesar de sua simplicidade na montagem, o instrumento encontra importantes aplicações utilizando o fenômeno de interferência. Neste trabalho apresentamos a simulação e a construção de uma variante do interferômetro de Michelson-Morley utilizando o dioptro ar-água como divisor de feixe. A proposta é uma importante aplicação para discussão de diferentes temas vistos na formação em Física e Engenharias. Na montagem foram utilizados um laser vermelho centrado em 630 nm, com polarização linear orientada em um ângulo de cerca de 45∘ do plano de incidência, como fonte de excitação e dois espelhos de primeira face para refletir os feixes refletido e o refratados no dioptro. A análise das intensidades das ondas foi realizada utilizando o Método dos Elementos Finitos e as imagens das interferências circulares foram obtidas utilizando-se uma câmera CCD.

Abstract This study aimed to resveratrol supplementation (at 5 or 10 mg/kg) and a hydroethanolic extract of canjiqueira fruits (150 mg/kg) on female SWISS mice. Total cholesterol, high-density lipoprotein (HDL), triglyceride levels, gestation rates, and embryonic implantation rates in their female Offspring was evaluated. In conclusion, the consumption of canjiqueira fruit extract altered the lipid profile of their female offspring, and did not impact their reproductive performance. Supplementing female SWISS mice with 10 mg/kg of resveratrol increased total cholesterol, triglycerides, and HDL levels, thereby enhancing the reproductive efficiency of their offspring.

ABSTRACT Objective To detect and treat cases of viral hepatitis B, C and D in patients seen at the Native American Outpatient Clinic of Universidade Federal de São Paulo. Methods This sample comprised 81 indigenous recruited between 2018 and 2020. Volunteers were aged 7 months to 70 years (mean age of 28±20 years), belonged to 26 ethnic groups spanning the Brazilian territory and answered a questionnaire, which was attached to their medical records. Peripheral blood samples (20mL) were collected, transported to the Clinical Laboratory of Hospital Israelita Albert Einstein, processed, and tested for markers of viral hepatitis B, C and D. Results In this study, 39 (48.1%) individuals were anti-HBs (+) only, 13 (16.0%) individuals were anti-HBs (+) and anti-HBc (+), and 28 (34.6%) individuals were negative for all markers. No anti-HBc IgM+ samples were found. No cases of hepatitis C and D were found. Conclusion This analysis provided evidence of previous infection by the hepatitis B virus. These findings led to prescription of vaccination against hepatitis B to all participants who were negative for all viral hepatitis B markers, given records of prior hepatitis B vaccination were unreliable.

Abstract Microalgae are considered a rich source of biostimulants for plants, as an excellent business opportunity for the agricultural sector, as they can activate plant metabolism, contributing to the improvement in physiological performance, phytomass and, subsequently, vigor and quality of seedlings. The objective of this work was to evaluate the potential of Spirulina platensis biomass, in enabling improvements in physiological performance, phytomass and, subsequently, vigor and quality of cashew rootstock seedlings. The experiment was carried out in a greenhouse in a completely randomized design, in a 4 x 2 factorial scheme (concentrations x rootstock), with three replications. The concentrations used were 0%, 0.04%, 0.08%, and 0.12% and the FAGA and CCP 76 genotypes. The seeds were immersed in the solutions for 12 hours. Applications were made via the leaves at 30 days after sowing (DAS), with an interval of seven days between each application and at 90 DAS evaluations were made. The FAGA and CCP 76 genotypes showed a positive response to the supply of S. platensis, with concentrations 0.04% and 0.08% which provided greater root length, aerial part length, number of leaves, diameter and leaf area. Concentrations 0.04% and 0.08% also promoted better percentages in the physiology of the CCP 76 genotype, while the FAGA genotype showed opposite action, which may be related to the mode of action of the microalgae on the different genetic and phenotypic characteristics of each genotype. The 0.12% concentration provided greater accumulations of aerial part and total dry mass to the genotypes.

Resumo Este artigo tem como objetivo compreender alguns acontecimentos políticos da Primeira República pelo olhar literário de Lima Barreto. Numa relação entre alegoria e história, buscamos entender como o escritor trabalha o mundo político a partir do figurado, da sátira e de temas clássicos da literatura universal, como o banquete. A crônica mestra que será analisada é Coisas do Jambon, publicada na revista Careta, em 1921. Por meio de seus rastros alegóricos, iremos descortinar outros testemunhos e apreender os fios que costuram a particularidade da história brasileira. Dois episódios históricos se cruzam nas imagens alegorizadas tecidas pelo autor: a vinda de Alberto I, rei da Bélgica, ao Brasil, em 1920; e a disputa presidencial entre Artur Bernardes e Nilo Peçanha, em 1921.

Abstract This article aims to understand some political events of the First Republic through the literary gaze of Lima Barreto. In a relationship between allegory and history, we seek to understand how the writer works the political world from the figurative, satire and classic themes of universal literature such as the banquet. The master chronicle that will be analyzed here is Coisas do Jambon, also published in the Careta magazine in 1921. Through its allegorical traces, we will unveil other testimonies and apprehend the threads that sew the particularity of Brazilian history. Two historical episodes intersect in the allegorized images made by the author: The arrival of Albert I, king of Belgium, to Brazil, in 1920; and the presidential dispute between Artur Bernardes and Nilo Peçanha, in 1921.

Abstract: The article presents a re-reading of Max Weber’s sociology based on Brian Epstein’s anchor individualism. After presenting Gert Albert’s thesis on Weber’s ontology, we reconstruct, in its broad outlines, the concepts of anchoring and grounding in Epstein’s individualistic ontology. We thus demonstrate that for Weber the social level is “anchored” in individuals conceived in their double dimension as bio-psychological and cultural beings. Regarding the “grounding” of the social, we show that the concept of meaningful action can be read as a form of mental projection that finds its collective translation in the dimension of institutionalized social relations [Social Order]. In this way, the relationship between the institutional level and the individual level is not thought of in terms of direct causation, but as “dependence” [grouding].

Resumen: El artículo presenta una relectura de la sociología de Max Weber basada en el individualismo de anclaje de Brian Epstein. Después de presentar la tesis de Gert Albert sobre la ontología de Weber, reconstruimos, a grandes rasgos, los conceptos de anclaje y fundamentación en la ontología individualista de Epstein. Demostramos así que para Weber el nivel social está “anclado” en los individuos concebidos en su doble dimensión de seres biopsicológicos y culturales. En relación con el “enraizamiento” [grounding] de lo social, mostramos que el concepto de acción con sentido puede leerse como una forma de proyección mental que encuentra su traducción colectiva en la dimensión de las relaciones sociales institucionalizadas [orden social]. De este modo, la relación entre el nivel institucional y el nivel individual no se plantea en términos de causalidad directa, sino de “dependencia” [grouding].

Resumo: O artigo apresenta uma releitura da sociologia de Max Weber com base no individualismo âncora de Brian Epstein. Após apresentar a reflexão de Gert Albert sobre a ontologia de Weber, reconstruímos, em suas linhas gerais, os conceitos de anchoring e grounding da ontologia individualista de Epstein. Demonstramos, assim, que para Weber o nível social está “ancorado” nos indivíduos concebidos em sua dupla dimensão de seres biopsicológicos e socioculturais. Em relação ao “fundamento” [grounding] do social, mostramos que o conceito de ação com sentido pode ser lido como uma forma de projeção mental que encontra sua tradução coletiva na dimensão das relações sociais institucionalizadas [ordem social]. Dessa forma, a relação entre o nível institucional e o nível individual não é pensada em termos de causação direta, mas enquanto “dependência” [grouding].

Abstract The use of edible coating has been an alternative to maintain the quality of vegetables and prolong their post-harvest life. This study aims to evaluate bioactive compounds in Spondias tuberosa submitted to different coating formulations based on Chlorella sp. associated with the pomegranate seed oil, to establish the one that best maintains post-harvest quality. The experiment was set in a completely randomized design, in a 5 × 6 factorial scheme, represented by five coating techniques (T1 = control; T2 = 0.5% Chlorella sp.; T3 = 1% Chlorella sp.; T4 = 1.5% Chlorella sp.; T5 = 2% Chlorella sp.), using 0.3% of pomegranate seed oil in coatings, during five evaluation periods (0, 1, 2, 3, 4 and 5 days), stored in BOD incubator at 24 ± 2 °C and 85 ± 5% RH, with three replicates of ten fruits per plot. Chlorella sp. associated with pomegranate seed oil produced a modified atmosphere around the fruit, retarding the ripening process. Coatings preserved the content of ascorbic acid and phenolic compounds. The treatment containing 2.0% of Chlorella sp. associated with pomegranate seed oil provided the best maintenance for fruit quality.

Resumo Introdução A estruturação dos serviços de saúde é um elemento fundamental para dar respostas à carga de doenças crônicas. Objetivo Analisar a relação entre internações e óbitos pelas doenças do aparelho circulatório e a estrutura nos serviços de saúde. Método Estudo transversal desenvolvido em estado do Centro-Oeste brasileiro, região de saúde composta de 17 municípios e 1.112.792 habitantes. Foram analisadas as dimensões demográfica, epidemiológica e de estrutura de saúde pela estatística descritiva e correlação linear de Pearson. Resultados A taxa da mortalidade por doenças do aparelho circulatório foi de 29,49%, superior aos achados no país e no Centro-Oeste. Houve correlação significativa entre internação por doenças isquêmicas do coração e número de leitos e entre internação por doenças do aparelho circulatório e número de serviços especializados para cada 10 mil habitantes. Conclusão As diferenças encontradas entre internações e a existência dos serviços especializados e leitos indicam que a população que reside em municípios com estrutura de serviços complexa possui mais acesso aos serviços e às internações. Os resultados demonstram que deve haver mais cuidado na conformação e oferta de serviços na Rede de Atenção à Saúde para as doenças do aparelho circulatório, visando assegurar equidade no acesso da população aos serviços pactuados.

Abstract Background The structuring of health services is a fundamental element to respond to the burden of chronic diseases. Objective To analyze the relationship between hospitalizations and deaths due to diseases of the circulatory system and the structure in health services. Method A cross-sectional study developed in the state of the Brazilian central-west was carried out with a health region composed of 17 municipalities and 1,112,792 inhabitants. The demographic, epidemiological and health structure dimensions were analyzed using descriptive statistics and Pearson's linear correlation. Results The mortality rate due to diseases of the circulatory system was 29.49%, higher than the findings in the country and in the center-west. There was a significant correlation between hospitalization for ischemic heart diseases and number of beds, and between hospitalization for diseases of the circulatory system and number of specialized services for each 10,000 inhabitants. Conclusion The differences found between hospitalizations and the existence of specialized services and beds indicate that the population that lives in municipalities with a complex service structure has more access to services and hospitalizations. The results demonstrate that there must be greater care in the conformation and offer of services in the Health Care Network for diseases of the circulatory system, aiming to ensure equity in the population's access to the agreed services.

RESUMO OBJETIVOS Revisar o conhecimento atual sobre os aspectos imunológicos da infecção por coronavírus 2019 (COVID-19) na gravidez, com base nas evidências científicas recentes. MÉTODOS Uma revisão integrativa foi realizada por dois pesquisadores independentes, com base na literatura disponível nas bases de dados MEDLINE (via PubMed) e LILACS, utilizando os descritores “gravidez” e “COVID-19”. Esta pesquisa incluiu artigos publicados até 14 de abril de 2020, publicados em inglês, espanhol ou português. Após a leitura integral dos artigos, foram selecionados aqueles relacionados especificamente aos aspectos imunológicos da doença na gravidez. Encontramos inicialmente um total de 62 artigos; 52 foram acessados em texto completo e 5 artigos foram finalmente selecionados. RESULTADOS As gestantes são sabidamente mais afetadas por doenças respiratórias, devido a alterações imunológicas e anatômicas fisiológicas. Alguns estudos destacam a importante mudança para uma resposta imune linfocitária T do tipo 2 (Th2) na gravidez, como potencial contribuinte para a gravidade nos casos de COVID-19. Além disso, a tempestade de citocinas apresentada em casos graves da doença leva a um aumento do estado inflamatório, que pode deteriorar o prognóstico clínico nessa população. Portanto, as mulheres grávidas podem representar um grupo vulnerável à infecção por COVID-19, principalmente devido ao desequilíbrio imunológico na interface fetal materna. CONCLUSÃO A resposta imune materna provavelmente desempenha um papel importante na fisiopatologia dessa infecção, apesar de alguns detalhes permanecerem sem solução. Embora sejam necessários mais estudos para investigar profundamente os aspectos imunológicos da doença na gravidez, nossos achados podem fornecer informações sobre possíveis mecanismos imunológicos envolvidos na fisiopatologia do COVID-19 na gravidez.

SUMMARY OBJECTIVE To review the immunological aspects of the 2019 coronavirus disease (COVID-19) in pregnancy, based on the scientific evidence currently available. METHODS An integrative review was performed by two independent researchers, based on the literature available in the MEDLINE (via PubMed) and LILACS databases, using the descriptors “pregnancy” and “COVID-19”. This search included articles published up until 14th April 2020 published in English, Spanish or Portuguese. After reading the articles available in their entirety, those related specifically to the immunological aspects of the disease in pregnancy were selected. We initially found a total of 62 articles; 52 were accessed in full-text, and 5 were finally selected. RESULTS Pregnant women are more affected by respiratory diseases possibly because of physiological, immune, and anatomical changes. Some studies highlight the important shift to a T-helper lymphocyte type 2 (Th2) immune response in pregnancy, as a potential contributor to the severity in cases of COVID-19. Additionally, the cytokine storm present in severe cases leads to an increased inflammatory state, which may deteriorate the clinical prognosis in this population. Therefore, pregnant women may represent a vulnerable group to COVID-19 infection, primarily due to the immune imbalance in the maternal-fetal interface. CONCLUSION Maternal immune response probably plays an important role in the pathophysiology of this infection, although some details remain unsolved. Although further studies are needed to deeply investigate the immunological aspects of the disease in pregnancy, our findings may provide insights into the possible immune mechanisms involved in the pathophysiology of COVID-19 in pregnancy.

Resumo Objetivo: analisar os resultados do Censo Nacional das Unidades Básicas de Saúde no que se refere às barreiras arquitetônicas e de comunicação na Atenção Básica em Saúde em todo o território brasileiro. Métodos: estudo transversal com base nos dados do primeiro Censo Nacional das Unidades Básicas de Saúde, coletados de maio a outubro de 2012. Resultados: a região Norte apresentou menores índices de adequação, enquanto a Sudeste apresentou os melhores índices, comparados às demais regiões, porém insatisfatórios, pois muitos itens permaneceram abaixo de 50%; itens sobre acessibilidade por pessoas com deficiência (5,7 a 34,2%) e não alfabetizadas (0,1 a 27,4%) apresentaram pontuação muito baixa. Conclusão: a maioria das unidades avaliadas possuem barreiras arquitetônicas e de comunicação, prejudicando a acessibilidade aos serviços de saúde prestados às pessoas com deficiência, não alfabetizadas ou idosas; destaca-se a importância da alocação de recursos para redução de iniquidades e melhoria do acesso.

Abstract Objective: to analyze the results of the National Census of Primary Health Care Centers with regard to architectural and communication barriers in Primary Health Care throughout Brazil. Methods: this was a cross-sectional study based on data from the first National Census of Primary Health Care Centers conducted between May and October 2012. Results: the Northern region had the lowest rates of adequacy; although the Southeast region had the best rates when compared to the country’s other regions, they were nevertheless unsatisfactory, since for many items adequacy was still below 50%; the items relating to accessibility by people with disabilities (5.7 to 34.2%) and/or the illiterate (0.1 to 27.4%) had very low scores. Conclusion: the majority of services evaluated had architectural and communication barriers, hindering access to health services by disabled, illiterate or elderly people; the importance of allocating resources to reduce iniquities and improve access is stressed.

Resumen Objetivo: analizar la accesibilidad de los usuarios al Censo Nacional de las Unidades Básicas de Salud en lo referente a barreras arquitectónicas y de comunicaciones en todo Brasil. Métodos: estudio descriptivo analítico con base en los datos del primer Censo Nacional de las Unidades Básicas de Salud; la encuesta se realizó entre mayo y octubre de 2012. Resultados: la región Norte presentó menores índices de adecuación, mientras que el Sudeste presentó mejores índices comparados a las demás regiones, pero insatisfactorios, pues muchos ítems permanecieron por debajo del 50%; los ítems sobre accesibilidad por personas con discapacidad (5,7 a 34,2%) y no alfabetizadas (0,1 a 27,4%) presentaron una puntuación muy baja. Conclusión: los datos demuestran que la mayoría de los servicios evaluados poseen barreras arquitectónicas y de comunicación, perjudicando la accesibilidad a los servicios de salud prestados a las personas con discapacidad, no alfabetizadas o ancianas, y exalta la importancia de asignación de recursos para la reducción de iniquidades y mejoría del acceso.