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Koch R, Fuhr H, Koifman L, Sturm H, March C, Vianna Sobrinho L, Joos S, Borges FT. A post-Flexner comparative case study of medical training responses to health system needs in Brazil and Germany. BMJ Glob Health 2022; 7:bmjgh-2021-008369. [PMID: 35346956 PMCID: PMC8961159 DOI: 10.1136/bmjgh-2021-008369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/14/2022] [Indexed: 11/03/2022] Open
Abstract
Health systems need medical professionals who can and will work in outpatient settings, such as general practitioner practices or health centres. However, medical students complete only a small portion of their medical training there. Furthermore, this type of training is sometimes seen as inferior to training in academic medical centres and university hospitals. Hence, the healthcare system’s demand and the execution of medical curricula do not match. Robust concepts for better alignment of both these parts are lacking. This study aims to (1) describe decentral learning environments in the context of traditional medical curricula and (2) derive ideas for implementing such scenarios further in existing curricula in response to particular medicosocietal needs.This study is designed as qualitative cross-national comparative education research. It comprises three steps: first, two author teams consisting of course managers from Brazil and Germany write a report on change management efforts in their respective faculty. Both teams then compare and comment on the other’s report. Emerging similarities and discrepancies are categorised. Third, a cross-national analysis is conducted on the category system.Stakeholders of medical education (medical students, teaching faculty, teachers in decentral learning environments) have differing standards, ideals and goals that are influenced by their own socialisation—prominently, Flexner’s view of university hospital training as optimal training. We reiterate that both central and decentral learning environments provide meaningful complementary learning opportunities. Medical students must be prepared to navigate social aspects of learning and accept responsibility for communities. They are uniquely positioned to serve as visionaries and university ambassadors to communities. As such, they can bridge the gap between university hospitals and decentral learning environments.
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Affiliation(s)
- Roland Koch
- Institute for General Practice and Interprofessional Care, Universitätsklinikum Tübingen, Tubingen, Germany
| | - Hannah Fuhr
- Institute for General Practice and Interprofessional Care, Universitätsklinikum Tübingen, Tubingen, Germany
| | | | - Heidrun Sturm
- Institute for General Practice and Interprofessional Care, Universitätsklinikum Tübingen, Tubingen, Germany
| | | | | | - Stefanie Joos
- Institute for General Practice and Interprofessional Care, Universitätsklinikum Tübingen, Tubingen, Germany
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Watanabe M, Borges FT, Pessoa EA, Fonseca CD, Fernandes SM, Drew RC, Volpini RA, Vattimo MFF. Renoprotective effect of N-acetylcysteine depends upon the severity of the ischemia reperfusion injury. Braz J Med Biol Res 2021; 54:e9941. [PMID: 34495252 PMCID: PMC8427747 DOI: 10.1590/1414-431x2021e9941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/29/2021] [Indexed: 01/16/2023] Open
Abstract
Acute kidney injury (AKI) is a common complication in seriously ill patients, while renal ischemia-reperfusion (I/R) injury is the most frequent event in this oxidative renal injury. N-acetylcysteine (NAC) is a small molecule containing a thiol group that has antioxidant properties, promoting detoxification and acting directly as a free radical scavenger. In this study, the protective effect of NAC was investigated in short-term (30 min) and long-term (45 min) ischemic AKI. This was achieved via clamping of the renal artery for 30 or 45 min in Wistar rats to induce I/R injury. AKI worsened with a longer period of ischemia (45 compared to 30 min) due to probable irreversible damage. Preconditioning with NAC in short-term ischemia improved renal blood flow and increased creatinine clearance by reducing oxidative metabolites and increasing antioxidant capacity. Otherwise, NAC did not change these parameters in the long-term ischemia. Therefore, this study demonstrated that the period of ischemia determines the severity of the AKI, and NAC presented antioxidant effects in short-term ischemia but not in long-term ischemia, confirming that there is a possible therapeutic window for its renoprotective effect.
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Affiliation(s)
- M Watanabe
- Laboratório Experimental de Modelos Animais, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brasil
| | - F T Borges
- Divisão de Nefrologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - E A Pessoa
- Divisão de Nefrologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - C D Fonseca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - S M Fernandes
- Laboratório Experimental de Modelos Animais, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brasil
| | - R C Drew
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - R A Volpini
- Departamento de Nefrologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - M F F Vattimo
- Laboratório Experimental de Modelos Animais, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brasil
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Borges FT, Fernández LAL, Campos GWDS. Políticas de austeridade fiscal: tentativa de desmantelamento do Sistema Nacional de Salud da Espanha e resistência cidadã. Saude soc 2018. [DOI: 10.1590/s0104-12902018180043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Este ensaio de natureza teórica analisa os ajustes fiscais colocados em marcha na Espanha como resposta à crise financeira de 2008, suas implicações para o Sistema Nacional de Salud (SNS) e a consequente resistência cidadã. Elaboramos um estudo de caso tendo como fonte primária a narrativa de um ator social que participou da reforma espanhola. Utilizamos também fontes secundárias para coleta de dados socioeconômicos e a análise de 20 artigos publicados pelo Relatório Sespas 2014. O SNS formou-se por aumento progressivo da cobertura populacional, financiamento total por impostos e organização da rede por meio da Atenção Primária em Saúde (APS). As medidas de austeridade fiscal impuseram limitações de ordem orçamentária, reduziram a provisão de serviços, introduziram copagamentos e retrocederam o direito à saúde à meritocracia. A corrente crítica da economia política sinaliza que o propósito dos ajustes econômicos é a transferência regressiva de renda e riqueza. As Mareas Ciudadanas constituíram-se numa resposta cidadã com êxito em muitas lutas sociais contra a austeridade fiscal. A alternativa de resistência e superação pela via política se fez presente com vigor na Espanha e tem resistido ao desmantelamento do SNS.
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Alves JFDS, Martins MAC, Borges FT, Silveira C, Muraro AP. Use of health services by Haitian immigrants in Cuiabá-Mato Grosso, Brazil. Cien Saude Colet 2018; 24:4677-4686. [PMID: 31778517 DOI: 10.1590/1413-812320182412.32242017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 05/07/2018] [Indexed: 11/22/2022] Open
Abstract
This paper aims to analyze the use of health services by Haitian immigrants in Cuiabá, Mato Grosso. This is a cross-sectional study with a random sample of 452 Haitian immigrants in Cuiabá and Várzea Grande, interviewed between December 2014 and February 2015. Sociodemographic and health characteristics, lifestyle factors, and the use of health services were evaluated. Data analysis included Chi-square test and Poisson regression to investigate the factors associated with the use of health services. We found that 45.6% of respondents used some health service in Brazil, with a higher prevalence of use among women, those with higher income, longer residence time in Brazil, better understanding of the Portuguese language, and with poor self-reported health. The PHC Unit (UBS) and public urgent and emergency care were the primary services used. We conclude by saying that the SUS assisted the immigrants under the Brazilian constitutional principle of the right to health.
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Affiliation(s)
- Jenniffer Francielli de Sousa Alves
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso. Av. Fernando Corrêa da Costa 2367, Boa Esperança. 78060-900 Cuiabá MT Brasil.
| | - Maria Angela Conceição Martins
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso. Av. Fernando Corrêa da Costa 2367, Boa Esperança. 78060-900 Cuiabá MT Brasil.
| | | | - Cássio Silveira
- Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo SP Brasil
| | - Ana Paula Muraro
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso. Av. Fernando Corrêa da Costa 2367, Boa Esperança. 78060-900 Cuiabá MT Brasil.
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Borges FT, Muraro AP, da Costa Leão LH, de Andrade Carvalho L, Siqueira CEG. Socioeconomic and Health Profile of Haitian Immigrants in a Brazilian Amazon State. J Immigr Minor Health 2018; 20:1373-1379. [DOI: 10.1007/s10903-018-0694-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Caires A, Fernandes GS, Leme AM, Castino B, Pessoa EA, Fernandes SM, Fonseca CD, Vattimo MF, Schor N, Borges FT. Endothelin-1 receptor antagonists protect the kidney against the nephrotoxicity induced by cyclosporine-A in normotensive and hypertensive rats. ACTA ACUST UNITED AC 2017; 51:e6373. [PMID: 29267497 PMCID: PMC5731326 DOI: 10.1590/1414-431x20176373] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 09/12/2017] [Indexed: 01/13/2023]
Abstract
Cyclosporin-A (CsA) is an immunosuppressant associated with acute kidney injury and chronic kidney disease. Nephrotoxicity associated with CsA involves the increase in afferent and efferent arteriole resistance, decreased renal blood flow (RBF) and glomerular filtration. The aim of this study was to evaluate the effect of Endothelin-1 (ET-1) receptor blockade with bosentan (BOS) and macitentan (MAC) antagonists on altered renal function induced by CsA in normotensive and hypertensive animals. Wistar and genetically hypertensive rats (SHR) were separated into control group, CsA group that received intraperitoneal injections of CsA (40 mg/kg) for 15 days, CsA+BOS and CsA+MAC that received CsA and BOS (5 mg/kg) or MAC (25 mg/kg) by gavage for 15 days. Plasma creatinine and urea, mean arterial pressure (MAP), RBF and renal vascular resistance (RVR), and immunohistochemistry for ET-1 in the kidney cortex were measured. CsA decreased renal function, as shown by increased creatinine and urea. There was a decrease in RBF and an increase in MAP and RVR in normotensive and hypertensive animals. These effects were partially reversed by ET-1 antagonists, especially in SHR where increased ET-1 production was observed in the kidney. Most MAC effects were similar to BOS, but BOS seemed to be better at reversing cyclosporine-induced changes in renal function in hypertensive animals. The results of this work suggested the direct participation of ET-1 in renal hemodynamics changes induced by cyclosporin in normotensive and hypertensive rats. The antagonists of ET-1 MAC and BOS reversed part of these effects.
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Affiliation(s)
- A Caires
- Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - G S Fernandes
- Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - A M Leme
- Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.,Programa Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esporte, Universidade Cruzeiro do Sul, São Paulo, SP, Brasil
| | - B Castino
- Programa Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esporte, Universidade Cruzeiro do Sul, São Paulo, SP, Brasil
| | - E A Pessoa
- Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - S M Fernandes
- Laboratorio Experimental de Modelos Animais (LEMA), Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brasil
| | - C D Fonseca
- Laboratorio Experimental de Modelos Animais (LEMA), Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brasil.,Departamento de Enfermagem Clínica e Cirúrgica, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - M F Vattimo
- Laboratorio Experimental de Modelos Animais (LEMA), Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brasil
| | - N Schor
- Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - F T Borges
- Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.,Programa Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esporte, Universidade Cruzeiro do Sul, São Paulo, SP, Brasil
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Abstract
For more than 50 years, Cuba has been one of the most important players in the field of international medical cooperation in the Global South. Between 2013 and 2016, Cuba maintained one of its largest cooperations with Brazil: nearly 11,400 Cuban physicians were sent to work within the framework of the Brazilian health programme 'More-Doctors-for-Brazil', which was implemented to improve Brazil's precarious public health sector. This paper inquires into the manifold challenges of horizontal connectivity in this medical South-South cooperation. We will trace these back to deep-rooted contentions about the epistemological approaches to medical practice and professional recognition within and between Cuban and Brazilian arenas of public health, which do not, however, conform to a simplistic socialism-capitalism dichotomy. Rather, this particular South-South cooperation reveals significant differences in how powerful the postcolonial legacies of medical assistance remain in Global Health settings. This paper explores how these legacies may impact on the moral and professional legitimacy of the individuals involved in South-South partnership. Using ethnographic findings in newly established family clinics situated in urban poverty regions in Rio de Janeiro's North, we will also show how prolonged local interactions may create new spaces of horizontal encounters and connectivity in international medical cooperation.
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Affiliation(s)
- Maria Lidola
- a Division of Social and Cultural Anthropology, Department of History and Sociology , University of Konstanz , Konstanz (BW) , Germany
| | - Fabiano Tonaco Borges
- b Programa de Pós-Graduação em Saúde Coletiva, Instituto de Saúde Coletiva , Universidade Federal Fluminense (UFF) , Niterói (RJ) , Brazil
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Leão LHDC, Muraro AP, Palos CC, Martins MAC, Borges FT. [International migration, health, and work: an analysis of Haitians in Mato Grosso State, Brazil]. CAD SAUDE PUBLICA 2017; 33:e00181816. [PMID: 28767964 DOI: 10.1590/0102-311x00181816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 05/12/2017] [Indexed: 11/22/2022] Open
Abstract
This article addresses the relations between immigration, health, and work in Haitian immigrants in Cuiabá and Várzea Grande, Mato Grosso State, Brazil, emphasizing their work conditions. This was an exploratory study based on primary data collected through a survey of the Haitian population in Cuiabá in 2014-2015. A total of 452 Haitians were interviewed, living in Cuiabá and Várzea Grande (373 men and 79 women), and the findings point to the precarious social situation of Haitian immigrants in Mato Grosso State, marked by high unemployment. Of the immigrants interviewed, 52.7% were currently working and 26.5% reported a workweek greater than 48 hours. The two main occupations for Haitian immigrants in Cuiabá were construction and services, and most were working below their original level of training, skills sets, and job experience in Haiti. The main risks identified in these two sectors were physical (53.2% and 63.4%, respectively) and accidents (23.4% and 17.1%, respectively), in addition to reports of physical and psychosocial distress. The study points to the precarious social, economic, and labor conditions of the Haitian population in the capital of Mato Grosso.
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Affiliation(s)
| | - Ana Paula Muraro
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Cuiabá, Brasil
| | - Cássia Carraco Palos
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Cuiabá, Brasil
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Terra LSV, Borges FT, Lidola M, Hernández SS, Millán JIM, Campos GWDS. Analysis of the experience of Cuban physicians in a Brazilian metropolis in accordance with the Paideia Method. Cien Saude Colet 2016; 21:2825-36. [PMID: 27653067 DOI: 10.1590/1413-81232015219.15312016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 06/08/2016] [Indexed: 11/21/2022] Open
Abstract
We had hoped that the Mais Médicos Program (More Doctors Program) would have generated several changes and reflections in each municipality in which it was deployed. In order to observe those changes, we sought to analyze the experience of Cuban physicians in the Mais Médicos program from an actor-centered perspective, based on the Paideia Method - an approach that seeks to enhance the ability of the subjects to analyze and intervene in their practice. We performed semi-structured interviews to analyze our research object that consisted in the experience of those actors included professionally in the Mais Médicos program in a metropolis with unique characteristics. In order to assess the interviews, we applied Content Analysis followed by Thematic Analysis. From the discourse of the actors, of which illustrative excerpts are transcribed in this article, we can affirm that the program's potential surpassed any initial barriers, presenting itself as fine-tuning instrument for replacing the biomedical model in line with the Paideia Method.
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Affiliation(s)
- Lilian Soares Vidal Terra
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. Campinas SP Brasil.
| | - Fabiano Tonaco Borges
- Departamento de Planejamento em Saúde, Instituto de Saúde Coletiva, Universidade Federal Fluminense. Niterói RJ Brasil
| | - Maria Lidola
- Instituto para Estudos Latino-Americanos, Freie Universität Berlin. Berlin Alemanha
| | | | | | - Gastão Wagner de Sousa Campos
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. Campinas SP Brasil.
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Barreto Soares G, Tonaco Borges F, Reis dos Santos R, Adas Saliba Garbin C, Adas Saliba Moimaz S, Gomes Siqueira CE. Organizações Sociais de Saúde (OSS): Privatização da Gestão de Serviços de Saúde ou Solução Gerencial para o SUS? ACTA ACUST UNITED AC 2016. [DOI: 10.18673/gs.v7i2.22057] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Revisamos criticamente a literatura publicada no Brasil sobre as Organizações Sociais de Saúde como modelo de gestão de serviços de saúde ambulatoriais e hospitalares para o Sistema Único de Saúde. Optamos pelo método de revisão integrativa, através de busca na base de dados científicas Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e na biblioteca eletrônica Scientific Electronic Library Online (SciELO). Foram identificados 31 artigos que atenderam aos critérios de inclusão. Os estudos publicados até 2015 sobre as OSS são metodologicamente insuficientes e não permitem generalizações sobre a maior eficiência da gestão de serviços de saúde por meio das OSS em comparação com a gestão pública. Mesmo com a falta de dados empíricos conclusivos na literatura científica revisada, há fortes argumentos legais, administrativos, e políticos que sugerem que as OSS não se constituem como solução para resolver os problemas de gestão de serviços no SUS. Embora se apresentem como modelo “sem fins lucrativos” ou filantrópico e fundamentado em técnicas gerenciais modernas e eficientes, as OSS tendem a fortalecer a privatização do sistema público de saúde brasileiro.
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Borges FT, Reis LA, Schor N. Extracellular vesicles: structure, function, and potential clinical uses in renal diseases. Braz J Med Biol Res 2013; 46:824-30. [PMID: 24141609 PMCID: PMC3854311 DOI: 10.1590/1414-431x20132964] [Citation(s) in RCA: 184] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 07/17/2013] [Indexed: 11/22/2022] Open
Abstract
Interest in the role of extracellular vesicles in various diseases including
cancer has been increasing. Extracellular vesicles include microvesicles,
exosomes, apoptotic bodies, and argosomes, and are classified by size, content,
synthesis, and function. Currently, the best characterized are exosomes and
microvesicles. Exosomes are small vesicles (40-100 nm) involved in intercellular
communication regardless of the distance between them. They are found in various
biological fluids such as plasma, serum, and breast milk, and are formed from
multivesicular bodies through the inward budding of the endosome membrane.
Microvesicles are 100-1000 nm vesicles released from the cell by the outward
budding of the plasma membrane. The therapeutic potential of extracellular
vesicles is very broad, with applications including a route of drug delivery and
as biomarkers for diagnosis. Extracellular vesicles extracted from stem cells
may be used for treatment of many diseases including kidney diseases. This
review highlights mechanisms of synthesis and function, and the potential uses
of well-characterized extracellular vesicles, mainly exosomes, with a special
focus on renal functions and diseases.
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Affiliation(s)
- F T Borges
- Divisão de Nefrologia, Departamento de Medicina, Universidade Federal Paulista, Escola Paulista de Medicina, São PauloSP, Brasil
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Borges FT, Garbin CAS, Siqueira CE, Garbin AJÍ, Rocha NBD, Lolli LF, Moimaz SAS. Escolas Técnicas do SUS (ETSUS) no Brasil: regulação da integração ensino serviço e sustentabilidade administrativa. Ciênc saúde coletiva 2012; 17:977-87. [DOI: 10.1590/s1413-81232012000400020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Accepted: 06/30/2011] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste artigo foi discutir a sustentabilidade administrativa das Escolas Técnicas do SUS (ETSUS) a partir do princípio da integração ensino serviço, que traz uma nova dimensão do trabalho na saúde ainda não regulada pela administração pública brasileira. Trata-se de uma pesquisa qualitativa, por meio de um estudo de caso. A pesquisa foi realizada por meio de questionário semiestruturado junto aos gestores das ETSUS, abordando aspectos institucionais, administrativos e de gestão do trabalho. O universo amostral foi de 6 ETSUS pertencentes à Rede de Escolas Técnicas do SUS (RET-SUS). As ETSUS apresentaram gestão e planejamento centralizados e execução descentralizada de sua atividade fim, em sua maioria sem autonomia administrativa e altamente dependente de financiamento do governo federal. Segundo os gestores das escolas, a falta de regulação da atividade docente por servidor público fragiliza a gestão das ETSUS. Estas instituições apresentam problemas de gestão relacionados à integração ensino serviço, que precisa ser regulamentada para conferir sustentabilidade às escolas e evitar contradições com a legislação brasileira.
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Borges FT, Garbin CAS, Carvalhosa AAD, Castro PHDS, Hidalgo LRDC. [Oral cancer epidemiology in a public laboratory in Mato Grosso State, Brazil]. CAD SAUDE PUBLICA 2009; 24:1977-82. [PMID: 18813673 DOI: 10.1590/s0102-311x2008000900003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Accepted: 02/28/2008] [Indexed: 11/21/2022] Open
Abstract
This study analyzed oral cancer epidemiology based on histopathology reports from a public laboratory in Mato Grosso, Brazil, after a specific policy was implemented for treating oral and facial diseases in the State. This was a cross-sectional epidemiological study, based on 1,324 histopathology reports issued from January 2005 to December 2006. The study identified 44 cases of oral cancer, or 3% of all oral lesions, and analyzed them in relation to the following variables: histological type, gender, age, and patient's place of residence (capital versus rest of State). The most common histological type was squamous cell carcinoma. Most of the diagnoses occurred in men in their 50s and 60s living in the interior of the State. During two years in operation, this public oral pathology service had recorded a considerable number of oral cancer cases.
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Bueno MR, De Carvalhosa AA, De Souza Castro PH, Pereira KC, Borges FT, Estrela C. Mesenchymal Chondrosarcoma Mimicking Apical Periodontitis. J Endod 2008; 34:1415-1419. [DOI: 10.1016/j.joen.2008.08.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 08/06/2008] [Accepted: 08/09/2008] [Indexed: 11/29/2022]
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