The guidelines of Decree No. 7508 -June 28, 2011 -have contributed to enhance the capacity of governance of small municipalities in health regions. The objective of this study was to identify the potential and the obstacles in the process of integrated regional planning in health region 29, Rio Grande do Sul. This is a case study carried out through information from semi-structured interviews, field observations, and documentary records, analyzed according to Content Analysis method. The study had participation of health managers of five municipalities and three state public servants linked to the 16th Regional Health Coordination, selected intentionally. Five categories of analysis emerged: the Regional Intermanagers Committee (CIR) as a space of coordination; the strengthening of the Brazilian Unified Health System; the weakness of the management; individualism in observing the process; and what has guided the meetings of the CIR. Results indicate that the integrated regional planning process has advanced, in the sense of CIR being constituted as a space of mutual support between the municipal and state management. However, decisions are made with more political than technical basis, with little monitoring of the access to health actions and health services, hindering the ability of control and negotiation in relation to service providers. It is considered that the CIR needs to be strengthened and consolidated through improvement of the management and through effective participation of state and municipal health managers in order to enable regional governance.
<p>Este trabalho apresenta os resultados da análise qualitativa de um estudo que visou identificar e avaliar a atenção às condições crônicas mais prevalentes na região de cobertura da 16ª Coordenadoria Regional de Saúde/RS. Foram realizadas entrevistas semiestruturadas com 12 pessoas com Doenças Crônicas Não Transmissíveis (DCNT), descrevendo suas trajetórias assistenciais. Foram contatados os serviços de atenção básica (AB) de seis municípios. Os participantes foram selecionados segundo critérios populacionais e de cobertura de Estratégia de Saúde da Família (ESF). As entrevistas foram analisadas pelo método de Análise de Conteúdo (BARDIN, 2012), através de duas categorias. Na primeira, "Acesso ao sistema de saúde", foram abordados temas relativos às formas de entrada dos usuários no sistema e suas trajetórias assistenciais, dificuldades de acesso à atenção em saúde e a transporte, urgência e medicações. Na segunda categoria, "A satisfação dos usuários com os serviços de saúde", foram incluídos dados relacionados à percepção da atenção prestada na AB, à avaliação da atenção recebida e ao tempo entre diagnóstico e tratamento. A análise das trajetórias assistenciais sugere uma baixa efetividade da AB, tanto na prevenção quanto no diagnóstico das DCNT, demonstrando a inexistência de linhas de cuidado.</p>
Motor skill learning may induce behavioral and neurophysiological adaptations after intracerebral hemorrhage (ICH). Learning a new motor skill is associated with dendritic reorganization and requires protein synthesis and expression of MAP-2. The purpose of this study was to evaluate motor performance and expression of MAP-2 in the motor cortex of rats submitted to intracerebral hemorrhage model (ICH) and skill task training (SK) or unskilled training (US) during 4 weeks. The Staircase test was used for behavioral evaluation, and relative optical densities and morphometrical analysis were used to estimate MAP-2 immunoreactivity and parameters of brain tissue in both motor cortices. Results show that skill task training performed with the impaired forelimb was able to increase MAP-2 immunoreactivity in the motor cortex either in sham or in ICH groups in both cortices: ipsilesional [F (5,35) = 14.25 (P < 0.01)] and contralesional hemispheres [F (5,35) = 9.70 (P < 0.01)]. ICH alone also increased MAP-2 immunoreactivity despite the absence of functional gains. Behavioral evaluation revealed that ICH-SK group performed better than ICH and ICH-US animals in the Staircase test. Data suggest that motor skill training induces plastic modifications in both motor cortices, either in physiological or pathological conditions and that skill motor training produces higher brain plasticity and positive functional outcomes than unskilled training after experimental intracerebral hemorrhage.
Pesquisas evidenciam que Distúrbios Osteomusculares Relacionados ao Trabalho (DORT) estão presentes na maioria dos casos de uso do teclado. Assim objetiva-se avaliar atividade elétrica do músculo trapézio com e sem apoio do antebraço durante a digitação. A amostra foi composta por 21 indivíduos que realizassem atividades de digitação. Foi utilizado para a avaliação a Eletromiografia de Superfície (EMG). Os dados foram analisados através do teste t para dados pareados pelo software Bioestat 5.0. Evidenciou-se diferença para a digitação com apoio quando comparado à sem apoio em 100% da amostra, considerando o valor de p
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