RESUMO
Com o objetivo de compreender o desenvolvimento da integração ensino-serviço-comunidade (Iesc) no município de Bragança Paulista, São Paulo, por meio do Contrato Organizativo de Ação Pública Ensino-Saúde (Coapes), realizou-se um estudo de caso. Uma amostra intencional com dez integrantes do Comitê Gestor Local que participaram de entrevistas semiestruturadas, em ambiente virtual, gravadas e transcritas na íntegra. Os relatos passaram por análise de conteúdo na modalidade temática e os resultados indicaram que a condução da Iesc e do Coapes foi bem-sucedida. A sustentabilidade e os êxitos da contratualização estão relacionados a estratégias, como aproximação, diálogo institucional, igualdade de valor e transparência, provenientes de discussões técnicas, compreensão do processo, escolha do formato, sensibilização e engajamento dos atores. A combinação desses elementos, aliada a novos projetos e atitudes, aponta caminhos para a consolidação da Iesc no território, que apresenta desafios a serem superados.(AU)
Con el objetivo de comprender el desarrollo de la integración enseñanza-servicio-comunidad (IESC) en el municipio de Braganza Paulista (Estado de São Paulo), a partir del Contrato Organizativo de Acción Pública Enseñanza-Salud (Coapes), se realizó un estudio de caso. Una muestra intencional con diez integrantes del Comité Gestor Local participó en entrevistas semiestructuradas, realizadas en ambiente virtual, grabadas y transcritas integralmente. Los relatos pasaron por un análisis de contenido en la modalidad temática. Los resultados indicaron que la conducción de la IESC y del Coapes fue exitosa. La sostenibilidad y los éxitos de la contractualización están relacionados con estrategias tales como la aproximación, el diálogo institucional, la igualdad de valor y transparencia, provenientes de discusiones técnicas, comprensión del proceso, elección del formato, sensibilización y compromiso de los actores. La combinación de esos elementos, aliada a nuevos proyectos y actitudes, señala caminos para la consolidación de la IESC en el territorio que presenta desafíos que hay que superar.(AU)
To comprehend the evolution of education-service-community integration (ESCI) in the municipality of Bragança Paulista, SP, through the Teaching-Health Public Action Organizational Contract (Coapes), a case study was conducted. An intentional sample of ten members from the Local Management Committee participated in semi-structured interviews, conducted virtually, recorded, and transcribed in full. The narratives underwent thematic content analysis. The results indicated that the implementation of IESC and Coapes was successful. The sustainability and achievements in contractualization are related to strategies such as approaching, institutional dialogue, equal value, and transparency, resulting from technical discussions, understanding of the process, format selection, sensitization, and actor engagement. The combination of these elements, along with new projects and attitudes, points towards the consolidation of IESC in the territory, which presents challenges to be overcome.(AU)
RESUMO
The COVID-19 pandemic boosted the development of diagnostic tests to meet patient needs and provide accurate, sensitive, and fast disease detection. Despite rapid advancements, limitations related to turnaround time, varying performance metrics due to different sampling sites, illness duration, co-infections, and the need for particular reagents still exist. As an alternative diagnostic test, we present urine analysis through flow-injection-tandem mass spectrometry (FIA-MS/MS) as a powerful approach for COVID-19 diagnosis, targeting the detection of amino acids and acylcarnitines. We adapted a method that is widely used for newborn screening tests on dried blood for urine samples in order to detect metabolites related to COVID-19 infection. We analyzed samples from 246 volunteers with diagnostic confirmation via PCR. Urine samples were self-collected, diluted, and analyzed with a run time of 4 min. A Lasso statistical classifier was built using 75/25% data for training/validation sets and achieved high diagnostic performances: 97/90% sensitivity, 95/100% specificity, and 95/97.2% accuracy. Additionally, we predicted on two withheld sets composed of suspected hospitalized/symptomatic COVID-19-PCR negative patients and patients out of the optimal time-frame collection for PCR diagnosis, with promising results. Altogether, we show that the benchmarked FIA-MS/MS method is promising for COVID-19 screening and diagnosis, and is also potentially useful after the peak viral load has passed.