Whey protein and vitamin D supplementation in institutionalized older adults: A randomized trial.

Background: The increase in life expectancy and in the number of individuals over 60 years old brings new demands to health professionals and services based on the physiological changes that occur in this population. The aging process results in changes in body composition, increasing body fat and reducing muscle mass, in addition to a reduction in bone mass. Aim: The aim of this study was to examine the effect of whey protein and vitamin D supplementation on body composition and skeletal muscle in older adults living in long-term care facilities. Methods: This study is a double-blind randomized controlled trial. Thirty older adults (>60 years old) were randomized and allocated in three groups: group receiving resistance training and supplementation receiving resistance training, whey protein and vitamin D; group received resistance and placebo training receiving resistance training and placebo, and control group without any intervention. Body composition was measured by dual-energy X-ray absorptiometry at baseline, 12 weeks, and 24 weeks. Results: The mean age was 74.87 (± 8.14) years. A significant difference (p = 0.042) was observed between the group receiving resistance training and supplementation and control groups in relation to lean mass increase (kg) at 24 weeks. After 24 weeks of intervention, there was a significant increase in Relative index of muscle mass for the two groups that underwent resistance training, group received resistance and placebo training (p = 0.042) and group receiving resistance training and supplementation (p = 0.045), in relation to the control. Conclusion: Combined supplementation of whey protein and vitamin D with resistance training can significantly improve lean mass, total mass, and relative index of muscle mass in institutionalized older adults.

LEVELS OF SALIVARY CORTISOL IN ADULTS AND CHILDREN WITH BRUXISM DIAGNOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVES: To evaluate the levels of salivary cortisol in adults and children diagnosed with bruxism. METHODS: A search strategy was developed using the following terms: "cortisol", "bruxism" and "sleep bruxism". These were searched in databases: Medline, Embase, Scopus, Cochrane, Web of Science, LILACS and gray literature, for studies published until May 2020. RESULTS: We obtained a total of six primary studies, involving 854 participants, who met the criteria and were included in the present study. The analysis cortisol levels shows a significant difference favourable to the control group 1.10 (95% CI: 0.68-1.53), showing that patients with bruxism have higher values of salivary cortisol. Heterogeneity of I²â€¯= 4% (P = .31). CONCLUSIONS: It was concluded that despite the different methodologies adopted for the collection and analysis of salivary content, this review found significant results of higher levels of salivary cortisol in adult patients with bruxism.

Neurotrophins, cytokines, oxidative parameters and funcionality in Progressive Muscular Dystrophies.

We investigated the levels of brain derived-neurotrophic factor (BDNF), cytokines and oxidative parameters in serum and tried to correlate them with the age and functionality of patients with Progressive Muscle Dystrophies (PMD). The patients were separated into six groups (case and controls pared by age and gender), as follows: Duchenne Muscular Dystrophy (DMD); Steinert Myotonic Dystrophy (SMD); and Limb-girdle Muscular Dystrophy type-2A (LGMD2A). DMD patients (± 17.9 years old) had a decrease of functionality, an increase in the IL-1ß and TNF-α levels and a decrease of IL-10 levels and superoxide dismutase activity in serum. SMD patients (± 25.8 years old) had a decrease of BDNF and IL-10 levels and superoxide dismutase activity and an increase of IL-1ß levels in serum. LGMD2A patients (± 27.7 years old) had an decrease only in serum levels of IL-10. This research showed the first evidence of BDNF involvement in the SMD patients and a possible unbalance between pro-inflammatory and anti-inflammatory cytokine levels, along with decreased superoxide dismutase activity in serum of DMD and SMD patients.

[The quality and characteristics of sleep of hypertensive patients]. / Características e qualidade do sono de pacientes hipertensos.

OBJECTIVE: Analyzing the quality of sleep of hypertensive patients registered in the national registration system and monitoring of hypertensive patients. METHODS: A cross-sectional study of quantitative and descriptive analyses with 280 hypertensive patients registered in the National Program of Hypertension and Diabetes of the Federal Government in the months from August to October 2011. Questionnaires were used which allowed for tracking sociodemographic data on hypertension and Pittsburgh Sleep Quality Index (PSQI). RESULTS: The prevalence of poor sleep quality among respondents (156 hypertensive patients) and high rates of using medication for sleeping (106 hypertensive patients) was observed. Other relevant data refers to the quality of sleep among hypertensive patients using sleep medication compared to those who do not use it (p≤0.01). CONCLUSION: Individuals with high blood pressure have a negative association with sleep quality.

Serum Biomarkers to Mild Cognitive Deficits in Children and Adolescents.

Intellectual disability (ID) is a condition characterized by significant limitations in both cognitive development and adaptive behavior. The diagnosis is made through clinical assessment, standardized tests, and intelligence quotient (IQ). Genetic, inflammation, oxidative stress, and diet have been suggested to contribute to ID, and biomarkers could potentially aid in diagnosis and treatment. Study included children and adolescents aged 6-16 years. The ID group (n = 16) and the control group (n = 18) underwent the Wechsler Intelligence Scale for Children (WISC-IV) test, and blood samples were collected. Correlations between biomarker levels and WISC-IV test scores were analyzed. The ID group had an IQ score below 75, and the values of four domains (IQ, IOP, IMO, and IVP) were lower compared to the control group. Serum levels of FKN, NGF-ß, and vitamin B12 were decreased in the ID group, while DCFH and nitrite levels were increased. Positive correlations were found between FKN and the QIT and IOP domains, NGF and the QIT and IMO domains, and vitamin B12 and the ICV domain. TNF-α showed a negative correlation with the ICV domain. Our study identified FKN, NGF-ß, and vitamin B12 as potential biomarkers specific to ID, which could aid in the diagnosis and treatment of ID. TNF-α and oxidative stress biomarkers suggest that ID has a complex etiology, and further research is needed to better understand this condition and develop effective treatments. Future studies could explore the potential implications of these biomarkers and develop targeted interventions based on their findings.

Mitochondrial respiratory chain and creatine kinase activities in mdx mouse brain.

In this study we investigated energy metabolism in the mdx mouse brain.To this end, prefrontal cortex, cerebellum, hippocampus, striatum, and cortex were analyzed. There was a decrease in Complex I but not in Complex II activity in all structures. There was an increase in Complex III activity in striatum and a decrease in Complex IV activity in prefrontal cortex and striatum. Mitochondrial creatine kinase activity was increased in hippocampus, prefrontal cortex, cortex, and striatum. Our results indicate that there is energy metabolism dysfunction in the mdx mouse brain.

Time-dependent behavioral recovery after sepsis in rats.

OBJECTIVE: To evaluate the cognitive performance in rats that survived sepsis induced by cecal ligation and puncture (CLP) after 10, 30 and 60 days. DESIGN: Prospective, controlled experiment. SETTING: Animal basic science laboratory. SUBJECTS: Male Wistar rats, weighing 300-350 g. INTERVENTIONS: The rats were sham-operated or submitted to CLP (sepsis group) with "basic support" (saline, s.c. at 50 mL/kg immediately and 12 h after CLP plus ceftriaxone, s.c. at 30 mg/kg and clindamycin, s.c. at 25 mg/kg 6, 12 and 18 h after CLP). MEASUREMENTS AND MAIN RESULTS: The animals underwent six behavioral tasks 10, 30 and 60 days after surgery: (a) habituation to the open field; (b) inhibitory avoidance task; (c) continuous multiple trials step-down inhibitory avoidance task; (d) object recognition; (e) elevated plus-maze; and (f) forced swimming test. We demonstrated that survivors 10 days after CLP presented deficits on the habituation to the open field, step-down inhibitory avoidance, continuous multiple-trials step-down inhibitory avoidance, object recognition and forced swimming. After 30 days of sepsis induction, survivors maintained deficits on the step-down inhibitory avoidance, continuous multiple-trials step-down inhibitory avoidance and forced swimming. However, after 60 days all behavior deficits were reversed. CONCLUSIONS: These results indicate that the impairment of memory and learning, demonstrated 10 days after the induction of sepsis, persist 30 days after the CLP. The cognitive impairments did not persist after 60 days suggesting that this model can help in the understanding of the biological mechanisms associated with sepsis-induced sickness behavior.

Memory-enhancing treatments reverse the impairment of inhibitory avoidance retention in sepsis-surviving rats.

INTRODUCTION: Survivors from sepsis have presented with long-term cognitive impairment, including alterations in memory, attention, concentration, and global loss of cognitive function. Thus, we evaluated the effects of memory enhancers in sepsis-surviving rats. METHODS: The rats underwent cecal ligation and perforation (CLP) (sepsis group) with 'basic support' (saline at 50 mL/kg immediately and 12 hours after CLP plus ceftriaxone at 30 mg/kg and clindamycin at 25 mg/kg 6, 12, and 18 hours after CLP) or sham-operated (control group). After 10 or 30 days, rats were submitted to an inhibitory avoidance task. After task training, animals received injections of saline, epinephrine, naloxone, dexamethasone, or glucose. Twenty-four hours afterwards, animals were submitted to the inhibitory avoidance test. RESULTS: We demonstrated that memory enhancers reversed impairment in the sepsis group 10 and 30 days after sepsis induction. This effect was of lower magnitude when compared with sham animals 10 days, but not 30 days, after sepsis. CONCLUSIONS: Using different pharmacologic approaches, we conclude that the adrenergic memory formation pathways are responsive in sepsis-surviving animals.

Acolhimento de pessoas com deficiência auditiva na Atenção Primária à Saúde no município de Criciúma, Santa Catarina / Reception of the hearing impaired in Primary Health Care in the municipality of Criciúma, Santa Catarina

As pessoas com deficiência auditiva (DA) possuem barreiras a serem descontruídas quando o assunto é acesso aos serviços de saúde. Estas se dão devido à dificuldade na comunicação, falta de profissionais qualificados, ausência de intérprete da Língua Brasileira de Sinais (LIBRAS) dentre outros aspectos. O objetivo deste trabalho é analisar o acolhimento dos indivíduos com surdez na Atenção Primária em Saúde (APS). Trata-se de um estudo de métodos mistos com triangulação concomitante por meio de um estudo descritivo e quantitativo. O estudo foi realizado nas Unidades Básicas de Saúde (UBS) do município de Criciúma ­ Santa Catarina, participaram os gerentes das unidades de saúde, cirurgiões dentistas, enfermeiros e médicos. Foram entrevistados 43 profissionais de saúde de 44 UBS diferentes do município, dos quais os resultados apontaram frágeis condições de acolhimento e atendimento humanizado das pessoas com DA que procuram as unidades básicas de saúde. A comunicação predominante é de forma verbal e na maioria das vezes, conta com a presença de um familiar durante as consultas para facilitar essa comunicação. Alguns profissionais afirmaram que o DA não possui atendimento humanizado, inclusivo e resolutivo, e que os programas de capacitação deixariam os atendimentos mais humanizados. Em suma, existem inúmeras barreiras no acolhimento dos pacientes com DA na APS, sendo necessária a aprimoração das práticas para que seja desenvolvido um atendimento inclusivo, humanizado, acolhedor e integral.

The person with hearing loss (AD) has barriers to be deconstructed regarding access to health services. These are due to the difficulty in communication, lack of qualified professionals, and absence of interpreters of Brazilian Sign Language, among other aspects. This study aims to analyze the reception of individuals with deafness in Primary Health Care (PHC). This is a mixed methods study with concomitant triangulation through descriptive and quantitative analysis. The study was conducted in the Basic Health Units (BHU) of the municipality of Criciúma - Santa Catarina, with the participation of managers of health units, dental surgeons, nurses, and physicians. Participants were 43 health professionals from 44 different BHUs in the city, of which the results showed fragile conditions of reception and humanized care of people with AD who seek basic health units. The predominant communication is verbal and, in most cases, relies on the presence of a family member during the consultations to facilitate this communication. Some professionals stated that the DA lacks humanized, inclusive and resolutive care and that the training programs would make the care more humanized. In short, there are numerous barriers in the reception of patients with AD in PHC, and it is necessary to improve practices so that inclusive, humanized, welcoming, and integral care is developed.

Perfil do absenteísmo dos servidores públicos de um município do Extremo Sul Catarinense

O objetivo do presente estudo foi verificar o perfil do absenteísmo dos servidores públicos de um município do extremo sul catarinense. A pesquisa é de natureza observacional e transversal, utilizando-se de dados fornecidos pela prefeitura municipal estudada. Foram analisados 578 servidores públicos municipais que afastaram-se entre 2015 e 2020. Dentre os servidores em afastamento, aponta-se que 77,3% eram do sexo feminino, 31,5% tinham entre os 29 aos 38 anos de idade, 53,3% eram servidores estatutários, e 65,1% ocorreram nos primeiros 5 anos de trabalho. Os Auxiliares de Ensino de Educação, foram os profissionais que mais se afastaram, e entre as secretarias, foi a Secretaria de Educação. Como principais causas de afastamento foram identificadas as doenças causadas por transtornos mentais e comportamentais, doenças do sistema osteomuscular, doenças do sistema respiratório e fatores que influenciam o estado de saúde e o contato com os serviços de saúde. Conclui-se que as causas de afastamentos são preocupantes, e provocam alterações nos processos de trabalho. Dessa forma, é importante compreender essa dinâmica, contribui para planejar medidas para reduzir os índices de absenteísmo no município.

Imipramine reverses the depressive symptoms in sepsis survivor rats.

OBJECTIVE: To evaluate the antidepressant effect of imipramine on depressive symptoms observed in sepsis survivors rats. DESIGN AND SETTING: Prospective, controlled experiment in an animal basic science laboratory. SUBJECTS: Male Wistar rats weighing 300-350 g. INTERVENTIONS: The rats underwent cecal ligation and perforation (CLP; sepsis group) with "basic support" (saline at 50 ml/kg immediately and 12 h after CLP plus ceftriaxone at 30 mg/kg and clindamycin at 25 mg/kg 6, 12, and 18 h after CLP) or sham-operated (control group). After 10 days of recovery rats received intraperitoneal injections of imipramine 10 mg/kg or saline and were subjected to the forced swimming test. MEASUREMENTS AND RESULTS: The observed increase in the immobility time in the forced swimming test in animals subjected to CLP, as a parameter of depressive behavior, was reversed by imipramine. CONCLUSIONS: The depressive symptoms evaluated by forced swimming test had been reversed after imipramine administration. Our data provide evidence that CLP-induced depressive symptoms are sensitive to antidepressants.

Centrais de Regulação e Consórcios Intermunicipais de Saúde: a Percepção de Gestores Catarinenses

Objetivo: Analisar a percepção dos gestores dos consórcios intermunicipais de saúde e das comissões intergestores regionais do sul de Santa Catarina sobre a incorporação das centrais de regulação nos procedimentos eletivos de média e alta complexidade, inseridos nos consórcios intermunicipais de saúde do estado. Métodos: Trata-se de um estudo descritivo como abordagem mista, realizado com representantes legais de consórcios intermunicipais de saúde e gestores municipais representantes da Comissão Intergestores Regional do sul de Santa Catarina, totalizando 6 participantes. A coleta de dados se deu através de entrevista semiestruturada. A análise ocorreu por método de condensação de significados com auxílio do programa SPSS versão 23.0. Resultados: Foi possível obter a percepção dos representantes legais e gestores acerca dos mecanismos de regulação, legislação vigente, sua eficácia e seu conhecimento prévio a respeito dos mesmos. Além disso, conseguiu-se traçar as características do perfil profissional dos respectivos indivíduos. Conclusões: Os resultados obtidos apontam uma percepção positiva dos gestores acercada regulação e o auxílio que a mesma trouxe aos municípios em relação à continuidade na linha de cuidado e a garantia do acesso aos pacientes com critérios clínicos mais graves. Evidenciou-se também a necessidade de melhorias na eficiência e fiscalização das legislações vigentes, além da necessidade dos gestores receberem capacitações acerca de características pontuais dos mecanismos legais.

Entre o sofrimento e a saúde: considerações sobre o trabalho do Agente Comunitário de Saúde / Between suffering and health: considerations about the Community Health Agent's work

No Sistema Único de Saúde (SUS) os Agentes Comunitários de Saúde (ACS) estão em constante contato com o território em que atuam, pela sua função e papel de morador, resultando em consequências ambíguas no estabelecimento de suas ações. Assim, o presente estudo busca compreender o papel dos Agentes Comunitários de Saúde, sua relação com o território, unidade e profissionais, e os processos de saúde e adoecimento no desempenho da função. Trata-se de um estudo qualitativo no formato de pesquisa participante, por meio de entrevista semiestruturada com 6 ACS, que também foram acompanhados em suas atividades diárias. A análise de conteúdo dos dados obtidos por diário de campo e entrevista possibilitou a identificação de 3 categorias: Papel dos ACS; Relação com a Equipe, e Saúde e Sofrimento dos ACS. O sofrimento dos ACS decorre da vigilância sobre seu trabalho, dificuldades no relacionamento interpessoal com a equipe, adversidades no território e sobrecarga de trabalho. Identifica-se que são profissionais muitas vezes subestimados e incompreendidos

In the Unified Health System, Community Health Agents (CHA) are in constant contact with the territory in which they operate, due to their role and role as residents, resulting in ambiguous consequences in the establishment of their actions. Thus, the present study seeks to understand the role of Community Health Agents, their relationship with the territory, unit and professionals, and the processes of health and illness in the performance of the function. This is a qualitative study in the form of participatory research, through a semi-structured interview with 6 CHA, who were also monitored in their daily activities. The content analysis of the data obtained by field diary and interview enabled the identification of 3 categories: Role of the CHA; Relationship with the Team, and Health and Suffering from the CHA. The CHA's suffering stems from surveillance over their work, difficulties in interpersonal relationships with the team, adversities in the territory and work overload. It is identified that they are professionals often underestimated and misunderstood.

[Spatial orientation memory: evaluation in patents with Alzheimer disease and temporal lobe epilepsy]. / Memória de orientação espacial: avaliação em pacientes com doença de Alzheimer e com epilepsia mesial temporal refratária.

Experimental studies have identified pyramidal cells in hippocampus in rats with participation in the spatial orientation memory (SOM), which are named location cells. This study had the purpose to adapt a test based in these experiments in order to check the performance of SOM and the participation of hippocampus into SOM in patients with mesial temporal sclerosis (MTS). The research was divided into two studies: the first one the test was adapted, and in order to check its capacity to investigate the deficits of SOM, it has applied in groups of 10 (ten) subjects, one group with patients that have Alzheimer disease and the other one with healthy elderly (p<0.001). The second study has evaluated the participation of hippocampus into SOM in 43 patients (23 with mesial temporal sclerosis (MTS) and 20 submitted to selective amygdala hippocampectomy (SAH)) and 23 healthy volunteers with p<0,05 between MTS and SAH and between controlled and SAH. It was shown that the test of SOM is suitable to evaluate deficits, but it seems the SOM is not a specific function of human hippocampus.

Laser fluorescence of caries detection in permanent teeth in vitro: a systematic review and meta-analysis.

BACKGROUND/OBJECTIVES: The detection of dental caries in the early stages, particularly on the occlusal surfaces, has become a mainstay of contemporary clinical practice. The objective of the study was to verify the accuracy of laser fluorescence for caries detection. METHODS: A comprehensive search of the MEDLINE (PubMed), EMBase, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS, Congress Abstracts, and Grey literature databases was undertaken from 1980 through January 2016. We included cross-sectional studies that evaluated laser fluorescence in caries diagnoses in vitro and compared them with histological analyses. RESULTS: A total of 39 articles were included in the meta-analysis, which included 2082 caries sites. The pooled sensitivity was 0.71 (0.69, 0.73), and the specificity was 0.81 (0.73, 0.82). The diagnostic odds ratio was 14.93 (11.2, 19.9). A summary receiver operating characteristic curve was constructed. The area under the curve was 0.865. CONCLUSION: This meta-analysis showed that laser fluorescence in vitro had the ability to diagnose occlusal caries lesions in permanent teeth and enamel and dentin caries.

Percepção dos usuários sobre a atenção primária em saúde: estudo transversal em um município de grande porte / Users' perception about primary health care: a cross-sectional study in a large municipality

O objetivo deste estudo foi avaliar o nível de satisfação dos usuários da Atenção Primária em Saúde de um município de grande porte. Trata-se de um estudo transversal, do tipo censitário e com amostra por conveniência, visto que foram incluídas todas as unidades de saúde e entrevistados os usuários que estavam na sala de espera no dia da coleta e aceitaram participar da pesquisa. Toda a coleta de dados foi realizada por meio de questionários, e,posteriormente,tabulada e analisada no software Stata 14.0. Os usuários relataram satisfação com a unidade e equipe, e com serviços assistenciais. Entretanto, usuários que manifestaram que trocariam de unidade caso isto fosse possível, tinham razões atribuídas à organização do cuidado e agendamento de consultas. Concluímos que a satisfação com os cuidados exercidos pelos profissionais e com o acolhimento de informações de cunho afetivo foram evidentemente altas, ao passo que a insatisfação com a organização do cuidado é aparente.

This study aimed to assess the level of satisfaction of users of PrimaryHealth Care in a large city. This is a cross-sectional, census-type study with a convenience sample, as all health units were included and users who were in the waiting room on the day of collection and who agreed to participate in the survey were interviewed. All data collection was performed through questionnaires, and later tabulated and analyzed using the Stata 14.0 software. Users reported satisfaction with the unit and team, and with care services. However, users who stated that they would change units if this was possible had reasons attributed to the organization of care and appointment scheduling. We conclude that satisfaction with the care provided by professionals and with the reception of information of an affective nature were evidently high, while dissatisfaction with the organization of care is apparent.

Incidence of hepatitis C in Brazil.

INTRODUCTION: Hepatitis C is a public health problem of global dimensions, affecting approximately 200 million people worldwide. The main objective of this study was to estimate the incidence rate of hepatitis C in Brazil during the period between 2001 and 2012. METHODS: An epidemiological, temporal, and descriptive study was performed using data from the Information System for Reportable Diseases. RESULTS: Between 2001 and 2012, a total of 151,056 hepatitis C cases were recorded, accounting for 30.3% of all hepatitis notifications in Brazil. The average gross coefficient for the analysis period was 6.7 new cases per 100,000 inhabitants. The regions with the highest rates were the Southeast region (8.7 new cases/100,000 inhabitants) and the South (13.9 new cases/100,000 inhabitants). There was a predominance of men with respect to the incidence rate (8.0 new cases/100,000 inhabitants) compared to women (5.5 new cases/100,000 inhabitants). Injection drug use was the most common source of infection, and members of the white race, residents of urban areas, and those aged 60 to 64 years had the highest incidences. CONCLUSIONS: Over the last 10 years, the incidence of hepatitis C in Brazil has increased, mainly in the South and Southeast. The adoption of fast, accurate diagnostic methods, together with epidemiological awareness, can facilitate early intervention measures for adequate control of the disease.

Atenção ambulatorial especializada: perfil dos gestores de saúde nas regiões de saúde do sul de Santa Catarina / Specialized ambulatory care: profile of health managers in the southern health regions of Santa Catarina

A governança é explicitada no projeto regional de saúde, mediante a inter-relação nas instâncias e dos atores envolvidos. Esse modelo abre espaço para interações entre os municípios e requer um sistema de governança colaborativa. Esta pesquisa objetiva conhecer o perfil dos gestores e a percepção destes quanto à governança na Atenção Ambulatorial Especializada (AAE) nas regiões de saúde, Extremo Sul Catarinense e Carbonífera do estado de Santa Catarina, haja vista, que AAE é considerada um nó crítico no Sistema Único de Saúde (SUS). É um estudo transversal, exploratório e descritivo, de natureza quantitativa. Participaram deste, 23 gestores de saúde, por meio das respostas ao questionário elaborado pelos autores. Os dados coletados foram organizados e analisados com auxílio do software estatístico Statistical Package for the Social Sciences (IBM SPSS), versão 20.0® e, apresentados de forma descritiva. Apurou-se, que estes colegiados são constituídos por gestores, na maioria, de adultos jovens, do sexo feminino e com graduação completa, sendo a maior parte destas, relacionadas à área da saúde. Destaca-se, que 39,1% dos gestores apontaram a inexistência de governança nas instâncias da federação, portanto, conhecer o perfil dos gestores, assim como, a caracterização do diagnóstico da AAE, contribui para incrementar a visão e a atuação dos gestores no enfrentamento dos entraves na AAE, nestes colegiados.

Governance is made explicit in the regional health Project, through the interrelation in the instances and the actors involved. This model opens space for interactions between municipalities, and requires a, collaborative governance system. The objective was to get to know the profile of managers and their perception regarding governance in Specialized Outpatient Care (SEA), in health regions of Extreme South Catarinense and Carboniferous, Santa Catarina, given that SEA is considered a critical node in the Unified Health System Health (SUS). Cross-sectional, exploratory and descriptive study with a quantitative approach. 23 health managers participated through a questionnaire. The collected data were organized and analyzed using the statistical software Statistical Package for the Social Sciences (IBM SPSS), version 20.0®, and presented in a descriptive way. It was found that these collegiate bodies are composed of managers, mostly young-adult, female and with complete graduation, most of them related to the health area. It is noteworthy that 39.1% of managers pointed out the lack of governance in the instances of the federation. Therefore, knowing the profile of managers, as well as the characterization of the diagnosis of SEA, is believed to be significant to the vision and performance of managers in facing the barriers in SEA in these collegiate.

Serviço de atendimento móvel de urgência do Rio Grande do Sul / Emergency mobile care service of rio grande do sul

Objetivo: analisar os atendimentos realizados na Central de Regulação de Urgência/SAMU do Estado do Rio Grande do Sul no período de 2016 e 2017. Metodologia: estudo observacional, descritivo e retrospectivo com abordagem quantitativa. Foram coletados os dados sobre perfil do usuário, dia da semana, classificação de risco, tipo do agravo, tempo médio de atendimento às solicitações, quantitativo de desistência da solicitação e número de chamados não regulados por falta de equipes ou veículos. Resultados: o número de solicitações por motivos clínicos foi 53.8%, destes 51,6% foram média gravidade. A prevalência foi do sexo masculino e idade entre 18 e 29 anos. Em 84,7% dos chamados solicitou-se suporte básico. O tempo resposta total foi entre 30 minutos e 1 hora, maior que o recomendado de acordo com a média nacional, seja nas as zonas urbanas ou rurais. Conclusão: este serviço necessita reduzir o tempo resposta de atendimento das solicitações. (AU)

Objective: to analyze the attendances performed at the Emergency Regulation Center / SAMU of the State of Rio Grande do Sul in 2016 and 2017, focusing in response time. Methodology: observational, descriptive and retrospective study with quantitative approach. Data were collected on user profile, day of the week, risk classification, type of grievance, average time to respond to requests, amount of withdrawal and number of calls not regulated due to lack of teams or vehicles. Results: The number of requests for clinical reasons was 53.8%, of these 51.6% were medium severity. The prevalence was male and aged between 18 and 29 years. In 84.7% of the calls, basic support was requested. The total response time was between 30 minutes and 1 hour, longer than recommended according to the national average, whether in urban or rural areas. Conclusion: After analyzing the calls, it is clear that the worst problem with the calls is the response time, and it is necessary to decrease the same of the requests. (AU)

Objetivo: analizar las asistencias realizadas en el Centro de Regulación de Emergencias / SAMU del Estado de Rio Grande do Sul en 2016 y 2017, centrándose en el tiempo de respuesta. Metodología: estudio observacional, descriptivo y retrospectivo con enfoque cuantitativo. Se recopilaron datos sobre el perfil del usuario, el día de la semana, la clasificación de riesgos, el tipo de queja, el tiempo promedio para responder a las solicitudes, la cantidad de retiros y la cantidad de llamadas no reguladas debido a la falta de equipos o vehículos. Resultados: El número de solicitudes por razones clínicas fue del 53.8%, de estas 51.6% fueron de gravedad media. La prevalencia fue masculina y de edades comprendidas entre 18 y 29 años. En el 84.7% de las llamadas, se solicitó soporte básico. El tiempo de respuesta total fue de entre 30 minutos y 1 hora, más de lo recomendado según el promedio nacional, ya sea en áreas urbanas o rurales. Conclusión: Después de analizar las llamadas, está claro que el peor problema con las llamadas es el tiempo de respuesta, y es necesario disminuir las mismas solicitudes. (AU)

Perfil de governança colaborativa na atenção ambulatorial especializada: uma experiência em duas regiões de saúde / Profile of collaborative governance in specialized ambulatorial attention: an experience in two health regions

Objetivos: Objetivou-se caracterizar o perfil da governança na Atenção Ambulatorial Especializada na região Sul de Santa Catarina (SC), a partir da percepção dos gestores em relação as especificidades da governança colaborativa. Métodos: A pesquisa baseou-se no modelo analítico, desenvolvido por Milagres et al. (2016). A população é formada por 23 gestores das Comissões de Intergestores Regionais (CIRs). Pesquisa de cunho qualitativo - quantitativo, aplicada, descritiva do tipo levantamento. O questionário foi o instrumento de coleta de dados e o período de aplicação foi entre julho a setembro de 2018. Foi aplicado nas reuniões das CIRs, após serem devidamente autorizadas e aprovadas. Para análises estatísticas, os dados foram organizados, codificados, tabulados no software estatístico IBM SPSS, versão 20.0®, utilizando- se de estatística descritiva. Resultados: Constatou-se que, o princípio da confiança é reconhecido por 68% dos gestores, assim como os elementos: Antecedentes em torno de 70%; Governança Contratual, 35,5%; Governança Processual em média 70% e Governança Relacional aproximadamente 64%. No entanto, observou-se que os gestores não têm clareza em identifica-los com tamanha importância. Conclusões: A adoção da gestão colaborativa está em apropriar ­ se de conhecimento, fornecendo subsídios para que seja possível o enfrentamento dos entraves, possibilitando tornar a Atenção Ambulatorial Especializada efetiva, e gerar resultados atendo as demandas da população.

Introduction: To characterize the governance profile in the Specialized Outpatient Care in the southern region of Santa Catarina (SC), based on the perception of managers in relation to the specificities of collaborative governance. Methods: The research was based on the analytical model developed by Milagres et al. (2016). The population is formed by 23 managers of the Comissões de Intergestores Regionais (CIRs). Qualitative - quantitative research, applied, descriptive of the survey type. The questionnaire was the main instrument of data collection and the period of application was between July and September 2018. It was applied in the meetings of the CIRs. For statistical analysis, the data were organized, coded, tabulated in the statistical software IBM SPSS, version 20.0®, using descriptive statistics. Results: It was found that, the trust principle is recognized by 68% of the managers, as well as the elements: Antecedents around 70%; Contractual Governance, 35.5%; Process Governance on average 70%; and Relational Governance approximately 64%. However, it was observed that managers are not clear on identifying them with such importance. Conclusion: The adoption of collaborative management is to appropriate knowledge, providing subsidies to face the obstacles, making it possible to make Specialized Outpatient Care effective, and generate results and meeting the demands of the population.