Morphoanatomical Changes in Eucalyptus grandis Leaves Associated with Resistance to Austropuccinia psidii in Plants of Two Ages.

The fungus Austropuccinia psidii infects young tissues of Eucalyptus plants until they are two years old in the nursery and field, causing Myrtaceae rust. The characteristics making older eucalypt leaves resistant to A. psidii and the reason for the low levels of this pathogen in older plants need evaluations. The aim of this study was to evaluate the morphological differences between Eucalyptus grandis leaves of different growth stages and two plant ages to propose a visual phenological scale to classify E. grandis leaves according to their maturation stages and to evaluate the time of leaf maturation for young and adult plants. A scale, based on a morphological differentiation for E. grandis leaves, was made. The color, shape and size distinguished the leaves of the first five leaf pairs. Anatomical analysis showed a higher percentage of reinforced tissue, such as sclerenchyma-like tissue and collenchyma, greater leaf blade thickness, absence of lower palisade parenchyma in the mature leaves and a higher number of cavities with essential oils than in younger ones. Changes in anatomical characteristics that could reduce the susceptibility of older E. grandis leaves to A. psidii coincide with the time of developing leaf resistance. Reduced infection of this pathogen in older plants appears to be associated with a more rapid maturation of their leaf tissues.

Contribution of community health workers to primary health care performance in Brazil.

OBJECTIVE: To associate the strength of community health workers interventions with primary health care strategies for women's and children's health, diabetes, and hypertension. METHODS: This is a cross-sectional study assessing 29,778 family health teams working in primary health care in Brazil in 2014. The association between community health workers activity levels and primary health care facilities was analyzed using multiple logistic regression. RESULTS: We found higher levels of community health workers activities strongly associated with primary health care practices (OR = 6.88) for those activities targeting hypertension management, followed by children's health (OR = 6.56), and women's health (OR = 6.21). CONCLUSIONS: At a time when Brazil discusses whether community health workers should or should not remain in the same scale-up and skill level as they currently are, our results reinforce the importance of these workers for the care model advocated by the Brazilian Unified Health System.

Implementation of Telehealth Resources in Primary Care in Brazil and Its Association with Quality of Care.

Background:Although several reviews on the relation between telemedicine and health care outcomes have pointed out some evidence, they have also underscored the need for further investigation.Introduction:Brazil has a national telehealth program implemented in 2007, involving teleconsulting and distance education actions in primary care.Objective:This study aims to describe the implementation of telehealth in primary care in Brazil and to identify if there is an association between telehealth and quality of care.Methods:A cross-sectional study analyzing data from interviews with 29,778 primary care team professionals in Brazil in 2014, which represents 92.5% of existing health care teams, on aspects of information technology, telehealth, and care was carried out. A multiple binary regression analysis was performed to study the associations between the extent of health care actions and using telehealth.Results:Of the 24,055 primary care units in Brazil where teams worked, only 50.1% (n: 12,055) had internet access, and 32.71% of teams claimed to be involved in telehealth actions in 2014. Between 2012 and 2014 there was an expansion in the use of telehealth resources in all regions of Brazil. The highest magnitude was observed for the association between employment of telehealth and improvement in child care (odds ratio [OR] = 2.09), followed by diabetes mellitus care (OR = 1.91), hypertension (OR = 1.89), and finally, women's health (OR = 1.86).