Enterobacteria in anaerobic digestion of dairy cattle wastewater: Assessing virulence and resistance for one health security.

Samples from a dairy cattle waste-fed anaerobic digester were collected across seasons to assess sanitary safety for biofertilizer use. Isolated enterobacteria (suggestive of Escherichia coli) were tested for susceptibility to biocides, antimicrobials, and biofilm-forming capability. Results revealed a decrease in total bacteria, coliforms, and enterobacteria in biofertilizer compared to the effluent. Among 488 isolates, 98.12 % exhibited high biofilm formation. Biofertilizer isolates exhibited a similar biofilm formation capability as effluent isolates in summer, but greater propensity in winter. Resistance to biocides and antimicrobials varied, with tetracycline resistance reaching 19 %. Of the isolates, 25 were multidrug-resistant (MDR), with 64 % resistant to three drugs. Positive correlations were observed between MDR and increased biofilm formation capacity in both samples, while there was negative correlation between MDR and increased biocide resistance. A higher number of MDR bacteria were found in biofertilizer compared to the effluent, revealing the persistence of E. coli resistance, posing challenges to food safety and public health.

Virulence profile of Candida spp. isolated from an anaerobic biodigester supplied with dairy cattle waste.

Anaerobic biodigesters play a crucial role in enhancing animal waste management. However, the presence of pathogens in the biodigestion process poses a significant concern. Candida spp., a widespread fungus known for its opportunistic nature and adaptability to diverse environmental conditions, including reciprocal transmission between humans and animals, is one such pathogen of concern. Therefore, it is imperative to assess the virulence profile of Candida spp. originating from anaerobic biodigestion processes. Here we demonstrate that strains isolated from the biodigestion process of dairy cattle waste exhibit noteworthy virulence mechanisms, surpassing the virulence of clinical control strains. After we identified strains from affluent, effluent, and biofertilizer, we observed that all analyzed isolates produced biofilm. Additionally, a substantial proportion of these isolates demonstrated phospholipase production, while only a few strains exhibited protease production. Furthermore, all strains exhibited resistance or dose-dependent responses to amphotericin B and itraconazole, with the majority displaying resistance to fluconazole. In the in vivo test, we observed a significant correlation (p < 0.05) between the LT50 and biofilm formation as well as hyphae/pseudohyphae production. Additionally, some isolates demonstrated a quicker nematode-killing capacity compared to clinical controls. Our findings underscore the considerable pathogenic potential of certain Candida species present in the dynamics of anaerobic biodigestion. Importantly, the anaerobic biodigester system did not eliminate Candida strains from dairy cattle waste, highlighting the need for caution in utilizing biodigester products. We advocate for further studies to explore the virulence of other microorganisms in various animal production contexts. Furthermore, our results emphasize the urgency of enhancing waste treatment methods to effectively eliminate pathogens and curb their potential dissemination.

Biofuel recovery from microalgae biomass grown in dairy wastewater treated with activated sludge: The next step in sustainable production.

Microalgae biofuel could be the next step in avoiding the excessive use of fossil fuels and reducing negative impacts on the environment. In the present study, two species of microalgae (Scenedesmus obliquus and Chlorella vulgaris) were used for biomass production, grown in dairy wastewater treated by activated sludge systems. The photobioreactors were operated in batch and in continuous mode. The dry biomass produced was in the range of 2.30 to 3.10 g L-1. The highest volumetric yields for lipids and carbohydrates were 0.068 and 0.114 g L-1 day-1. Maximum CO2 biofixation (750 mg L-1 day-1) was obtained in continuous mode. The maximum values for lipids (21%) and carbohydrates (39%) were recorded in the batch process with species Scenedesmus obliquus. In all of the experiments, the Linolenic acid concentration (C18:3) was greater than 12%, achieving satisfactory oxidative stability and good quality. Projected biofuel production could vary between 4,863,708 kg and 9,246,456 kg year-1 if all the dairy wastewater produced in Brazil were used for this purpose. Two hectares would be needed to produce 24,99 × 109 L year-1 of microalgae bioethanol, a far lower value than used in cultivating sugar cane. If all dairy wastewater generated annually in Brazil were used to produce microalgae biomass, it would be possible to obtain approximately 30,609 to 53,647 barrels of biodiesel per year. These data show that only by using dairy wastewater would biofuels be produced to replace 17% to 40% of the fossil fuels currently used in Brazil.

Shifts of acidogenic bacterial group and biogas production by adding two industrial residues in anaerobic co-digestion with cattle manure.

Anaerobic biodigestion figures as a sustainable alternative to avoid discharge of cattle manure in the environment, which results in biogas and biofertilizer. The anaerobic bioconversion of biomass to methane via anaerobic biodigestion requires a multi-step biological process, including microorganisms with distinct roles. Here, the dynamics of acidogenic bacterial populations by classical microbiology, as well as biogas productivity by gasometer and chromatography, in the anaerobic co-digestion process were studied. This paper presents a performance evaluation of co-digestion systems for biogas production using cattle manure and wastes from the Sewage Treatment Station of a brewery and ricotta cheese whey. The search revealed that the type of substrate added in co-digestion with cattle manure, Carbon/Nitrogen ratio, and Ammonia Nitrogen were the most influential factors that explained many of the variations of the microbiota in the biodigesters fed. This study demonstrated a good potential for the use of ricotta cheese whey in the production of biogas and its further conversion into energy. These findings could provide some fundamental and technical information for the co-treatment of industrial derived wastes in centralized anaerobic biodigestion facilities in a sustainable manner with high process capacity and methane recovery.

Quantitative microbial risk assessment of occupational and public risks associated with bioaerosols generated during the application of dairy cattle wastewater as biofertilizer.

The reuse or recycling of wastewater provides environmental and economic benefits, representing a sustainable and circular alternative for the management of liquid waste. However, the application of effluents to agricultural crops via spraying creates a potentially dangerous situation for individuals exposed to airborne pathogens. This study used Quantitative Microbial Risk Assessment (QMRA) tools to quantitatively assess the microbial risks of occupational and public exposures to bioaerosols in fertigation scenarios by spraying untreated and treated dairy cattle wastewater. Analyses of Escherichia coli (EC) and spores of Clostridium perfringens (CpSP) in raw and treated effluents as well as pathogen / indicator ratios from the literature were used to estimate the concentrations of Escherichia coli O157:H7 (EC O157:H7) and Cryptospodirium spp. (Crypto) in the air, and the results were applied to an atmospheric microbiological dispersion model. From the concentrations of pathogens in the air, infectious risks for downwind receptors were calculated. The risks of infection by EC O157:H7 to workers at 10 m and 50 m away from the emission source ranged between 3.81 × 10 1 and 2.68 × 10 3 pppy (per person per year), whereas to residents at 100 m and 500 m ranged from 4.59 × 10 1 to 1.51 × 10 4 pppy. Peak values (95th percentile) of occupational and public risks associated with the exposure to Crypto were 3.41 × 10 3 and 6.84 × 10 4 pppy at 10 m and 50 m from the source, respectively, and were lower than 1.48 × 10 6 pppy regarding exposures to CpSP. Anaerobic digestion reduced risks by approximately one order of magnitude. The distance from the source was inversely proportional to the risk of exposure. It is recommended that wastewater is treated prior to its reuse and the adoption of application methods with low aerosolization potential. In addition, the need for workers to use personal protective equipment (PPE) is highlighted.

Microalgae-mediated bioremediation and valorization of cattle wastewater previously digested in a hybrid anaerobic reactor using a photobioreactor: Comparison between batch and continuous operation.

Scenedesmus obliquus (ACOI 204/07) microalgae were cultivated in cattle wastewater in vertical alveolar flat panel photobioreactors, operated in batch and continuous mode, after previous digestion in a hybrid anaerobic reactor. In batch operation, removal efficiencies ranges of 65 to 70% of COD, 98 to 99% of NH4+ and 69 to 77.5% of PO4-3 after 12days were recorded. The corresponding figures for continuous flow were from 57 to 61% of COD, 94 to 96% of NH4+ and 65 to 70% of PO4-3 with mean hidraulic retention time of 12days. Higher rates of CO2 fixation (327-547mgL-1d-1) and higher biomass volumetric productivity (213-358mgL-1d-1) were obtained in batch mode. This microalgae-mediated process can be considered promising for bioremediation and valorization of effluents produced by cattle breeding yielding a protein-rich microalgal biomass that could be eventually used as cattle feed.

Bioenergy recovery from cattle wastewater in an UASB-AF hybrid reactor.

New data on biogas production and treatment of cattle wastewater were registered using an upflow anaerobic sludge blanket-anaerobic filter (UASB-AF) hybrid reactor under mesophilic temperature conditions (37 °C). The reactor was operated in semi-continuous mode with hydraulic retention times of 6, 5, 3 and 2 days and organic loading rates of 3.8, 4.6, 7.0 and 10.8 kg CODt m-3 d-1. Biogas volumes of 0.6-0.8 m3 m-3 d-1 (3.8-4.6 kg CODt m-3 d-1) and 1.2-1.4 m3 m-3 d-1 (7.0-10.8 kg CODt m-3 d-1), with methane concentrations between 69 and 75%, were attained. The removal of organic matter with values of 60-81% (CODt) and 51-75% (CODs) allowed methane yields of 0.155-0.183 m3 CH4 kg-1 CODt and 0.401-0.513 m3 CH4 kg-1 CODs to be obtained. Volatile solids were removed in 34 to 69%, with corresponding methane yields of 0.27 to 0.42 m3 CH4 kg-1 VSremoved. The good performance of the novel hybrid reactor was demonstrated by biogas outputs higher than reported previously in the literature, along with the quality of the gas obtained in the various experimental phases. The hybrid reactor investigated in this study presents comparative advantages, particularly in relation to conventional complete mixture units, considering economic factors such as energy consumption, reactor volume and installation area.

Optimization of the skimmed-milk flocculation method for recovery of adenovirus from sludge.

Return of treated sludge to the environment poses concerns and has stimulated the development of studies on viral monitoring in this matrix, in order to assess its potential risks for public health. Human adenovirus (HAdV) has been identified as a putative viral marker of faecal contamination due to its stability and resistance to the sewage treatment process. The aim of this study was to optimize the organic flocculation procedure in order to establish an appropriate methodology for HAdV recovery from sewage sludge samples. Four protocols (A-D) have been proposed, with changes in the initial sample dilution, in the stirring time and in the final concentration of skimmed-milk. A single sludge sample was obtained in Wastewater Treatment Plant (WWTP) and divided into aliquots. In each protocol, three aliquots were inoculated with HAdV and bacteriophage PP7 and a non-inoculated one was used as negative control. Viral load and recovery rate were determined by quantitative PCR. HAdV recovery rate varied between the protocols tested (p=0.016) and the best result was obtained through the protocol C. In order to confirm this result a field study with activated, thickened and digested sludge samples was carried out. Different types of sludge were obtained in two WWTPs and processed using protocol C. HAdV was detected in all samples, with a similar or higher viral load than those obtained with other concentration techniques already applied to sludge. Protocol C proved to be really efficient, with the advantage of showing low cost and practicability in routine laboratories.

Seasonal Variation on Microbial Community and Methane Production during Anaerobic Digestion of Cattle Manure in Brazil.

Anaerobic digestion is an alternative method for the treatment of animal manure and wastewater. The anaerobic bioconversion of biomass requires a multi-step biological process, including microorganisms with distinct roles. The diversity and composition of microbial structure in pilot-scale anaerobic digestion operating at ambient temperature in Brazil were studied. Influence of the seasonal and temporal patterns on bacterial and archaeal communities were assessed by studying the variations in density, dynamic and diversity and structure. The average daily biogas produced in the summer and winter months was 18.7 and 16 L day(-1), respectively, and there was no difference in the average methane yield. Quantitative PCR analysis revealed that no differences in abundances and dynamics were found for bacterial communities and the total number of Archaea in different seasons. Analysis of bacterial clone libraries revealed a predominance of Firmicutes (54.5 %/summer and 46.7 %/winter) and Bacteroidetes (31.4 %/summer and 44.4 %/winter). Within the Archaea, the phylum Euryarchaeota was predominant in both digesters. Phylogenetic distribution showed changes in percentage between the phyla identified, but no alterations were recorded in the quality and amount of produced methane or community dynamics. The results may suggest that redundancy of microbial groups may have occurred, pointing to a more complex microbial community in the ecosystem related to this ambient temperature system.

Relationship between viral detection and turbidity in a watershed contaminated with group A rotavirus.

Enteric viruses are present in aquatic environments due to contamination by raw sewage, even in the absence of fecal coliforms, which are considered to be significant indicators when it comes to microbial water quality assessment. This study investigated the presence of group A rotavirus (RVA) in surface water from a river basin in Minas Gerais, Brazil, assessing the influence of the urbanization, the rainfall, and the microbiological and physico-chemical parameters regarding water quality. Forty-eight surface water samples collected in urbanized and non-urbanized areas, both in dry and rainy periods, were obtained throughout the study. The viral particles were concentrated by adsorption-elution in a negatively charged membrane. Fecal coliforms, as well as physico-chemical water parameters were determined at each point in all collections. The RVA was detected in 62.5 % (30/48) of the water samples through a real-time PCR assay. All the sequenced RVA strains belonged to genotype I1. The RVA was detected in 50.0 % (11/22) of the water samples regarded as being acceptable by current microbiological standards. The presence of the RVA and the viral load were influenced by the collection area (p < 0.05). It was also observed a significant association between the RVA and detecting the turbidity of water (p < 0.05). The collected data showed a high level of contamination in this watershed by the discharge of raw sewage, highlighting the need for urgent measures to improve water quality, ensuring the safe use of this matrix.

Agricultural exploitation impact on the quality of natural waters in the trout-breeding region of the Mantiqueira ecological corridor / Impacto da exploração agropecuária na qualidade de águas naturais em região de truticultura no corredor ecológico da Mantiqueira

Seasonal assessment of water quality was undertaken in an agricultural cattle-raising and trout-breeding region. Seventeen sites were sampled in ten municipalities close to the Papagaio and Ibitipoca State Parks in Minas Gerais, Brazil. Landsat 5 satellite images and Spotmap mosaic images with resolution of 2.5 m were employed to correlate classes of land use and topographic characteristics with the environmental contamination index of the water bodies at these sites. Results show a change in hydric classification of three sites evaluated. During the rainy season, sites 3, 7 and 17 were classified as class 3 according to CONAMA regulations, whereas the other sites were classified as class 2. During the dry season, sites 10 and 11 belonged to class 3 and the others to class 2. Literature and analysis of images and visits on the area showed that the principles of sustainable farming were not being followed in the region. Current research may be a tool for planning the preservation of natural resources. Results indicate there is a need for specific planning for fish farming and agriculture in the region for its sustainable economic exploitation.

Realizou-se a avaliação sazonal da qualidade da água, em região de truticultura e agropecuária, por amostragem, em 17 pontos, dez municípios, em torno dos parques estaduais do Papagaio e do Ibitipoca em Minas Gerais, Brasil. Usando imagens gratuitas Landsat 5 e imagens de mosaico Spotmap, resolução de 2,5 m, correlacionando as classes de uso da terra e características topográficas com o índice de contaminação ambiental dos corpos d'água nesses pontos. Os resultados mostram alteração da classificação hídrica de três dos pontos avaliados. Na época das chuvas, os pontos 3, 7 e 17 foram classificados como classe 3, de acordo com as normas do Conama (Conselho Nacional do Meio Ambiente), enquanto os outros pontos foram 2. Durante a estação seca, os pontos 10 e 11 eram de classe 3 e os outros como classe 2. A revisão de literatura, com a análise das imagens e visitas na área, mostrou que os princípios da agricultura sustentável não estão sendo seguidos na área. Este trabalho serve como ferramenta para o planejamento para preservação dos recursos naturais. Os resultados indicam que há a necessidade de um planejamento específico para a criação de peixes e agropecuária na região, permitindo assim sua exploração sustentável.

Prevalence and persistence of potentially pathogenic and antibiotic resistant bacteria during anaerobic digestion treatment of cattle manure.

Anaerobic digestion figures as a sustainable alternative to avoid discharge of cattle manure in the environment, which results in biogas and biofertilizer. Persistence of potentially pathogenic and drug-resistant bacteria during anaerobic digestion of cattle manure was evaluated. Selective cultures were performed for enterobacteria (ENT), non-fermenting Gram-negative rods (NFR) and Gram-positive cocci (GPC). Antimicrobial susceptibility patterns were determined and a decay of all bacterial groups was observed after 60days. Multidrug-resistant bacteria were detected both the influent and effluent. GPC, the most prevalent group was highly resistant against penicillin and levofloxacin, whereas resistance to ampicillin, ampicillin-sulbactam and chloramphenicol was frequently observed in the ENT and NFR groups. The data point out the need of discussions to better address management of biodigesters and the implementation of sanitary and microbiological safe treatments of animal manures to avoid consequences to human, animal and environmental health.

O conhecimento da esquistossomose para pacientes positivos / The role of knowledge on schistosomiasis for the positive patient

A esquistossomose também conhecida como "Doença do Caramujo" e "Barriga d'água" é considerada, ainda nos dias atuais, como um importante problema de saúde pública, uma vez que há uma ampla distribuição geográfica de focos de contaminação e uma larga relação de fatores ambientais e sociais que possibilitam a sua transmissão, e dificultam as ações de controle. É relevante identificar a representação da esquistossomose para pacientes positivos com o intuito de entender o processo pelo qual as pessoas constroem o conhecimento e dão significado à prevenção da doença, partindo do princípio de que a realidade vivida é uma representação e, nesta representação, os atores sociais se movem e direcionam suas vidas. Esta pesquisa foi desenvolvida no município de Santa Amélia, localizado na região norte do estado do Paraná, Brasil, e buscou conhecer o significado da esquistossomose para os pacientes positivos. Utilizou-se como estratégia metodológica em pesquisa qualitativa a construção do Discurso do Sujeito Coletivo (DSC) que consiste numa forma qualitativa de representaro pensamento de uma coletividade, agregando em um discurso-síntese os conteúdos discursivos de sentidos semelhantes emitidos por pessoas distintas. Os discursos revelam que 56% dos sujeitos entrevistados compartilham da falta de conhecimento além do acúmulo de informações errôneas sobre esquistossomose pelos pacientes positivos desta doença. Por refletir a realidade dos próprios atores sociais, os resultados obtidospoderão subsidiar a (re) construção de práticas mais adequadas na relação homem-saúde-ambiente.

Also known as "snail disease" or as "water belly", schistosomiasis is still considered an important public health problem in Brazil. Control of the disease is difficult given the wide geographical distribution of contamination sources, and the complex interplay of environmental and social factors that promote the transmission of the disease and impede the control actions. As such, it becomes relevant to identify the representation and significance of schistosomiasis for patients tested as positive for the disease, aiming at a fundamental understanding of the process that leads to knowledge and give meaning to the prevention of disease, assuming that the lived reality is a representation and this representation the social actors move and direct their lives. Therefore, the present study seeks to elucidate the social meaning of schistosomiasis for disease-positive individuals, and was conducted at Santa Amelia Township, in the northern region of Parana state, Brazil. This research adopted the Discourse of the Collective Subject (DCS) technique, which consists of a qualitative way to represent the thoughts of a group by merging similar speech contents uttered by interviewed individuals into a single synthetic declaration. The resulting declarations show that 56% of the DCS-interviewed individuals share a lack of knowledge beyond the accumulation of wrong information on schistosomiasis. Because they reflect the reality of the social actors themselves may help the (re) construction of best practices in human-health-environment.

Representação da participação do enfermeiro no processo educativo e nas relações humanas do trabalho / Nursing representation in the education process and in the working human relations

A construção de um novo modelo pedagógico deve ter como perspectiva o equilíbrio entre a excelência técnica e a relevância social. Este estudo teve como objetivo conhecer as representações de educador de Enfermagem sobre a Educação Permanente em Saúde (EPS) e sua atuação em seu processo de implementação nas transformações do mundo do trabalho na área de saúde. Foram entrevistados cinco educadores que ministram disciplinas práticas no Serviço Público de Saúde para o curso de Enfermagem. Utilizou-se como estratégia metodológica em pesquisa qualitativa a construção do Discurso do Sujeito Coletivo (DSC); para tabulação e organização dos depoimentos, foi utilizado o software Qualiquantisoft®. Os resultados mostraram que 60 por cento dos educadores compartilham a ideia de que a EPS representa um “aprendizado contínuo”, 80 por cento concordaram que este é um facilitador no processo de implementação da política de EPS na formação profissional e 40 por cento dos educadores afirmaram que a concepção pedagógica crítico reflexiva constitui uma ferramenta adequada para propiciar a articulação de ações entre o serviço e o ensino, mas 40 por cento deles também concordaram que a problematização não é colocada em prática. Diante dos resultados obtidos, constatou-se que os educadores entrevistados possuem experiências relacionadas à educação permanente na instituição investigada, por atuarem em disciplina de campo prático junto aos educandos, e também em disciplina de cunho teórico, atribuindo-lhes significativa qualificação profissional.

The construction of a new pedagogical model should have as perspective the balance between the technical excellence and the social relevance. This study aimed to evaluate the representations of Nursing educator on Permanent Education in Health (PEH) and its role in the implementation of PEH in the working changes in healthcare. Five educators who teach practical subjects in the Public Health Service to the Nursing course had been interviewed. The construction of the Collective Subject Discourse (CSD) was used as a methodological strategy in qualitative research; for tabulation and organization of the statements the software Qualiquantisoft® was used. The results showed that 60% of educators shared the idea that permanent education is a “continuous learning”, 80% considered that the Professor is a facilitator in the policy implementation of PEH in the professional training and 40% of educators verbalized the concept that the critical-reflective pedagogical model is an appropriate educational process to facilitate the articulation of actionsbetween service (practice) and education, but 40% of them also agreed with the idea that the “problematization” is not put into practice. Based on these results it seemed that the interviewed educators have experiences related to permanent education in the investigated institution for working in practical field discipline with learners, and also in a theoretical discipline, thus giving them a significant professional qualification.

Representação da participação do enfermeiro no processo educativo e nas relações humanas do trabalho / Nursing representation in the education process and in the working human relations

A construção de um novo modelo pedagógico deve ter como perspectiva o equilíbrio entre a excelência técnica e a relevância social. Este estudo teve como objetivo conhecer as representações de educador de Enfermagem sobre a Educação Permanente em Saúde (EPS) e sua atuação em seu processo de implementação nas transformações do mundo do trabalho na área de saúde. Foram entrevistados cinco educadores que ministram disciplinas práticas no Serviço Público de Saúde para o curso de Enfermagem. Utilizou-se como estratégia metodológica em pesquisa qualitativa a construção do Discurso do Sujeito Coletivo (DSC); para tabulação e organização dos depoimentos, foi utilizado o software Qualiquantisoft®. Os resultados mostraram que 60 por cento dos educadores compartilham a ideia de que a EPS representa um ôaprendizado contínuoö, 80 por cento concordaram que este é um facilitador no processo de implementação da política de EPS na formação profissional e 40 por cento dos educadores afirmaram que a concepção pedagógica críticoreflexiva constitui uma ferramenta adequada para propiciar a articulação de ações entre o serviço e o ensino, mas 40 por cento deles também concordaram que a problematização não é colocada em prática. Diante dos resultados obtidos, constatou-se que os educadores entrevistados possuem experiências relacionadas à educação permanente na instituição investigada, por atuarem em disciplina de campo prático junto aos educandos, e também em disciplina de cunho teórico, atribuindo-lhes significativa qualificação profissional (AU)

Gestão da qualidade no serviço de saúde pública: relato de experiência de uma farmácia de manipulação municipal / Quality management in public health care: experience of a city compound prescription pharmacy

O modelo de atenção à saúde no Brasil é a busca por um sistema equânime, integral e resolutivo. Apesar de seu alcance social, não tem sido possível implantá-lo da maneira desejada, em decorrência de dificuldades relacionadas com seu financiamento e com a eficiência administrativa de sua operação. Essa situação fez com que fossem ampliados os debates sobre o aumento do financiamento do setor público da saúde e a melhor utilização dos limitados recursos existentes. As alternativas passam por novas propostas de modelos de gestão aplicáveis ao setor e que pretendem resultar, em última análise, em menos desperdício e melhoria da qualidade dos serviços oferecidos. O presente estudo tem por objetivo descrever os impactos das políticas públicas de saúde para melhoria da qualidade da gestão do SUS, com o relato de experiência da Unidade de Farmácia de Manipulação Municipal do Posto Central em Bandeirantes- PR, no período de agosto de 2005 a maio de 2006. Diante dos resultados observados nesta pesquisa, constatou-se a importância de investimentos financeiros desta iniciativa, cujas necessidades de demanda e economia são respectivamente atendidas. A farmácia magistral é uma atividade predominantemente privada no Brasil, traz para o serviço público a garantia de qualidade somada ao baixo custo e faz com que o sistema apresente para o usuário os príncipios do SUS. A qualidade, por sua vez, só se obtém com mudanças comportamentais e participação efetiva das pessoas. É um processo dinâmico que supõe uma estrutura ágil e flexível, dando enfoque aos processos.

Gestão da qualidade no serviço de saúde pública: relato de experiência de uma farmácia de manipulação municipal / Quality management in public health care: experience of a city compound prescription pharmacy

O modelo de atenção à saúde no Brasil é a busca por um sistema equânime, integral e resolutivo. Apesar de seu alcance social, não tem sido possível implantá-lo da maneira desejada, em decorrência de dificuldades relacionadas com seu financiamento e com a eficiência administrativa de sua operação. Essa situação fez com que fossem ampliados os debates sobre o aumento do financiamento do setor público da saúde e a melhor utilização dos limitados recursos existentes. As alternativas passam por novas propostas de modelos de gestão aplicáveis ao setor e que pretendem resultar, em última análise, em menos desperdício e melhoria da qualidade dos serviços oferecidos. O presente estudo tem por objetivo descrever os impactos das políticas públicas de saúde para melhoria da qualidade da gestão do SUS, com o relato de experiência da Unidade de Farmácia de Manipulação Municipal do Posto Central em Bandeirantes- PR, no período de agosto de 2005 a maio de 2006. Diante dos resultados observados nesta pesquisa, constatou-se a importância de investimentos financeiros desta iniciativa, cujas necessidades de demanda e economia são respectivamente atendidas. A farmácia magistral é uma atividade predominantemente privada no Brasil, traz para o serviço público a garantia de qualidade somada ao baixo custo e faz com que o sistema apresente para o usuário os príncipios do SUS. A qualidade, por sua vez, só se obtém com mudanças comportamentais e participação efetiva das pessoas. É um processo dinâmico que supõe uma estrutura ágil e flexível, dando enfoque aos processos.(AU)

Noise level in a 222 bed hospital in the 18th health region-PR.

UNLABELLED: Environment noise pollution is common place today, at intolerable levels. In hospitals, technological developments have, as a consequence, potentially harmful noise levels. Much of the hospital noise comes from inside, rather than outside, and the major source of such noise is the Intensive Care Unit, for example equipment and hospital staff talk. Our goal with the present study was to investigate the noise level present in the different hospital environments, within a 222 bed hospital located at the 18th health zone, PR. MATERIALS AND METHODS: The study was carried out in March, 2005, during a period of 24 hours, in tem different sectors. CASE STUDY: We checked environmental sound level by means of a model 1350 decibel meter. RESULTS: The sound level found in our study was of 63.7 dB(A) in average, which exceeds the 45 dB recommended by the Brazilian Association of Technical Standards (1987). CONCLUSION: In the analyzed sectors, the sound level was considerably above the recommended maximum. The hospital staff should be aware of this noise level and its effects, so that they may act in a more efficient way in order to reduce this noise pollution; thus benefiting the professionals and patient recovery.

Intensidade de ruído em hospital de 222 leitos na 18ª Regional de Saúde - PR / Noise level in a 222 bed hospital in the 18th health region - PR

A poluição sonora ambiental torna-se hoje onipresente e beira o intolerável. Nos hospitais, os avanços tecnológicos trazem, como conseqüência, níveis de ruído potencialmente danosos. Muito do ruído no hospital provém mais de dentro, do que de fora desse ambiente, sendo as principais causas de ruído em Unidade de Terapia Intensiva, por exemplo, os equipamentos e a conversação entre a equipe hospitalar. O objetivo deste trabalho foi avaliar o nível de ruído nos diversos ambientes hospitalares, em Hospital de 222 leitos na 18ª RS de Saúde - PR. MATERIAIS E MÉTODOS: Conduziu-se, em março de 2005 no período de 24 horas, em dez setores. Forma de Estudo: Aferição do nível de ruído ambiental utilizando um Decibelímetro modelo 1350. RESULTADOS: O nível de ruído encontrado em nosso estudo apresentou média total de 63,7 dB(A), que excede os valores máximos permitidos de 45 dB recomendados pela Associação Brasileira de Normas Técnicas (1987). CONCLUSÃO: Nos setores analisados, o nível de ruído encontrado neste está consideravelmente acima do recomendado. A equipe hospitalar deve estar consciente do ruído e dos efeitos deste, para que possa atuar de maneira mais efetiva na redução da poluição sonora, beneficiando assim a função laborativa dos profissionais e recuperação dos pacientes.

Environment noise pollution is common place today, at intolerable levels. In hospitals, technological developments have, as a consequence, potentially harmful noise levels. Much of the hospital noise comes from inside, rather than outside, and the major source of such noise is the Intensive Care Unit, for example equipment and hospital staff talk. Our goal with the present study was to investigate the noise level present in the different hospital environments, within a 222 bed hospital located at the 18th health zone, PR. MATERIALS AND METHODS: The study was carried out in March, 2005, during a period of 24 hours, in tem different sectors. CASE STUDY: We checked environmental sound level by means of a model 1350 decibel meter. RESULTS: The sound level found in our study was of 63.7 dB(A) in average, which exceeds the 45 dB recommended by the Brazilian Association of Technical Standards (1987). CONCLUSION: In the analyzed sectors, the sound level was considerably above the recommended maximum. The hospital staff should be aware of this noise level and its effects, so that they may act in a more efficient way in order to reduce this noise pollution; thus benefiting the professionals and patient recovery.

Caracterização da biota de protozoários e sua função depurativa na lagoa de estabilização da estação de tratamento de esgoto de Bandeirantes – PR / Characterization of the protozoan biota and its depurating function in the stabilization pond of the Bandeirantes water treatment plant, Paraná State

Os protozoários são, usualmente, maiores que as bactérias e podem se alimentar das mesmas. Isto faz com que os protozoários constituam-se em importantes degraus na pirâmide alimentar, possibilitando que organismos maiores se alimentem indiretamente das bactérias que, de outra forma, seriam um alimento inacessível (VON SPERLING, 1996). Este estudo objetivou a caracterização físico-química e microbiológica da lagoa de estabilização da ETE Bandeirantes - PR, analisando sua inter-relação e nível de estratificação, relacionando os parâmetros físico-químicos e microbiológicos, a variação populacional dos protozoários frente a valores de matéria orgânica e microbióta bacteriana do esgoto e dos vários estratos da lagoa anaeróbia. A identificação de protozoários foi feita conforme metodologia empregada por Pace e Orcutt (1981) e Foissnere Berger (1996). As análises físico-químicas foram realizadas conforme metodologia padronizada por Clesceri et al. (2000); e as análises microbiológicas foram realizadas por metodologia padronizada conforme CETESB, (NT.L5.214), 1992; CETESB, (NT. L5.201), 1986; CETESB, (NT.L5.221), 1984. As coletas e análises foram realizadas em triplicata, no mês de outubro de 2003. A análise qualitativa do zooplâncton revelou a presença de onze gêneros de ciliados e organismos da classe nematoda distribuídos em diferentes pontos e estratos. A distribuição aleatória do zooplâncton está relacionada com parâmetros físico-químicos e valores quantitativos de bactérias eterotróficas, coliformes totais e fecais. O gênero Chilodontopsis foi o protozoário mais encontrado e estava presente em pontos com altos valores de contagem de bactérias, o que denota sua característica ecológica de preferência alimentar por bactérias, conforme Foissner e Berger (1996).

The protozoans are usually bigger than the bacteria and can feed themselves of the same ones. This consequence is that the protozoan consists in an important step in the alimentary pyramid, making possible that bigger organisms feeds the bacteria it self indirectly which, in the other hand, would be an in accessible food form (VON SPERLING, 1996). This study aim characterize microbiological physicist-chemistry profile in a lagoon of stabilization of the Sewer Plant Bandeirantes - PR, analyzing its interrelation and level of stratification, relating the parameters microbiological physicistchemistries and the protozoa’s population variation front the values of bacterial and organic substance of the sewer, and some stratus of the anaerobic lagoon. The identification of protozoan was made in agreement the methodology used for Pace and Orcutt (1981) and Foissner and Berger (1996). The physicist-chemistries analysis had been carried through in agreement standardized methodology for Clesceri et al. (2000); e the microbiological analysis had been carried through by standardized methodology, as CETESB (NT.L5.214), 1992; CETESB, (NT L5.201), 1986; CETESB,(NT.L5.221), 1984. The samplings and analysis were realized intriplicate in October of 2003. The qualitative analysis of zooplankton disclosed to the presence of eleven kinds of ciliates organisms and Nematoda class organisms distributed in different points and stratus. The random distribution of zooplankton is related with physicistchemistries parameters and quantitative values of heterotrophic bacteria, total and fecal coliformes. The Chilodontopsis sort was the greater found and was present in points with high values of counting of bacteria, what it denotes its ecological characteristic of alimentary preference for bacteria, as referenced by Foissner and Berger (1996).