Growth and carbon turnover of Piaractus mesopotamicus Holmberg, 1887 (Osteicthyes: Characidae): contribution of extruded feed and natural food.

Piaractus mesopotamicus, is a fish usually farmed in semi-intensive systems with access to natural food and supplementary feed. This study evaluates effects of feed allowance on the productive performance, carbon turnover and proportions of nutrient (carbon) contribution of feed and natural food for the growth of pacu. Juvenile fish were stocked in fiberglass tanks and fed to 100, 75, 50, 25, 0% apparent satiety (ApS), with a practical, extruded (C4 photosynthetic pathway) feed in a randomized design trial (n=3); plankton production for simulated semi-intensive farming system condition was induced by chemical fertilization. A control treatment was set up in tanks devoid of natural food. Data on muscle stable carbon isotope ratios were used to study carbon turnover using a relative growth-based model. Low variation of the δ13C impaired fitting a turnover model curve for the 0 and 25 % ApS treatments. Fish of the 100% and 75% ApS treatments reached circa 95% and 82.85% of the carbon turnover, respectively. Extruded feed was the main nutrient source for the growth of pacu in the semi-intensive, simulated farming condition. The current study contributes to the knowledge of the relationship between feeding rates and carbon turnover rates in the pacu muscle.

Microencapsulation of Bacillus subtilis and oat ß-glucan and their application as a synbiotic in fish feed.

To improve survival during storage and exposure to adverse conditions, Bacillus subtilis was microencapsulated with oat ß-glucan by spray-drying technology. The characterisation of the microcapsules was designed to compare free and microencapsulated cells through exposure to simulated gastric fluids (SGF) throughout storage for 90 days at different temperatures. The characterisation included analysis of efficiency, morphology, moisture, water activity, hygroscopicity, particle size, and zeta potential. The microcapsules presented a particle size of 1.5 ± 0.34 µm and an encapsulation efficiency of 77.9 ± 3.06%. After SGF, the survival of microencapsulated cells was 8.4 ± 0.07 log CFU mL-1 while that of free cells was 7.6 ± 0.06 log CFU mL-1. After 90 days of storage, only microencapsulated cells remained above 6 log-unit of viability. In conclusion, spray-drying technique combined with the addition of oat ß-glucan proved to be an efficient method to protect B. subtilis under storage and SGF with potential application in fish feed.

Feed intake and gene expression of appetite-regulating hormones in Salminus brasiliensis fed diets containing soy protein concentrate.

Dourado (Salminus brasiliensis) is a large carnivorous fish with high commercial value for which sustainable aquaculture relies on the substitution of expensive dietary animal protein sources in aquafeeds, in particular fish meal (FM), by cheaper plant protein, such as soy protein concentrate (SPC). This study aimed at evaluating feed intake and gene expression of appetite- regulating hormones [orexin, cocaine and amphetamine regulated transcript (CART), leptin, cholecystokinin (CCK) and peptide YY (PYY)] in the intestine, pyloric caeca and hypothalamus of juvenile dourado fed diets containing graded levels of SPC and FM as dietary protein sources for a period of three weeks. Increasing dietary plant protein contents reduced daily feed consumption and the expressions of the anorexigenic hormone CCK in the anterior intestine and in pyloric caeca and PYY in pyloric caeca. No changes were detected in the hypothalamic expression of appetite-regulating hormones, suggesting that gastrointestinal hormones are more involved in the decrease in feeding induced by plant protein diets than central appetite-regulating systems.

Appetite regulating factors in pacu (Piaractus mesopotamicus): Tissue distribution and effects of food quantity and quality on gene expression.

The pacu Piaractus mesopotamicus is an omnivorous fish considered a promising species for aquaculture. Little is known about the endocrine regulation of feeding in this species. In this study, transcripts for orexin, cocaine and amphetamine regulated transcript (CART), cholecystokinin (CCK) and leptin were isolated in pacu. Orexin, CCK and leptin have widespread mRNA distributions in brain and periphery, CART is limited to the brain. To examine the role of these peptides in the regulation of feeding and energy status, mRNA expression levels were compared between fed and fasted fish and around feeding time. Both orexin and CART brain expressions were affected by fasting and displayed periprandial changes, suggesting a role in both short- and long-term regulation of feeding. CCK intestinal expression decreased in fasted fish and displayed periprandial changes, suggesting CCK acts as a peripheral satiety factor. Leptin was not affected by fasting but displayed periprandial changes, suggesting a role as a short-term regulator. To examine if these peptides are affected by diet, brain and gut expressions were assessed in fish fed with different diets containing soy protein concentrate. Food intake, weight gain and expressions of orexin, CART, CCK and leptin were little affected by replacement of fish protein with soy protein, suggesting that pacu is able to tolerate and grow well with a diet rich in plant material. Overall, our results suggest that orexin, CART, CCK and leptin are involved in the physiology of feeding of pacu and that their expressions are little affected by plant-based diets.

Water temperature, body mass and fasting heat production of pacu (Piaractus mesopotamicus).

Knowledge on fasting heat production (HEf) of fish is key to develop bioenergetics models thus improving feeding management of farmed species. The core of knowledge on HEf of farmed, neotropical fish is scarce. This study assessed the effect of body mass and water temperature on standard metabolism and fasting heat production of pacu, Piaractus mesopotamicus, an omnivore, Neotropical fresh water characin important for farming and fisheries industries all through South American continent. An automated, intermittent flow respirometry system was used to measure standard metabolic rate (SMR) of pacu (17 - 1,050 g) at five water temperatures: 19, 23, 26, 29 and 33 °C. Mass specific SMR increased with increasing water temperature but decreased as function of body mass. The allometric exponent for scaling HEf was 0.788, and lied in the range recorded for all studied warm-water fish. The recorded van't Hoff factor (Q10) for pacu (2.06) shows the species low response to temperature increases. The model HEf = 0.04643×W0.7882×T1.837 allows to predict HEf (kJ d-1) from body mass (W, kg) and water temperature (T, °C), and can be used in bioenergetical models for the species.

Appetite regulating factors in dourado, Salminus brasiliensis: cDNA cloning and effects of fasting and feeding on gene expression.

The dourado, Salminus brasiliensis (Cuvier, 1816) is a freshwater piscivorous Characin native to South American rivers. Owing to the high quality of its flesh and its fast growth, it is the object of both capture fisheries and fish farming. However, very little is known about the endocrine regulation of feeding and metabolism of dourado. In this study, cDNAs for orexin, CART and CCK were isolated in dourado, and their mRNA tissue distributions examined. In order to assess the role of these peptides in the regulation of feeding of dourado, the effects of fasting and feeding on mRNA expression levels of orexin, CART and CCK in the brain as well as CCK in the intestine were assessed. Whereas orexin and CCK have widespread mRNA distributions in the brain and peripheral organs, CART seems to be mostly limited to the brain. Orexin brain expression increased with fasting and displayed periprandial changes, suggesting it is involved in both long- and short-term regulation of feeding and appetite. CART and CCK hypothalamic expressions were not affected by fasting, but displayed periprandial changes with post-feeding decreases, suggesting roles in short-term satiation. CCK expression in the anterior intestine was not affected by fasting and did not display periprandial changes. Overall, our results suggest that orexin, CART and CCK are involved in the physiology of feeding of dourado.

Patient loss to follow-up before antiretroviral therapy initiation in rural Mozambique.

Within Mozambique's current HIV care system, there are numerous opportunities for a person to become lost to follow-up (LTFU) prior to initiating antiretroviral therapy (pre-ART). We explored pre-ART LTFU in Zambézia province utilizing quantitative and qualitative methods. Patients were deemed LTFU if they were more than 60 days late for either a scheduled appointment or a CD4+ cell count blood draw, according to national guidelines. Among 13,968 adult patients registered for care, 211 (1.8 %) died, one transferred, 2,196 (15.7 %) initiated ART, and 9,195 (65.8 %) were LTFU during the first year. Being male, younger, less educated, and/or having no home electricity were associated with LTFU. Qualitative interviews revealed that poor clinical care, logistics and competing priorities contribute to attrition. In addition, many expressed fears of stigma and/or rejection by family or community members because they were HIV-infected. At 66 %, pre-ART LTFU in Zambézia, Mozambique is a significant problem. This study highlights characteristics of lost patients and discusses barriers requiring consideration to improve retention.

Mobile clinics for antiretroviral therapy in rural Mozambique.

PROBLEM: Despite seven years of investment from the President's Emergency Plan For AIDS Relief (PEPFAR), the expansion of human immunodeficiency virus (HIV)-related services continues to challenge Mozambique's health-care infrastructure, especially in the country's rural regions. APPROACH: In 2012, as part of a national acceleration plan for HIV care and treatment, Namacurra district employed a mobile clinic strategy to provide temporary manpower and physical space to expand services at four rural peripheral clinics. This paper describes the strategy deployed, the uptake of services and the key lessons learnt in the first 18 months of implementation. LOCAL SETTING: In 2012, Namacurra´s adult population was estimated to be 125,425, and of those 15,803 were estimated to be HIV infected. Although there is consistent government support of antiretroviral therapy (ART) programmes, national coverage remains low, with less than 15% of those eligible having received ART by December 2012. RELEVANT CHANGES: Between April 2012 and September 2013, Namacurra district enrolled 4832 new patients into HIV care and treatment. By using the mobile clinic strategy for ART expansion, the district was able to expand provision of ART from two to six (of a desired seven) clinics by September 2013. LESSONS LEARNT: Mobile clinic strategies could rapidly expand HIV care and treatment in under-funded settings in ways that both build local capacity and are sustainable for local health systems. The clinics best serve as a transition to improved capacity at fixed-site services.

Histochemical distribution of intestinal enzymes of juvenile pacu (Piaractus mesopotamicus) fed lyophilized bovine colostrum.

Enzyme activity was evaluated in the intestine of juvenile pacu, Piaractus mesopotamicus, fed diets containing 0, 10 or 20 % of lyophilized bovine colostrum (LBC) inclusion for either 30 or 60 days. The enzymes intestinal acid and alkaline phosphatase (ACP and ALP, respectively), nonspecific esterase (NSE), lipase (LIP), dipeptidyl aminopeptidase IV (DAP IV) and leucine aminopeptidase (LAP) were studied using histochemistry in four intestinal segments (S1, S2, S3 and rectum). Moderate activity of the DAP IV was detected in the three last intestinal segments, but no differences among the treatments were detected. Enzymes LAP, NSE and LIP were weakly stained in all intestinal segments and the inclusion of 10 or 20 % of LBC in the diet commanded a moderate reaction to NSE in the S3 segment at day 60. ACP activity was detected only in the brush border of the S1 segment of fish fed 0 % LBC for either 30 or 60 days. The activity of ALP was very strong in the first intestinal segment, but a weak reaction was seen in the last segments. The inclusion of 20 % of LBC changed the pattern of staining to the ALP, eliciting moderate staining in S2 at day 30 and S1 at day 60. The consumption of diets containing LBC by juvenile pacu did not have significant implications in intestinal enzymatic activity, which still was not fully stimulated.

Impact of definitions of loss to follow-up on estimates of retention, disease progression, and mortality: application to an HIV program in Mozambique.

Patient retention is critical to the management of chronic diseases such as human immunodeficiency virus (HIV); hence, accurate measures of loss to follow-up (LTF) are important. Many different LTF definitions have been proposed. In a cohort of 9,692 HIV-infected patients initiating antiretroviral therapy in Mozambique from 2006 to 2011, we investigated the impact of the definition of LTF on estimated rates of LTF, acquired immunodeficiency syndrome (AIDS)-defining events, and death by applying 17 different definitions of LTF gleaned from HIV literature. We further investigated the impact of 4 specific components of the LTF definitions. Cumulative incidences of LTF and AIDS-defining events were estimated by treating death as a competing risk; Kaplan-Meier techniques and variations to account for informative censoring were used to estimate rates of mortality. Estimates of LTF 2 years after treatment initiation were high and varied substantially, from 22% to 84% depending on the LTF definition used. Estimates of 2-year mortality varied from 11% to 16%, and estimates of 2-year AIDS-defining events varied from 6% to 8%. As seen here, the choice of LTF definition can greatly affect study conclusions and program evaluations. Selection of LTF definitions should be based on the study outcome, available data on clinical encounters, and the patients' visit schedules; we suggest some general guidelines.

Evaluation of the use of a Renal Health application by kidney transplant recipients.

OBJECTIVE: to evaluate the use of a renal health application by kidney transplant recipients. METHOD: a retrospective, observational study with a sample composed of individuals registered in the kidney transplant section of the application from July of 2018 to April of 2021. Demographic data, data entry, time of use, weight, blood pressure, blood glucose, creatinine, medication schedules, appointments, and tests were the variables collected. Descriptive analysis of the data was performed. RESULTS: eight hundred and twenty-three downloads of the application were identified, and 12.3% of those were registered as kidney transplant recipients, the majority from southeastern Brazil (44.9%), 36±11 years old, and female (59.1%). Of the sample, 35.1% entered information such as creatinine (62%), weight (58.2%), and blood pressure (51.8%). Most used the application for one day (63.3%) and 13.9% for more than one hundred days. Those who used it for more than one day (36.7%) recorded weight (69%), medication intake (65.5%) and creatinine (62%), and scheduled appointments (69%). CONCLUSION: the kidney transplant recipient section of the Renal Health application generated interest in the young population, but showed low adherence throughout the assessed months. These results offer a relevant perspective on the implementation of mHealth technologies in kidney transplantation.

Food and Nutrition Surveillance System: temporal trend of coverage and nutritional status of adults registered on the system, Brazil, 2008-2019. / Sistema de Vigilância Alimentar e Nutricional: tendência temporal da cobertura e estado nutricional de adultos registrados, 2008-2019.

OBJECTIVE: To analyze the temporal trend of Food and Nutrition Surveillance System (SISVAN) coverage and nutritional status of adults undergoing follow-up in the Brazilian Primary Health Care, 2008-2019. METHODS: This was an ecological time series study using data on Brazilian macro-regions. The annual percent change in the classification of nutritional status and total coverage was estimated using the Prais-Winsten regression model. RESULTS: A total of 115,034,534 records were identified in the period. Coverage increased from 5.0% in 2008 to 10.6% in 2019, with an annual change of 8.4%, 95% confidence interval (95%CI 6.7;10.0). Obesity and overweight showed a rising trend between 2008 and 2019, with an annual change of 6.4% (95%CI 5.3;7.3) and (1.8%; 95%CI 1.2;2.5) respectively, while underweight (-7.0%; 95%CI -8.0;-6.1) and eutrophy (-3.8%; 95%CI -4.1;-3.4) decreased in the period. CONCLUSION: There was an improvement in SISVAN coverage, with an increase in overweight and obesity among the population studied.

Evaluation of the 'Gestação' application from the perspective of semiotics: pregnant women's views. / Avaliação do aplicativo "Gestação" na perspectiva da semiótica: o olhar das gestantes.

Evaluating health-related applications is necessary for their adequacy and dissemination in society. The GestAção application was evaluated based on the opinion of 13 pregnant women followed up in prenatal care consultations at three public health services and at a private institution in Fortaleza, Ceará, Brazil. Data emerged from an evaluation carried out from June to December 2017, including semi-structured interviews. Data were analyzed from content analysis in thematic and semiotic modality. Thus, the theme "meanings attributed to the application by pregnant women" emerged, which is associated with the following cores of meaning: provision of safe and diverse information; possibility of changing behavior and motivations for using the application. It is considered that semiotics allowed to understand the meanings attributed to the application from the interaction of pregnant women with the tool. The GestAção application was considered satisfactory, motivating to use, informative, safe and promoter of changes in the context of gestational health. Participants' views allow the evaluated technology to compose strategies aimed at promoting health care for pregnant women.

A avaliação de aplicativos voltados à saúde é necessária para a sua adequação e disseminação na sociedade. O aplicativo GestAção foi avaliado com base na opinião de 13 gestantes acompanhadas em consultas pré-natais, em três serviços públicos de saúde e em uma instituição privada, em Fortaleza, Ceará, Brasil. Os dados emergiram do processo avaliativo realizado de junho a dezembro de 2017, incluindo entrevistas semiestruturadas, tendo sido analisados a partir da análise de conteúdo na modalidade temática e da Semiótica, resultando no tema "significados atribuídos ao aplicativo pelas gestantes", a qual se associa aos seguintes núcleos de sentido: fornecimento de informações seguras e diversificadas; possibilidade de mudança de comportamento e motivações para a utilização do aplicativo. Considera-se que a Semiótica permitiu compreender os significados atribuídos ao aplicativo, a partir da interação das gestantes com a ferramenta, indicando o GestAção como satisfatório, motivador ao uso, informativo, seguro e promotor de mudanças no contexto da saúde gestacional. O olhar das participantes possibilita que a tecnologia avaliada possa compor as estratégias voltadas à promoção e aos cuidados à saúde das gestantes.

Blood donation support application: contributions from experts on the tool's functionality. / Aplicativo de apoio à doação de sangue: contribuições de especialistas sobre a funcionalidade da ferramenta.

Blood donation is a social practice that helps treat diseases and maintain public health. The DoeSangue application was designed and developed to support donor recruitment and loyalty, strengthening health promotion and social engagement. We aimed to assess the DoeSangue application from the perspective of hematology and hemotherapy experts. A methodological, applied and qualitative research was carried out from September 2015 to July 2017 in Fortaleza, Ceará. The study was based on Participatory Interaction Design associated with Symbolic Interactionism. After conducting the first two steps, application design and development in a laboratory and assessment by donor users, the application was validated by eight experts from the Fortaleza's public blood center. For data collection, the 'application validation form with experts' was used based on a Likert-type scale, and a focus group was conducted. The tool was positively assessed by participants, with an average Content Validation Index of 0.88. Evaluators pointed out, among other features, the tool's ability to promote interactivity, mobilization and social engagement, in addition to contributing to gathering and loyalty of blood donors.

A doação de sangue é uma prática social que auxilia no tratamento de doenças e na manutenção da saúde coletiva. O aplicativo DoeSangue foi concebido e desenvolvido para apoiar a captação e a fidelização de doadores, fortalecendo a promoção da saúde e o engajamento social. Objetivou-se avaliar o aplicativo DoeSangue sob a perspectiva de especialistas das áreas de hematologia e hemoterapia. Realizou-se uma pesquisa metodológica, aplicada e qualitativa, de setembro de 2015 a julho de 2017, em Fortaleza, Ceará. O estudo fundamentou-se no Design de Interação Participativo associado ao Interacionismo Simbólico. Após as duas primeiras etapas - concepção e desenvolvimento do aplicativo em laboratório, e avaliação pelos usuários doadores - o aplicativo foi validado por oito especialistas do hemocentro público de Fortaleza. Para a coleta de dados, utilizou-se o 'formulário de validação do aplicativo com especialistas', com base na escala de Likert, e realizou-se um grupo focal. A ferramenta foi avaliada positivamente pelos participantes, com Índice de Validação de Conteúdo médio de 0,88. Os avaliadores apontaram, dentre outras funcionalidades, a capacidade da ferramenta em promover interatividade, mobilização e engajamento social, além de contribuir com a captação e a fidelização de doadores de sangue.

Renal Health: Providing Information and Technological Tools to Empower Patients to Live Better with Kidney Disease.

Chronic kidney disease (CKD) is a growing Public Health problem. Recent evidence points that low education and poor socio-economic conditions are associated with higher risk of developing CKD and progressing to dialysis or transplantation need. Hence patient empowerment through health education and qualification with technological tools that allows better treatment adherence may play an important role in the achievement of optimal clinical outcomes. The Renal Health is a multidisciplinary project created at the University of Fortaleza, northeast Brazil, in 2015, aiming to create novel educational material and technological tools for people with CKD, in different treatment modalities, including dialysis and transplant. The products developed so far in the project include an application for smartphones aiming to help patients in dialysis and transplant in their treatments, including schedule for medications, with alarms, water ingestion control, laboratory tests results, and medical appointments' agenda, besides all information regarding CKD. The other tools include a medication box, an insole for weight control (both are in the prototype phase), connection with smartbands (for vital signs monitoring) and multimedia educational tools, including a profile in the Instagram and a channel in YouTube. Since the first release of the application in the virtual stores, there were more than 1,000 downloads, predominantly in Brazil, although the app is also available in English and Spanish. All these tools represent innovative ways of patient empowerment and may be increasingly present in daily life. Further studies are required to assess the impact of these tools in patients' outcomes, including CKD progression and mortality.

Implementing OpenMRS for patient monitoring in an HIV/AIDS care and treatment program in rural Mozambique.

We have adopted the Open Medical Record System (OpenMRS) framework to implement an electronic patient monitoring system for an HIV care and treatment program in Mozambique. The program provides technical assistance to the Ministry of Health supporting the scale up of integrated HIV care and support services in health facilities in rural resource limited settings. The implementation is in use for adult and pediatric programs, with ongoing roll-out to cover all supported sites. We describe early experiences in adapting the system to the program needs, addressing infrastructure challenges, creating a regional support team, training data entry staff, migrating a legacy database, deployment, and current use. We find that OpenMRS offers excellent prospects for in-country development of health information systems, even in severely resource limited settings. However, it also requires considerable organizational infrastructure investment and technical capacity building to ensure continued local support.

The Renal Health Instagram: An Analysis of Comments.

Chronic kidney disease (CKD) is a Public Health problem affecting a considerable number of patients worldwide. CKD treatment is complex and requires patients' education. Based on this we have created technological tools, including an application for smartphones and a profile on Instagram (Renal Health) aiming to educate patients to self-monitor and cope with their disease, to increase adherence to treatment. In this study, we have analyzed the spontaneous feedbacks patients, and other people have posted on the Renal Health Instagram (comments) to investigate which information was needed the most by which types of patients. During the first 15 months since the release of this profile, there were 3380 followers, a total of 449 posts, with 36,079 "likes". Most of the followers were patients and parents, they gave spontaneous testimonials of their experiences with having kidney disease, and were thankful for the information provided and for the response we gave to their questions. From the analysis of the comments, we found that information on nutrition, physical activities and kidney transplant were the most discussed and valued. Our results also showed that the main use of this medium for dialysis and transplant patients was to share their experience. The Renal Health Instagram was considered a good digital platform of trusted information for both patients and the general population and also a space for sharing experiences in the context of kidney disease epidemics.

Development and evaluation of an application for syphilis control.

OBJECTIVE: to develop and evaluate an application for syphilis control in pregnant women. METHOD: methodological research developed between March and November of 2016 in two phases: bibliographic survey of the years 2012 to 2016 in the databases PubMed, CAPES and Scopus and application development. Eight users participated in the usability test and five doctors and five nurses working in prenatal care participated in the evaluation. RESULTS: the application contains informative video, information about the disease, map of health clinics, agenda function and anonymous notification. The evaluation of the objective, function and relevance was considered adequate with value higher than 0.80 in all items of the Content Validity Index. FINAL CONSIDERATIONS: the application makes easier the routine of health services in the context of health promotion, in the convocation and treatment of pregnant women and their partners.

Oral administration of antibiotics increased the potential mobility of bacterial resistance genes in the gut of the fish Piaractus mesopotamicus.

BACKGROUND: Aquaculture is on the rise worldwide, and the use of antibiotics is fostering higher production intensity. However, recent findings suggest that the use of antibiotics comes at the price of increased antibiotic resistance. Yet, the effect of the oral administration of antibiotics on the mobility of microbial resistance genes in the fish gut is not well understood. In the present study, Piaractus mesopotamicus was used as a model to evaluate the effect of the antimicrobial florfenicol on the diversity of the gut microbiome as well as antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs) using a metagenomic approach. RESULTS: The total relative abundance of ARGs and MGEs significantly increased during the antibiotic exposure. Additionally, phage integrases, transposases, and transposons flanking ARGs accumulated in the gut microbiome of P. mesopotamicus because of the antibiotic exposure. MGEs co-occurring with ARGs showed a significant positive correlation with the total ARGs found. Furthermore, shifts in the gut microbiome towards well-known putative pathogens such as Salmonella, Plesiomonas, and Citrobacter were observed following florfenicol treatment. Mainly Plesiomonas and Citrobacter harbored genes that code for multidrug and phenicol efflux pumps. Moreover, several genes related to RNA processing and modification, cell motility, SOS response, and extracellular structure were enriched due to the antibiotic application. The observed effects were visible during the complete application phase and disappeared at the post-exposure phase. CONCLUSIONS: Our findings suggest that the oral administration of antibiotics increases the potential for MGE-mediated exchange of ARGs in the gut of fish and could contribute to the enrichment and dispersion of ARGs in aquaculture systems. Importantly, this increase in the potential for ARGs exchange could be an effect of changes in community structure and/or ARG mobilization.

Coping with problems that impact on the health of a socially vulnerable community from the residents' perspective. / Enfrentamento de problemas que impactam na saúde de uma comunidade socialmente vulnerável sob a ótica dos moradores.

This research aims to identify the strategies adopted by dwellers of a socially vulnerable community, characterized by social and economic inequality, to address the problems that interfere in the health conditions. A participant investigation anchored in hermeneutics was conducted through participatory diagnosis, with 31 residents of the Dendê community, who were called vital informants. Data were collected from semi-structured interviews, street walking and focus groups. WebQDA software was adopted to support data analysis, based on content analysis in the thematic modality, which resulted in the following categories: "individual or small group actions", "partnerships between residents and social organizations" and "partnerships with public and private sectors". We considered that the condition of vulnerability motivated by a diversity of social determinants generates negative impacts on health, requiring planning and implementation of policies and actions geared to people's well-being. This reflects the relevance of the participatory diagnosis, which can be supported by people and Information and Communication Technologies to increase community participation in health promotion actions.

Esta pesquisa objetiva identificar as estratégias adotadas por moradores de uma comunidade socialmente vulnerável, caracterizada pela desigualdade econômica e social, para o enfrentamento dos problemas que interferem nas condições de saúde. Realizou-se pesquisa participante por meio do diagnóstico participativo, ancorada na Hermenêutica. Participaram 31 moradores da Comunidade do Dendê, denominados informantes-chave. Coletaram-se os dados a partir de entrevista semiestruturada, caminhada de rua e grupos focais. Utilizou-se o software WebQDA para amparar a análise dos dados, com base na Análise de Conteúdo na modalidade temática, identificando-se as seguintes categorias: "ações individuais ou de pequenos grupos de pessoas", "parcerias entre moradores e organizações sociais" e "parcerias com segmentos públicos e privados". Considera-se que a condição de vulnerabilidade, motivada por uma diversidade de determinantes sociais, gera impactos negativos sobre a saúde, tornando necessário o planejamento e a efetivação de políticas e ações voltadas ao bem estar da população. Isso reflete a relevância do diagnóstico participativo, o qual pode ser apoiado pelas pessoas e Tecnologias da Informação e Comunicação para ampliar a participação comunitária nas ações promotoras de saúde.