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A sarcoidose é uma doença inflamatória multissistêmica, com apresentação e curso clínico variável, podendo afetar qualquer órgão e evoluir desde remissão espontânea até disfunção de múltiplos órgãos. Essa diversidade clínica, associada à semelhança com outras doenças mais comuns, muitas vezes leva à incerteza diagnóstica e atrasos no tratamento. Com isso, o diagnóstico da sarcoidose é desafiador, mas pode ser baseado em três critérios: apresentação clínica compatível; evidência de granulomas não caseosos; e exclusão de diagnósticos alternativos. No entanto, mesmo quando todos os critérios são preenchidos, a probabilidade de diagnóstico de sarcoidose varia de definitiva a apenas possível, dependendo da presença de sinais radiológicos e histopatológicos mais ou menos característicos. O diagnóstico de sarcoidose pode ser difícil na ausência de manifestações torácicas ou cutâneas e a busca pela evidência histopatológica nem sempre é fácil. Além disso, diagnósticos diferenciais, principalmente tuberculose, devem ser considerados. Neste artigo, discutimos os principais pontos a serem considerados nesse trabalho diagnóstico e propomos um algoritmo para sistematizar o diagnóstico dessa patologia. Unitermos: sarcoidose; diagnóstico; granuloma; biomarcadores; diagnóstico diferencial.

A educação interprofissional (EIP) desenvolve competências colaborativas favoráveis para formação de profissionais na saúde, como trabalho em equipe, resolutividade e integralidade da atenção em saúde, porém experiências sobre EIP no ensino da Odontologia no Brasil são escassas. O objetivo deste trabalho foi analisar os planos de ensino da matriz curricular do curso de Odontologia, de uma instituição pública, no que se refere à EIP. Foi realizada pesquisa documental, descritiva, exploratória, com análise dos planos de ensino das disciplinas obrigatórias e optativas, disponibilizados pelo Colegiado de Graduação em 2019 do curso de Odontologia da Universidade Federal de Minas Gerais (UFMG). Entre as 97 disciplinas, distribuídas do 1° ao 10° período, nenhuma disciplina citou pressupostos ou princípios da EIP. Apenas oito mencionaram alguma ação multiprofissional totalizando 15% da carga horária total do curso que corresponde a 4005 horas. Os planos de ensino evidenciaram o trabalho multiprofissional por observação (n=3) e atuação com outros profissionais (n=5). Das disciplinas que apresentam interação com outros profissionais, somente uma tem sua prática dentro da Faculdade de Odontologia. Foi percebido que estas disciplinas com trabalhos multiprofissionais são campos estratégicos para a inserção da EIP no currículo de Odontologia da UFMG. Estes resultados sugerem que a EIP é inexistente dentro do projeto pedagógico do curso em Odontologia na UFMG, quadro comum em outras instituições nacionais que oferecem este curso. Nesse sentido, é necessário um apoio e incentivo aos cursos de Odontologia para que promovam mudanças em seus currículos, visando contribuir para qualificação dos profissionais e na atenção à saúde.

To assess the association between user satisfaction in relation to secondary dental care services and the structure and process of Brazilian Dental Specialty Centers (CEO, in Portuguese).This study used nationwide secondary data from two CEO evaluation cycles. Ten users from each CEO answered questions on the self-perception of healthcare quality and satisfaction with health services. Latent class analysis (LCA) was performed to identify subgroups of satisfied and dissatisfied users (outcome). The CEO structure included equipment, supplies, instruments, ambience and type of CEO (type I, II or III, according to the number of dental chairs and dental professionals). The work process referred to the planning/monitoring of actions, collaborative care, characteristics of the demand for medical care /the organization of scheduling, and continuing education for employees. Covariables concerned user profiles. A multilevel logistic regression model was used (p-value.05).Seven thousand nine hundred and ninety-seven users in 794 CEOs, together with 10056 users in 911 CEOs, participated in the 1st and 2nd evaluation cycles, and satisfied users corresponded to 85.3% and 87.1%, respectively. In both cycles, the CEO's structural characteristics explained most of the variance in satisfaction. CEOs with more favourable structural characteristics showed higher satisfaction. Users from CEOs, type II and III, and those who received dental care where there was an interruption of services due to a lack of equipment or instruments reported a lower level of satisfaction. CEOs that organize their demand through referrals received from primary care dentists who have participated in continuing education actions for dental professionals presented a higher frequency of satisfied users.Characteristics of the process and structure were associated with user satisfaction, but a quality of care was perceived by users, mainly due to structural characteristics.

Cranial and facial bone fractures are frequent events that bring great socioeconomic impact to the Brazilian health system. Thus, it became an objective to investigate the epidemiology of the hospital admissions motivated by cranial and facial bone fractures in the state capitals of the Brazilian North region. The methodology adopted was descriptive, documental, quantitative and comparative through secondary data gathered during June 2020. Information relative to annual frequency of admissions, age group and gender were found in the DATASUS website for the years 2010 to 2019. Results show that there was a total of 10,762 admissions for cranial and facial bone fractures in this period. All the region capitals have a prevalence of occurrences with young and male victims, while Belém was the capital with the greater number of hospitalizations and incidence rates. A reduction of cases along the years was evidenced. In conclusion, hundreds of individuals of both genders and every age group are admitted yearly in the hospitals of the Brazilian North region because of these fractures.

Made available in DSpace on 2022-04-29T08:30:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-08-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Terrestrial, marine, or aquatic oil spills can directly or indirectly contaminate bird eggs. We hypothesized that chicken embryos exposed to crude oil can physiologically compensate to mitigate the potentially toxic effect of lower doses of oil. Embryos exposed to 0, 1, 3, or 5 µL of oil on embryonic days 4 and 10 were initially analyzed for mortality. All oil doses decreased day 4 embryo survival, but only the 2 highest oil doses lowered survival when applied on day 10. Thus, day 15 embryos treated with 1, 3, and 5 µL of source oil on day 10 had arterialized blood analyzed. The hematological variables hematocrit, red blood cell concentration ([RBC]), and hemoglobin concentration increased in response to 1 µL, were unchanged by 3 µL, and decreased by 5 µL of oil treatment. No changes occurred in arterialized blood gas variables (partial pressure of O2 [PO2], pH, bicarbonate concentration) for 1 and 3 µL embryos, but 5 µL of oil decreased PO2 and caused metabolic acidosis. Increased blood lactate in embryos treated with 3 and 5 µL of oil was correlated with decreased hematocrit and [RBC] and increased body mass, the latter likely reflecting edema. We conclude that embryos in middle development physiologically compensated for negative effects of lower doses of crude oil but that higher doses of oil were harmful to the embryos at all developmental stages. Environ Toxicol Chem 2021;40:2347–2358. © 2021 SETAC. Developmental Integrative Biology Department of Biological Sciences University of North Texas Integrative Thermal Physiology Department of Animal Morphology and Physiology São Paulo State University Jaboticabal Integrative Thermal Physiology Department of Animal Morphology and Physiology São Paulo State University Jaboticabal FAPESP: 2017/21581-2

Evaluability Studies (ES) are pre-evaluative studies that precede the evaluation of a service. The objective of this study was to conduct an ES of secondary oral health care in Brazil, offered by the national public health system - SUS (Unified Health System) - through the Dental Specialty Centers (DSC). Nationally based study, carried out between the years 2017-2020, based on the system of Thurston e Ramaliu’s 7 elements. Twenty-nine members involved in the implementation and operation of the DSC participated in the study. The evaluation tool was validated in its content and appearance. Data were analyzed through the Content Validity Index (CVI) and according to the Content Analysis method. DSC description, based on documents and scientific evidence, allowed to understand its legal framework, operationalization, and main events that characterize it. The theoric-logic model defined 3 components to be evaluated: comprehensiveness health care, access to secondary oral health care and DSC management. The evaluation tool was validated in 2 rounds, with CVI>75%. The study demonstrated that secondary oral health care is evaluable and has a favorable scenario for its development. An inedited DSC questionnaire was established and validated. Los Estudios de Evaluabilidad (EE) son estudios pre-evaluativos que preceden a la evaluación real de un servicio. El objetivo de este trabajo fue realizar una EE de atención secundaria en salud bucal en Brasil, ofrecida por el sistema nacional de salud pública – SUS (Sistema Único de Salud) - a través de los Centros de Especialidad Odontológica (CEO). Estudio de base nacional, realizado en los años 2017-2020, basado en el sistema de 7 elementos de Thurston y Ramaliu. Participaron 29 miembros involucrados con la implementación y operación del CEO. El instrumento de evaluación fue validado en cuanto a contenido y apariencia. Los datos fueron analizados utilizando el Índice de Validez de Contenido (IVC) y según el método de Análisis de Contenido. La descripción de los CEO, con base en documentos y evidencias científicas, permitió comprender su estructura jurídica, funcionamiento y principales hechos que lo caracterizan. El modelo teórico-lógico definió 3 componentes a evaluar: atención integral, acceso a la atención secundaria de salud bucal y gestión del CEO. El cuestionario de evaluación fue validado en 2 rondas, con CVI>75%. El estudio mostró que la atención especializada en salud bucal está disponible y tiene un escenario favorable para su desarrollo. Se estableció y validó un cuestionario de evaluación de CEO sin precedentes. Estudos de Avaliabilidade (EA) são estudos pré-avaliativos que precedem a avaliação propriamente dita de um serviço. O objetivo deste trabalho foi conduzir um EA da atenção secundária em saúde bucal no Brasil, ofertada pelo sistema público de saúde nacional – SUS (Sistema Único de Saúde) – através dos Centros de Especialidades Odontológicas (CEO). Estudo de base nacional, realizado nos anos 2017-2020, baseado no sistema de 7 elementos de Thurston e Ramaliu. Participaram 29 integrantes envolvidos com a implantação e funcionamento do CEO. O instrumento de avaliação foi validado em conteúdo e aparência. Os dados foram analisados por meio do Índice de Validade de Conteúdo (IVC) e de acordo com o método de Análise de Conteúdo. A descrição do CEO, baseada em documentos e evidência científica, permitiu compreender sua estrutura legal, operacionalização e principais eventos que o caracterizam. O modelo teórico-lógico definiu 3 componentes a serem avaliados: integralidade do cuidado, acesso à atenção secundária em saúde bucal e gerenciamento do CEO. O questionário de avaliação foi validado em 2 rodadas, com IVC>75%. O estudo demonstrou que a atenção especializada em saúde bucal é avaliável e tem um cenário favorável ao seu desenvolvimento. Foi estabelecido e validado um questionário inédito de avaliação do CEO.

Neural networks tune synaptic and cellular properties to produce stable activity. One form of homeostatic regulation involves scaling the strength of synapses up or down in a global and multiplicative manner to oppose activity disturbances. In American bullfrogs, excitatory synapses scale up to regulate breathing motor function after inactivity in hibernation, connecting homeostatic compensation to motor behavior. In traditional models of homeostatic synaptic plasticity, inactivity is thought to increase synaptic strength via mechanisms that involve reduced Ca

Made available in DSpace on 2022-04-29T08:40:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-02-15 The febrile response to resist a pathogen is energetically expensive, while regulated hypothermia seems to preserve energy for vital functions. We hypothesized here that immune-challenged birds facing metabolic trade-offs (reduced energy supply/increased energy demand) favor a regulated hypothermic response at the expense of fever. To test this hypothesis, we compared 5 day old broiler chicks exposed to fasting, cold (25°C), and fasting combined with cold with a control group fed under thermoneutral conditions (30°C). The chicks were injected with saline or with a high dose of endotoxin known to induce a biphasic thermal response composed of a drop in body temperature (Tb) followed by fever. Then Tb, oxygen consumption (metabolic rate), peripheral vasomotion (cutaneous heat exchange), breathing frequency (respiratory heat exchange) and huddling behavior (heat conservation indicator) were analyzed. Irrespective of metabolic trade-offs, chicks presented a transient regulated hypothermia in the first hour, which relied on a suppressed metabolic rate for all groups, increased breathing frequency for chicks fed/fasted at 30°C, and peripheral vasodilation in chicks fed/fasted at 25°C. Fever was observed only in chicks kept at thermoneutrality and was supported by peripheral vasoconstriction and huddling behavior. Fed and fasted chicks at 25°C completely eliminated fever despite the ability to increase metabolic rate for thermogenesis in the phase correspondent to fever when it was pharmacologically induced by 2,4-dinitrophenol. Our data suggest that increased competing demands affect chicks' response to an immune challenge, favoring regulated hypothermia to preserve energy while the high costs of fever to resist a pathogen are avoided. Department of Animal Morphology and Physiology São Paulo State University (FCAV-UNESP) Department of Biology University of North Carolina at Greensboro (UNCG) Department of Animal Morphology and Physiology São Paulo State University (FCAV-UNESP)

The study aimed to evaluate the role of the preceptor in the training of dentistry students in the discipline "Supervised Internship in Dentistry" at the Faculty of Dentistry at UFMG. A questionnaire with open and closed questions about the experiences and impressions of students, teachers and tutors from six internship fields located in Belo Horizonte was used. Eleven students, ten preceptors and four professors participated in this study. All students and professors and 50% of preceptors consider that preceptorship is part of the health professional's attributions. Most actors stated that the health professional feels motivated and prepared to act as a preceptor. All actors considered important the student's participation in internships in health services during professional training and stated that the preceptor knows about the discipline's objectives. Only 20% of preceptors said they had already participated in a preceptorship training course and 80% expressed interest in participating. The participants' perception of the role of the preceptor in the training of health professionals was positive. Some preceptors are not aware that preceptorship is part of their role as health professional. Actions that seek to train and make preceptors aware of their role in training future health professionals are needed. Evaluar el papel del preceptor en la formación del estudiante de odontología en la disciplina "Internado Supervisado en Odontología" de la Facultad de Odontología de la UFMG. Se utilizó un cuestionario con preguntas abiertas y cerradas sobre las experiencias e impresiones de los estudiantes, profesores y preceptores de seis campos de prácticas ubicados en Belo Horizonte. El análisis descriptivo se realizó utilizando el programa estadístico SPSS 18.0 (CAAE 44100415.3.0000.5149). Once estudiantes, diez preceptores y cuatro profesores participaron en este estudio. Todos los alumnos y profesores y el 50% de los preceptores consideran que la preceptoria forma parte de las atribuciones del profesional de la salud. La mayoría de los actores afirmó que el profesional de la salud se siente motivado y preparado para actuar como preceptor. Todos los actores consideraron importante la participación del estudiante en pasantías en servicios de salud durante la formación profesional y afirmaron que el preceptor tiene conocimiento sobre los objetivos de la disciplina. Sólo el 20% de los preceptores afirmaron que ya participaron en curso de capacitación de precepción y el 80% manifestaron interés en participar. La percepción de los participantes sobre el papel del preceptor en la formación del profesional de la salud fue positiva. Algunos preceptores no son conscientes de que la preceptoria forma parte de su atribución como profesional de la salud. Son necesarias acciones que buscan capacitar y concientizar a los preceptores de su papel en la formación de los futuros profesionales de salud. O estudo objetivou avaliar o papel do preceptor na formação do estudante de Odontologia na disciplina “Estágio Supervisionado em Odontologia” da Faculdade de Odontologia da UFMG. Foi utilizado um questionário com questões abertas e fechadas sobre as experiências e impressões dos estudantes, professores e preceptores de seis campos de estágio localizados em Belo Horizonte. Onze estudantes, dez preceptores e quatro professores participaram deste estudo. Todos os alunos e professores e 50% dos preceptores consideram que a preceptoria faz parte das atribuições do profissional de saúde. A maioria dos atores afirmou que o profissional de saúde se sente motivado e preparado para atuar como preceptor. Todos os atores consideraram importante a participação do estudante em estágios em serviços de saúde durante a formação profissional e afirmaram que o preceptor tem conhecimento sobre os objetivos da disciplina. Apenas 20% dos preceptores afirmaram que já participaram de curso de capacitação de preceptoria e 80% manifestaram interesse em participar. A percepção dos participantes sobre o papel do preceptor na formação do profissional de saúde foi positiva. Alguns preceptores não têm consciência de que a preceptoria faz parte de sua atribuição como profissional da saúde. São necessárias ações que busquem capacitar e conscientizar os preceptores do seu papel na formação dos futuros profissionais de saúde.

his study explores the recalibration and adequacy of a measure of vocabulary size – the Vocabulary Levels Test (VLT) – as a predictor of Brazilian Portuguese-English speakers’ ability to access grammatical representations through their non-dominant language. Such endeavor concerns a specific part of the test (composed majorly by cognates) which has been blurring the results when participants are natives in Latin-derived languages, such as Brazilian Portuguese. A new test (nVLT) was designed, with a novel version of this problematic part (level 4) present in the older test that, now, avoids the proliferation of cognates. Both versions were applied to a number of Brazilian participants and the results were correlated with another proficiency measure, taken from an acceptability judgment task designed according to the model reported in Souza et al (2015). When the low-proficiency participants took the VLT, there were a decreasing pattern in their scores from the first level of the exam all the way to level 3 (because each level is harder than the preceding). But, when they got to level 4, which is “harder” than level 3, their scores increased surprisingly, and then decreased again in level 5. When they performed the nVLT, which has a level 4 recalibrated (without latin cognates), the decreasing pattern was maintained evenly through the whole test. These results from nVLT show an internal coherence of the test due to the recalibration.

Os livros ilustrados, cada vez mais frequentes no mercado editorial brasileiro, são obras complexas, cujo conceito ainda se encontra em processo de formulação. Esta pesquisa, ao evidenciar o livro ilustrado na produção literária para a infância, analisa obras premiadas pela Fundação Nacional do Livro Infantil e Juvenil – FNLIJ, entre 1975 e 2020. Pretendeu-se investigar as possíveis transformações ocorridas na função da ilustração, sua articulação com o texto verbal e o suporte, de forma a caracterizar o processo de constituição do livro ilustrado brasileiro. A partir do percurso histórico da literatura infantil no ocidente, discutem-se as especificidades do livro ilustrado, considerando-o como objeto artístico. As contribuições teóricas de Michel Melot (2015), Odilon Moraes (2019), Sophie Van der Linden (2011), Martin Salisbury e Morag Styles (2012), Rui de Oliveira (2008b) e Maria Nikolajeva e Carole Scott (2011) apoiaram as análises e conclusões do trabalho. A metodologia consistiu na análise dos livros premiados nas categorias Criança, Livro de Imagem, Melhor Ilustração e Livro Brinquedo. O exame dos dados permitiu organizar o acervo em sete categorias principais: 1º) Texto e imagens: espaços em disputa; 2º) O silêncio da palavra e a imagem narrativa; 3º) O design da palavra; 4º) Materialidade e narrativa; 5º) Metaficção e intertextualidade; 6º) O Brasil expresso na visualidade e 7º) Autoria: referências e paradigmas. Observaram-se pontos de aproximação entre as obras, nas quatro dimensões do espaço-tempo: linha, página, livro e tempo (ALENCAR e COELHO, 2016). O percurso desta pesquisa reforça a complexidade e a potencialidade dos livros ilustrados e indica que esse modo de narrar é predominante nas premiações mais recentes da FNLIJ, nas categorias analisadas. A trajetória de premiações nos revela, também, que, mesmo antes do uso do termo “livro ilustrado” no Brasil, é possível observar um processo de ascensão da imagem, aliado à exploração do livro como objeto. O recurso pedagógico que integra esta pesquisa, em formato e-book, aborda a temática da formação leitora, da mediação literária e dos elementos narrativos que constituem os livros ilustrados, estabelecendo um diálogo da pesquisa com a ação docente, em especial, aquelas desenvolvidas no âmbito da Educação Infantil. Picturebooks, increasingly recurrent in the Brazilian publishing industry, are complex works whose concept is still in the process of formulation. By highlighting the picturebook in literary production for children this research analyses works awarded by ‘Fundação Nacional do Livro Infantil e Juvenil’ – FNLIJ, from 1975 to 2020. It has been intended to scrutinise the possible transformations occurred in the role of illustration, its association with the verbal text as well as with the object, in order to define the constitution of the Brazilian picturebook. In light of the historical course of children’s literature in the West, the particularities of the picturebook are examined considering it as an artistic object. The contributions of Michel Melot (2015), Odilon Moraes (2019), Sophie Van der Linden (2011), Martin Salisbury and Morag Styles (2012), Rui de Oliveira (2008b) and Maria Nikolajeva and Carole Scott (2011) supported the analysis and conclusions of the work. The methodology consisted of examining the award-winning books within the categories “Child”, “Picture Book”, “Best Illustration” and “Toybook”. Analysing the data enabled the organisation of the collection into seven main categories: 1st) Text and images: spaces in dispute; 2nd) The silence of the word and the narrative image; 3rd)The design of the word; 4th) Materiality and narrative; 5th) Metafiction and intertextuality; 6th) Brazil expressed in visuality and 7th) Authorship: references and paradigms. Aspects of convergence between the works were observed, within the four dimensions of space-time: line, page, book and time (ALENCAR and COELHO, 2016). The path of this research reinforces the complexity and potentiality of picturebook and indicates that this way of narrating is predominant in the most recent FNLIJ awards, within the categories scrutinised. The trajectory of the awards also demonstrates that even before the use of the term “picturebook” in Brazil, it is possible to observe a process of the image’s ascension, allied to the exploration of the book as an object. The pedagogical resource that integrates this research, in ebook format, addresses the issues of training readers, of literary mediation and of the narrative elements that constitute picturebooks, establishing a dialogue between research and teaching action, especially those developed within the scope of early childhood education.

Lactate ion sensing has emerged as a process that regulates ventilation during metabolic challenges. Most work has focused on peripheral sensing of lactate for the control of breathing. However, lactate also rises in the central nervous system (CNS) during disturbances to blood gas homeostasis and exercise. Using an amphibian model, we recently showed that lactate ions, independently of pH and pyruvate metabolism, act directly in the brainstem to increase respiratory-related motor outflow. This response had a long washout time and corresponded with potentiated excitatory synaptic strength of respiratory motoneurons. Thus, we tested the hypothesis that lactate ions enhance respiratory output using cellular mechanisms associated with long-term synaptic plasticity within motoneurons. In this study, we confirm that 2 mM sodium lactate, but not sodium pyruvate, increases respiratory motor output in brainstem-spinal cord preparations, persisting for 2 h upon the removal of lactate. Lactate also led to prolonged increases in the amplitude of AMPA-glutamate receptor (AMPAR) currents in individual motoneurons from brainstem slices. Both motor facilitation and AMPAR potentiation by lactate required classic effectors of synaptic plasticity, L-type Ca2+ channels and NMDA receptors, as part of the transduction process but did not correspond with increased expression of immediate-early genes often associated with activity-dependent neuronal plasticity. Altogether these results show that lactate ions enhance respiratory motor output by inducing conserved mechanisms of synaptic plasticity and suggest a new mechanism that may contribute to coupling ventilation to metabolic demands in vertebrates. KEY POINTS: Lactate ions, independently of pH and metabolism, induce long-term increases in respiratory-related motor outflow in American bullfrogs. Lactate triggers a persistent increase in strength of AMPA-glutamatergic synapses onto respiratory motor neurons. Long-term plasticity of motor output and synaptic strength by lactate involves L-type Ca2+ channels and NMDA-receptors as part of the transduction process. Enhanced AMPA receptor function in response to lactate in the intact network is causal for motor plasticity. In sum, well-conserved synaptic plasticity mechanisms couple the brainstem lactate ion concentration to respiratory motor drive in vertebrates.

OBJECTIVES To investigate the association between health management and human resource factors on matrix support (MS) in a nationally representative sample of Dental Specialty Centres (DSCs) in Brazil. METHODS This survey included 1042 DSCs (Response rate = 94.99%) in the second cycle of the National Program for the Improvement of the Quality and Access to the Dental Specialty Centres (PMAQ-CEO, in Portuguese) in 2018. Previously trained interviewers extracted information on MS, health management and human resources of the DSC by using a structured instrument. An MS score was created by adding the number of positive answers to the 10 MS questions. Negative binomial regression models were used to estimate the unadjusted and adjusted rate ratios (RR) and corresponding 95% confidence interval (CI). RESULTS Of all the DSCs (n = 1042), 116 (11.1%) performed all 10 MS procedures. Those DSCs with a manager who had a higher education degree in the area of Public Health or Public Management (RR = 1.01, 95% CI, 1.01-1.02) and with human resources that received incentives, bonuses or financial awards for performance related to the PMAQ-CEO result (RR = 1.01 95% CI 1.01-1.02) are more likely to perform MS, when compared to the reference categories. The DSCs that are more likely to perform MS include those that developed actions as a result of periodic planning and evaluation with confirmatory documentation (RR = 1.06, 95% CI; 1.01-1.10); those that received support for planning and organizing the work scheme (RR = 1.03, 95% CI; 1.01-1.05); those that monitored and analysed the goals set for each specialty offered at the DSC, with (RR = 1.06, 95% CI; 1.01-1.10) or without confirmatory documentation (RR = 1.06, 95%CI; 1.02-1.11); those whose team periodically performed self-assessment processes, using the Ministry of Health's formal self-assessment (AMAQ in Portuguese) (RR = 1.04, 95% CI; 1.02-1.05); those who followed clinical guidelines (with confirmatory documentation) regarding the referral of patients from primary care to the DSC (RR = 1.02, 95% CI; 1.01-1.04). On the contrary, DSCs that did not use the results achieved in previous PMAQ cycles in the organization of the DSC's team work scheme proved to be less likely to perform MS (RR = 0.98, 95% CI; 0.96-0.99). CONCLUSIONS Matrix support is associated with human resources and management factors in secondary oral health care in Brazil. Continuing professional development and some management characteristics are important for secondary dental care quality and could be considered in health policy initiatives.

A queima de combustiveis fosseis e as atividades industriais sao os principais responsaveis pela emissao de poluentes atmosfericos. Esses poluentes estao cada vez mais associados a efeitos negativos a saude humana. Este trabalho teve como objetivo avaliar a qualidade do ar no municipio de Sao Goncalo do Amarante, Estado do Ceara, o qual possui 46,8% de seu territorio na area do Complexo Industrial do Pecem (CIP). Experimentalmente, foram realizadas coletas no periodo entre outubro e dezembro de 2015 para os parâmetros de: material particulado total em suspensao (PTS), NO 2 , SO 2 , O 3 e metais pesados (Fe, Ni, Cu e Pb) usando amostradores de grande volume (64 m 3 /h) para o PTS e de pequeno volume (0,20 L/min) para o SO 2 e NO 2 . O O 3 foi determinado por absorcao no ultravioleta (254 nm) e as concentracoes dos metais pesados associados ao PTS foram estimadas por espectroscopia de absorcao atomica. Os resultados mostraram niveis de PTS (24 h) entre 32,6 e 75,3 µg/m 3 e de ozonio (1 h) entre 63,8 e 165,6 µg/m 3 . As concentracoes de SO 2 e NO 2 , por sua vez, apresentaram-se muito abaixo dos valores estabelecidos pela resolucao CONAMA 491/2018. Entre os metais somente o ferro foi quantitativamente identificado, com niveis entre 3,6 e 19,9 µg/m 3 . Em geral, os valores obtidos mostraram que a qualidade do ar na area durante o periodo do estudo pode ser considerada boa para os poluentes ambientais analisados.