RESUMO
Disturbances in tropical forests can have long-lasting ecological impacts, but their manifestations (ecological legacies) in modern forests are uncertain. Many Amazonian forests bear the mark of past soil modifications, species enrichments, and fire events, but the trajectories of ecological legacies from the pre-contact or post-colonial period remain relatively unexplored. We assessed the fire and vegetation history from 15 soil cores ranging from 0 to 10 km from a post-colonial Surinamese archaeological site. We show that (1) fires occurred from 96 bc to recent times and induced significant vegetation change, (2) persistent ecological legacies from pre-contact and post-colonial fire and deforestation practices were mainly within 1 km of the archaeological site, and (3) palm enrichment of Attalea, Oenocarpus and Astrocaryum occurred within 0, 1, and 8 km of the archaeological site, respectively. Our results challenge the notion of spatially extensive and persistent ecological legacies. Instead, our data indicate that the persistence and extent of ecological legacies are dependent on their timing, frequency, type, and intensity. Examining the mechanisms and manifestations of ecological legacies is crucial in assessing forest resilience and Indigenous and local land rights in the highly threatened Amazonian forests.
Assuntos
Floresta Úmida , Suriname , Incêndios , Arqueologia , Conservação dos Recursos Naturais , Fatores de TempoRESUMO
O presente artigo discute a atenção à saúde na comunidade quilombola de Jurussaca, no Pará, bem como analisa as repercussões da implantação do Programa Mais Médicos nesta comunidade. Realizou-se estudo de caso qualitativo, constituído por duas etapas exploratória e de coleta de dados na comunidade por meio de entrevistas semiestruturadas e grupo focal. Os atores-chaves da pesquisa foram usuários quilombolas, profissionais de saúde, gestores da Secretaria Municipal de Saúde e representante do Conselho Municipal de Saúde. Foram realizadas 30 entrevistas semiestruturadas, sendo 24 com usuários quilombolas adultos, e 1 grupo focal. Adotou-se a técnica de análise de conteúdo, com foco nas etapas empregadas por Bardin: pré-análise, exploração do material, tratamento e interpretação dos resultados. Os resultados apontaram que tanto a comunidade quilombola quanto os gestores apoiam e avaliam positivamente a implantação do Programa Mais Médicos. Os entrevistados ressaltaram que, após o Programa, houve aumento na qualidade do atendimento e ampliação de visitas domiciliares. Em relação à atenção à saúde, foi constatada a insuficiência dos serviços de saúde para garantir um atendimento equitativo e integral à saúde dos usuários quilombolas. Verificou-se uma fragilidade dos vínculos entre a equipe da Estratégia de Saúde na Família e a comunidade e uma inversão da lógica assistencial com maior procura pela atenção hospitalar. Os quilombolas afirmaram a existência de racismo e discriminação no atendimento. Assim, percebeu-se a necessidade de os serviços de saúde compreenderem as especificidades das demandas das comunidades quilombolas e suas características socioculturais e fomentarem ações de combate ao racismo institucional.
This article discusses health care in the Maroon (quilombola) community of Jurussaca, in Pará state, and analyses the repercussions of the More Doctors Programme in this community. A two-stage qualitative case study was carried out in the community, exploratory and data collection, by means of semi-structured interviews and focal group. The key actors of the research were Maroon health clientele, health professionals, municipal health department managers and representatives of the municipal health council. Thirty semistructured interviews were carried out, 24 with Maroon adults, and one focal group. The technique of content analysis was adopted, focusing on the steps employed by Bardin: pre-analysis, text exploration, treatment and interpretation of the results. The results showed that both the Maroon community and the managers evaluated the program positively and supported its implementation. The interviewees pointed out that after the programme there was an increase in the quality of care and in home-visits. Regarding health care, the results showed the inadequacy of healthcare services in guaranteeing an equitable and integrated service to the health of the Maroon clientele. Weaknesses were identified in the links between the Family Health Strat egy team and the community and a reversal of the care logic, with greater demand for hospital care. The Maroons confirmed the existence of racism and discrimination in the healthcare services. Thus, healthcare services need to understand the specificities of the demands of the Maroon communities and their sociocultural characteristics and to encourage actions to counter institutional racism.
Assuntos
Atenção à Saúde , Programas Nacionais de Saúde , Populações Vulneráveis , BrasilRESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: French Guiana is a French overseas territory with a rich history of migration that has led to a highly intercultural society. Today, its population is one of the youngest in the French territory and is rapidly increasing. Despite a context of cultural revival seeking "tradition", a distanced baseline of local practices is still lacking. This work addresses some aspects of the cultural hybridizations in progress in urban areas. METHODS: Semi directed interviews were conducted with willing participants aged between 18 and 40. Interviews took place in French Guiana's two main urban centres: Cayenne and Saint Laurent du Maroni. People were interviewed about the last medicinal plant they used in the preceding year. Due to the high use of plant baths in French Guiana, a focus was made on baths. RESULTS AND DISCUSSION: Eighty-three people answered: 43 women and 40 men (mean age of 28.7 years old). In total, 226 remedies were counted in our study, 155 single plant remedies and 71 compound remedies leading to 316 use reports of plants from 16 cultural groups. A surprising number of 108 botanical species were recorded. Eighty-one recipes for baths were also collected. Despite this high citation rate, a rather low proportion of people declare a systematic and regular recourse upon local pharmacopoeia (46%; 38/83). Although many interviewees used plants, far from the majority used them on a regular basis. In practice, 50% of the species (54/108 spp.; 99/316 URs) are non-native but domesticated exotic species, imported from Asia, Europe, Africa or remote parts of America, either during colonization, the slave trade era, or more recently with the latest migrations. CONCLUSION: Although phytotherapy use is often thought to be related to countryside dwellers and older people, medicinal plants seem to play an important role in the lives of urban French Guianese youth. Research shows a large diversity of medicinal species used linked with the great cultural diversity of the Guianese cities. One characteristic of this population is the hybridization process leading to a perpetual renewal of practices, both in terms of species and practice.
Assuntos
Cosméticos/química , Medicina Tradicional/métodos , Preparações de Plantas/uso terapêutico , Plantas Medicinais/química , Adolescente , Adulto , Banhos/métodos , Etnobotânica , Feminino , Guiana Francesa , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , Masculino , Farmacopeias como Assunto , Fitoterapia/métodos , População Urbana , Adulto JovemRESUMO
This study was designed to detect L. infantum infection in dogs and to evaluate the factors associated with canine visceral leishmaniasis in the maroon communities of Menino Jesus de Petimandeua and Itaboca in the municipality of Inhangapi, Pará, Brazil. Whole blood and intact skin samples were collected from 143 dogs, and a questionnaire was applied. L. infantum DNA was detected by polymerase chain reaction (PCR) using primers RV1 and RV2. Collection sites were georeferenced to obtain a spatial distribution of the residences visited and infected dogs. L. infantum DNA was detected in 8.4% (12/143) of the skin samples and in 1.4% (2/143) of the blood samples. On the risk map, three clusters were observed in Itaboca and one was observed in Menino Jesus de Petimandeua. We observed that most of the inhabitants in these maroon communities live close to forested areas and do not use protection against insect vectors. The presence of canine reservoirs of L. infantum associated to environment characteristics (preserved forests and deforested areas) and habits of dog owners (living near forested areas and not using any protection against insects) may favor the transmission of L. infantum in the studied areas.(AU)
O presente estudo objetivou detectar a infecção por Leishmania infantum em cães e avaliar os fatores associados com a leishmaniose visceral canina nas comunidades quilombolas Menino Jesus de Petimandeua e Itaboca, município de Inhangapi, Pará, Brasil. Foram coletadas amostras de sangue e de pele íntegra de 143 cães, sendo aplicado um questionário. A detecção do DNA de L. infantum foi realizada através da PCR com os iniciadores RV1 e RV2. Os locais de coleta foram georreferenciados para realizar a distribuição e análise espacial das residências visitadas e dos cães infectados. DNA de L. infantum foi detectado em 8,4% (12/143) das amostras de pele dos cães e em 1,4% (2/143) das amostras de sangue. No mapa de risco, foram observados três aglomerados em Itaboca e um em Menino Jesus de Petimandeua. Pôde-se constatar que a maioria dos moradores das comunidades quilombolas reside em áreas próximas de mata e não utilizam proteção contra insetos vetores. A presença de reservatórios caninos de L. infantum associada com características ambientais (floresta preservada e áreas de desmatamento) e os hábitos dos proprietários dos cães (que vivem perto de áreas de floresta e não usam qualquer tipo de proteção contra insetos) podem favorecer a transmissão de L. infantum nas áreas estudadas.(AU)
Assuntos
Animais , Cães , Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/veterinária , Reação em Cadeia da Polimerase/veterinária , População RuralRESUMO
This study was designed to detect L. infantum infection in dogs and to evaluate the factors associated with canine visceral leishmaniasis in the maroon communities of Menino Jesus de Petimandeua and Itaboca in the municipality of Inhangapi, Pará, Brazil. Whole blood and intact skin samples were collected from 143 dogs, and a questionnaire was applied. L. infantum DNA was detected by polymerase chain reaction (PCR) using primers RV1 and RV2. Collection sites were georeferenced to obtain a spatial distribution of the residences visited and infected dogs. L. infantum DNA was detected in 8.4% (12/143) of the skin samples and in 1.4% (2/143) of the blood samples. On the risk map, three clusters were observed in Itaboca and one was observed in Menino Jesus de Petimandeua. We observed that most of the inhabitants in these maroon communities live close to forested areas and do not use protection against insect vectors. The presence of canine reservoirs of L. infantum associated to environment characteristics (preserved forests and deforested areas) and habits of dog owners (living near forested areas and not using any protection against insects) may favor the transmission of L. infantum in the studied areas.
O presente estudo objetivou detectar a infecção por Leishmania infantum em cães e avaliar os fatores associados com a leishmaniose visceral canina nas comunidades quilombolas Menino Jesus de Petimandeua e Itaboca, município de Inhangapi, Pará, Brasil. Foram coletadas amostras de sangue e de pele íntegra de 143 cães, sendo aplicado um questionário. A detecção do DNA de L. infantum foi realizada através da PCR com os iniciadores RV1 e RV2. Os locais de coleta foram georreferenciados para realizar a distribuição e análise espacial das residências visitadas e dos cães infectados. DNA de L. infantum foi detectado em 8,4% (12/143) das amostras de pele dos cães e em 1,4% (2/143) das amostras de sangue. No mapa de risco, foram observados três aglomerados em Itaboca e um em Menino Jesus de Petimandeua. Pôde-se constatar que a maioria dos moradores das comunidades quilombolas reside em áreas próximas de mata e não utilizam proteção contra insetos vetores. A presença de reservatórios caninos de L. infantum associada com características ambientais (floresta preservada e áreas de desmatamento) e os hábitos dos proprietários dos cães (que vivem perto de áreas de floresta e não usam qualquer tipo de proteção contra insetos) podem favorecer a transmissão de L. infantum nas áreas estudadas.
Assuntos
Animais , Cães , Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/veterinária , População Rural , Reação em Cadeia da Polimerase/veterináriaRESUMO
PURPOSE: This study investigates the prevalence of anemia in young children living in the interior of Suriname and the influence of the associated factors age, nutritional status and ethnicity. RESULTS: In this cross-sectional observational study, 606 children aged 1-5 years from three different regions of Suriname's interior were included, and hemoglobin levels and anthropometric measurements were collected. Logistic regression models were computed to examine independent associations between anemic and nonanemic groups and to measure the influence of age, nutritional status and ethnicity. RESULTS: A total of 606 children were included, of whom 330 (55%) were aged 1-3 years and 276 were aged 4-5 years. The overall prevalence of anemia was 63%. Younger age was associated with anemia (odds ratio [OR]=1.78; 95% confidence interval [CI]: 1.27-2.51). Anemia was less prevalent in Amerindian than in Maroon children (OR=0.51; 95% CI: 0.34-0.76). Hemoglobin level was not influenced by nutritional status nor by sex. CONCLUSION: The prevalence of anemia in children aged 1-5 years living in Suriname's interior is high (63%) compared to that in similar aged children in Latin America and the Caribbean (4-45%). Children aged 1-3 years were more affected than those aged 4-5 years as were Maroon children compared to Amerindian children. Nutritional status and sex were not of influence.
RESUMO
ABSTRACT: This study was designed to detect L. infantum infection in dogs and to evaluate the factors associated with canine visceral leishmaniasis in the maroon communities of Menino Jesus de Petimandeua and Itaboca in the municipality of Inhangapi, Pará, Brazil. Whole blood and intact skin samples were collected from 143 dogs, and a questionnaire was applied. L. infantum DNA was detected by polymerase chain reaction (PCR) using primers RV1 and RV2. Collection sites were georeferenced to obtain a spatial distribution of the residences visited and infected dogs. L. infantum DNA was detected in 8.4% (12/143) of the skin samples and in 1.4% (2/143) of the blood samples. On the risk map, three clusters were observed in Itaboca and one was observed in Menino Jesus de Petimandeua. We observed that most of the inhabitants in these maroon communities live close to forested areas and do not use protection against insect vectors. The presence of canine reservoirs of L. infantum associated to environment characteristics (preserved forests and deforested areas) and habits of dog owners (living near forested areas and not using any protection against insects) may favor the transmission of L. infantum in the studied areas.
RESUMO: O presente estudo objetivou detectar a infecção por Leishmania infantum em cães e avaliar os fatores associados com a leishmaniose visceral canina nas comunidades quilombolas Menino Jesus de Petimandeua e Itaboca, município de Inhangapi, Pará, Brasil. Foram coletadas amostras de sangue e de pele íntegra de 143 cães, sendo aplicado um questionário. A detecção do DNA de L. infantum foi realizada através da PCR com os iniciadores RV1 e RV2. Os locais de coleta foram georreferenciados para realizar a distribuição e análise espacial das residências visitadas e dos cães infectados. DNA de L. infantum foi detectado em 8,4% (12/143) das amostras de pele dos cães e em 1,4% (2/143) das amostras de sangue. No mapa de risco, foram observados três aglomerados em Itaboca e um em Menino Jesus de Petimandeua. Pôde-se constatar que a maioria dos moradores das comunidades quilombolas reside em áreas próximas de mata e não utilizam proteção contra insetos vetores. A presença de reservatórios caninos de L. infantum associada com características ambientais (floresta preservada e áreas de desmatamento) e os hábitos dos proprietários dos cães (que vivem perto de áreas de floresta e não usam qualquer tipo de proteção contra insetos) podem favorecer a transmissão de L. infantum nas áreas estudadas.
RESUMO
Introduction: The Mais Médicos program was introduced in 2013 with the aim of reducing the shortage of doctors in priorityregions and diminishing regional inequalities in health. One of the strategies has been to offer 3-year contracts for doctors to work inprimary healthcare services in small towns, inland, rural, remote, and socially vulnerable areas. This report describes the programsimplementation and the allocation of doctors to these target areas in 2014.Methods: To describe the provision of doctors in the first year of implementation, we compared the doctor-to-population ratio inthe 5570 municipalities of Brazil before and after the program, based on the Federal Board of Medicine database (2013), and theofficial dataset provided by the Ministry of Health (2014).Results: In its first public call (July 2013) 3511 municipalities joined the Mais Médicos program, requesting a total of15 460 doctors; although the program prioritizes the recruitment of Brazilians, only 1096 nationals enrolled and were hired,together with 522 foreign doctors. As a consequence, an international cooperation agreement was set in place to recruit Cubandoctors. In 12 months the program recruited 14 462 doctors: 79.0% Cubans, 15.9% Brazilians and 5.1% of other nationalities,covering 93.5% of the doctors demanded; they were assigned to all the 3785 municipalities enrolled...
Assuntos
Humanos , Planos e Programas de Saúde , Povos Indígenas , Atenção Primária à Saúde , BrasilRESUMO
A presente tese é resultado de investigação que teve como objetivo realizar pesquisa avaliativa sobre o processo de implantação do ProgramaMais Médicos (PMM) em comunidades rurais e quilombolas e suas repercussões. Na realização da investigação, empregou-se as abordagens quantitativa e qualitativa a partir de duas fases: uma exploratória e outra de campo que foram realizadas em duas comunidades quilombolas do Rio Grande do Norte e uma comunidade quilombola do Pará, além de quatro áreas rurais também do Pará. Foram realizadas um total de 82 entrevistas semiestruturadas com os seguintes atores chaves: usuários e lideranças das áreas rurais e comunidades quilombolas, gestores, médicos do PMM, profissionais de saúde, que compõem as equipes da Estratégia Saúde da Família (ESF) e representantes do Conselho Municipal da Saúde. Além disso, foram realizados 3 grupos focais e anotações no diário de campo, a partir de observação. Destaca-se como principais alterações após a implantação do PMM nas áreas rurais e quilombolas: presença mais constante do profissional médico na UBS permitindo um melhor acompanhamento das doenças crônicas e maior continuidade da atenção, melhorias no acolhimento aos usuários e criação de vínculo, atuação mais resolutiva buscando resolver os problemas de saúde apresentados, aumento de atividades de educação em saúde e de realização de visitas domiciliares. Além disso, as narrativas apontam uma escuta mais atenta às queixas dos usuários, uma maior participação dos usuários nas atividades da Estratégia Saúde da Família, um melhor planejamento das atividades e uma maior organização do fluxo de demanda...
This doctoral dissertation is the result of an investigation that aimed to carry out an evaluation research on the implementation process of the Mais Médicos program (PMM) in rural and maroon communities in Brazil and its repercussions. In carrying out the study, the quantitative and qualitative methods were used, based on two steps: an exploratory and a field. The field research was conducted in two maroon communities from Rio Grande do Norte (Northeast Region from Brazil) and one from Pará (North Region from Brazil), and more four rural areas from Pará. We performed a total of 82 semi-structured interviews with users from the national health system (Sistema Único de Saúde - SUS), leaders from the rural and maroon communities, local SUS managers, PMM doctors, other health professionals from the teams of the Family Health Strategy (ESF) and representatives from the Municipal Health Council. In addition, we conducted three focus groups and notes in field diary, from the researcher observation. The main change after the implementation of PMM in rural and maroon areas was the continuous doctor presence in the primary health establishment. This improvement allowed better monitoring of chronic diseases and continuity of care, enhancements in SUS users admission and creating bonding with them. Furthermore, there were additional resolute action, more demand to solve the health problems from the people and increase in health educational activities and home care visits. The interviewee speeches show more attentive listening to the complaints from SUS users, greater social participation in the activities of the ESF, better planning of the activities and greatest organization in the demand flow...
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Humanos , Assistência Integral à Saúde , Estratégias de Saúde Nacionais , Programas Nacionais de Saúde , Médicos de Atenção Primária/provisão & distribuiçãoRESUMO
Current analysis investigates the sickle-cell syndrome among members of a maroon community (comunidade quilombola) in the state of Sergipe, Brazil. The entire population, comprising five hundred and ninety-three people, was screened. Blood samples were collected from 318 people, aged between six months and fifty years, who underwent a solubility test to assess the presence of HbS, followed by Sickle-Cell Test to confirm its presence. Results revealed that 2.2% of the three hundred and eighteen people tested have hemoglobin HbS in their blood; 57% have type HbAS and 43% have a combination between thalassemia and heterozygous with a variable percentage of HbS ranging between 24.9 and 37.9%. Blood sampling revealed that only five out of the 318 people belonged to different families. Results are highly relevant for public health policies on the sickle-cell syndrome and its management.
Este trabalho investiga a síndrome da anemia falciforme entre os membros de uma comunidade quilombola no Estado de Sergipe, Brasil. Foi rastreada toda a população, que compreende 593 pessoas. Amostras de sangue foram coletadas de 318 pessoas, com idades entre seis meses e 50 anos, que foram submetidas a um teste de solubilidade para avaliar a presença de HbS, seguido pelo teste de falcização para confirmar a sua presença. Os resultados revelaram que 2,2% das 318 pessoas testadas apresentaram hemoglobina variante HbS em seu sangue; 57% possuíam a variante HbAS e 43% apresentaram uma combinação entre talassemia e heterozigotos com percentagens variáveis de HbS entre 24,9 e 37,9%. A coleta de sangue revelou que apenas cinco das 318 pessoas pertenciam a famílias distintas. Os resultados são altamente relevantes para o planejamento e gestão de políticas públicas de saúde sobre a síndrome falciforme