Conselho Nacional de Desenvolvimento Científico e Tecnológico / A partir da formalização do Programa de Agentes Comunitários de Saúde e do Programa Saúde da Família pelo Ministério da Saúde (anos 90), as discussões sobre a reorientação dos modelos assistenciais ganham destaque. O Programa Saúde da Família passa a ser visto por boa parte dos profissionais de saúde coletiva como um modelo capaz de imprimir mudanças não apenas na atenção em si como também na dinâmica dos processos. Ao propor a substituição das estratégias tradicionais, voltadas para a doença e centradas no hospital, a nova proposta voltase, entre outros aspectos, para a ação preventiva e para a promoção da saúde. Busca contemplar também a atenção às necessidades de saúde da população adscrita, a família e seu território, ações intersetoriais e tem na equipe multiprofissional pilar importante no cuidado. O Agente Comunitário de Saúde se apresenta como ator importante na possibilidade de mudança de modelo assistencial; atuando intensamente na produção do cuidado assim como na organização de tal assistência. Criam-se conflitos acerca da percepção de potencialidades e da possibilidade de interação entre os diversos aspectos envolvidos neste contexto. Este trabalho buscou investigar a percepção de Agentes Comunitários de Saúde do município de Petrópolis RJ acerca dos saberes envolvidos na sua prática. A estratégia metodológica utilizada para coleta de dados em campo foi a de entrevistas semi estruturadas. O corpo textual gerado pelas entrevistas foi analisado com base na teoria da Análise do Discurso. Este estudo concluiu que o saber do Agentes Comunitários de Saúde aponta para uma posição que vai além de ser ponte ou de fazer ponte. Argumenta que a potencialidade deste saber é a de ser como a linha de costura entre comunidade e as propostas de cuidado. Esta imagem indica que ao pertencer em algum momento a ambos tecidos, e ao fazer o movimento de pertencer ora ao tecido comunidade e hora ao tecido UBS, o ACS pode aproximar essas partes na busca da construção de algo mais unificado. Como em uma colcha de retalhos, onde cada tecido mantém suas características e padronagens iniciais, mas aos serem costurados, formam algo único, inteiro. / The debate about a new orientation of health assistance models is highlighted after Brazilian Health Ministry developed Community Health Agents Program and Family Health Program (late 90s). Family Health Program then begins to be seen by health workers as a model that is able to make changes not only in health care itself but also in processes dynamics. This new model aims preventive actions and health promotion. It substitutes traditional strategies, which are more related to disease and hospitals. This model also aims to address attention to the target population health necessities, families and their territory and intersectional actions. Health workers from different professions form the teams and this fact is one of the most important features regarding health care. The Community Health Agent plays a very important role helping the model change, working intensively to provide care and organization of such assistance. Some conflicts come up as one gets aware of potentials and interaction possibilities among the several aspects this agent can offer in the health care context. This research has aimed to investigate the perception from Community Health Agents of the city of Petropolis, RJ Brazil, about the knowledges involved in their practice. The methodology used for data collection was semistructured interview. The text generated by the interviews was analysed based on Discourse Analysis Theory. Through this study one can come to the conclusion that the Community Health Agents knowledge appears to be more than only being a link or to make links. The study discusses that the potential of that knowledge plays a sewing cord between the community and the health care proposals. This image indicates that, as sometimes the Community Health Agents belongs to both fabrics, and by switching the position, from the community fabric to Heath Unit fabric, the Agent can bring those parts together, looking for a sort of unification. As a patchwork sheet, where each part keeps its root design and patterns, but when they are sewed together, they form one whole thing.

Made available in DSpace on 2014-12-17T13:53:16Z (GMT). No. of bitstreams: 1 EvelinCAR.pdf: 567410 bytes, checksum: b7c0c3cd63ebc68e2668e5484e00e43d (MD5) Previous issue date: 2007-08-31 / The inclusion of the dentist in the Family Health Program (FHP) teams designates a reorganization of the mouth health care in your country and establishes a new scenario in Brazilian odontology, through of a new way to organize the basic health care, creating conditions to consolidate in mouth health practice actions, in the level of the basic attention, the validation of Unique Health System (UHS) constitutional principles. The purpose of this research is to verify if the actuation of mouth health teams (MHT) dentists, in Natal city north sanitary district, is tuned with FHP goals.The target research population was composed by all dentists working in Basic Health Units (BHU) of Natal north sanitary district. Fifth-eight questionnaires were applied and using open and closed questions we look for identify the functional characteristics of each BHU, the dentists professional attributions on each BHU, as well as the clinical procedures that they execute. This research also searched to identify the factors that facilitate and/or difficult the inclusion process and the dentists activities performance on these BHUs, as well as the necessary actions to north sanitary district MHTs to fulfill the objectives proposed by FHP. The results point that the inclusion of mouth health actions in north sanitary district FHPs brought the incorporation of new values to the used practices. Whoever, its necessary a more frequent evaluation of the carried actions, in a way they can be adapted to the real community necessities, and, is fundamental the data accompaniment, for that these serve of base for planning and redirecting activities, in a way that we do not have only a reproduction of traditional practices, fragmented and isolated, but a truly substitution of the traditional practices and a new way of promoting health / A inclus?o do dentista nas equipes do Programa de Sa?de da Fam?lia (PSF) assinala uma reorganiza??o da aten??o ? sa?de bucal em nosso pa?s e estabelece um novo cen?rio na odontologia brasileira, atrav?s de uma nova forma de organizar a aten??o b?sica ? sa?de, criando condi??es para consolidar nas a??es da pr?tica em sa?de bucal, no n?vel da aten??o b?sica, a valida??o dos princ?pios constitucionais do SUS. O objetivo deste estudo ? verificar se a atua??o dos dentistas nas Equipes de Sa?de Bucal (ESB) do Distrito Sanit?rio Norte do Munic?pio de Natal RN, est? em sintonia com as diretrizes do PSF. A popula??o integrante da pesquisa foi composta por todos os dentistas lotados nas Unidades B?sicas de Sa?de (UBS) do Distrito Sanit?rio Norte de Natal-RN. Foram aplicados 58 question?rios e atrav?s de perguntas fechadas e abertas procurou-se identificar as caracter?sticas operacionais de funcionamento de cada UBS, as atribui??es profissionais dos dentistas em cada UBS e os procedimentos cl?nicos executados pelos mesmos. Esse instrumento procurou tamb?m identificar os fatores que facilitam e/ou dificultam o processo de inclus?o e o desempenho das atividades dos dentistas nessas UBS, bem como a??es necess?rias para que as ESB do Distrito Sanit?rio Norte cumpram os objetivos previstos pelo PSF. Os resultados encontrados apontam que a inclus?o das a??es de sa?de bucal no PSF do Distrito Sanit?rio Norte trouxe a incorpora??o de novos valores ?s pr?ticas exercidas. No entanto, ? preciso que haja uma avalia??o mais freq?ente das a??es realizadas, de modo que essas sejam adaptadas ?s reais necessidades da comunidade, e ainda, ? fundamental o acompanhamento dos dados, para que esses sirvam de base para o planejamento e redirecionamento das atividades afim de que n?o se tenha apenas uma reprodu??o de pr?ticas tradicionais, fragmentadas e isoladas, mas uma verdadeira substitui??o das pr?ticas tradicionais exercidas e um novo jeito de se fazer sa?de

Made available in DSpace on 2014-12-17T15:30:58Z (GMT). No. of bitstreams: 1 YannePA.pdf: 518158 bytes, checksum: e731a2f4a19abe63deb617707d7ba8af (MD5) Previous issue date: 2005-12-10 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The purpose of this research was to analyze the working profile of dentists from the Family Health Program (PSF Programa de Sa?de da Fam?lia, Brasil) of some Municipal Districts of Rio Grande do Norte (Brazil) in order to understand the way they handle the experience acquired with the work developed in that Program. This discussion evolves a reflection about the perspectives of consolidation of the FHP as well as the possible advancements of the Brazilian Unified Health System (SUS - Sistema ?nico de Sa?de). The target population was composed of dentists from the FHP of Rio Grande do Norte. Thus we performed twenty-one interviews orientated by a semi-structured guidebook with open questions and identification data. We opted for recording the speech of all the professionals in order to ensure the accuracy of the information gathered. The main results found were: predominance in the female gender; the majority of dentists has no post graduation courses; in those few cases of dentists with some post-graduation a lack of correlation with Public or Collective Health was observed; the dentists interviewed present a profile directed to clinical activities; the dentists used to develop basic restorative and periodontic treatment, simple surgeries and educative and preventive activities, even though the last two ones are carried out in an extremely traditional way (lectures and topical application of fluoride). In addition, as biggest difficulties to manage the work dentists pointed out the lack of permanent and consumer material, inadequate infrastructure, no transport to take them to distant places, no integration with the Health Family Team, technical difficulty such to perform educative and preventive activities as to provide adequate service to a repressed lawsuit. The results indicate the existence of a necessity to lead them to reflect and redirect their practices. In order to reach this aim it must be considered as initial measure the investment and encouragement toward to permanent education as well as a close follow-up and evaluation of the actions developed by them / A presente investiga??o tem como objetivo analisar o perfil de atua??o de cirurgi?es-dentistas inseridos no Programa de Sa?de da Fam?lia (PSF) de munic?pios do Rio Grande do Norte, buscando conhecer e compreender a maneira como estes experienciam o trabalho que desenvolvem neste Programa. Esta discuss?o envolve uma reflex?o a respeito das perspectivas da consolida??o do PSF e dos avan?os poss?veis do Sistema ?nico de Sa?de no pa?s. A popula??o que fez parte da pesquisa foi composta de Cirurgi?es-Dentistas que estavam trabalhando no PSF no Estado do Rio Grande do Norte. Foram realizadas 21 entrevistas orientadas por um roteiro semi-estruturado com perguntas abertas e composta de dados de identifica??o. Optou-se por gravar a fala dos profissionais, tendo em vista uma melhor fidelidade da coleta de informa??es. Os principais resultados encontrados foram: predomin?ncia do sexo feminino; maioria dos entrevistados sem p?s-gradua??o, sendo que, aqueles que a possuem, n?o h? rela??o com a sa?de p?blica ou coletiva; os cirurgi?es-dentistas t?m perfil voltado para a atividade cl?nica; e os mesmos desenvolviam atividades b?sicas de dent?stica, periodontia b?sica, cirurgia simples e atividades preventivas e educativas, embora realizadas de maneira tradicional (palestras e aplica??o de fl?or). Apontaram como dificuldades a falta de materiais, estrutura f?sica inadequada, falta de transporte para localidades distantes, falta de integra??o com a Equipe de Sa?de da Fam?lia, dificuldade t?cnica para realiza??o de atividades educativas e preventivas e de atendimento ? demanda reprimida. Os resultados apontam que h? necessidade de motiv?-los a refletir e redirecionar as suas pr?ticas, tendo como medida inicial o investimento e est?mulo ? educa??o permanente e um monitoramento e avalia??o das a??es desenvolvidas pelos mesmos

The presented doctoral thesis is focused on assessment of human factor impact on safety of industrial furnaces. Industrial furnaces are classified as machinery and belong to a group of industrial thermal equipment. The operation of industrial furnaces is burdened with the risks which the manufacturers and the furnace operators realize. The first part of the thesis presents an analysis of the current situation of legislation and scientific knowledges in the field of assessment of human factor impact on safety of industrial furnaces. In this part of the thesis the issue of human factor in other industrial branches: chemical industry, aviation and nuclear industry is also described. On the basis of conducted research the main aim of the thesis was established: preparation of a methodology for assessment of human factor impact on safety of industrial furnaces. Secondary targets were also listed. The second part deals with the assessment of risks connected with the operation of industrial furnaces and the assessment of human factor impact on safety of industrial furnaces. The furnace safety requirements, the process of furnaces risk assessment, the methods used for risk assessment and problems connected with the risk assessment are described. This part of the thesis explains the concept of human factor, presents a classification and description of the methods used for human reliability assessment, as well as the factors influencing the reliability of the operator. The third part of the thesis contains a proposed methodology for assessment of human factor impact on safety of industrial furnaces. Within the methodology performance shaping factors are stated, qualitative and quantitative assessment of human factor impact on safety of industrial furnaces is made and the system integration of the knowledges into the developed methodology is proposed – qualitative model for improvement of system state. The methodology is further verified on a real equipment – a hardening furnace.

No description available.

La reconstruction 3D par coupes sériées en microscopie optique est un moyen efficace pour étudier des spécimens biologiques fluorescents. Dans un tel système, la formation d'une image peut être représentée comme une convolution linéaire d'un objet avec une réponse impulsionnelle optique de l'instrument (PSF). Pour une étude quantitative, une estimation de l'objet doit être calculée en utilisant la déconvolution qui est le phénomène inverse de la convolution. Plusieurs algorithmes de déconvolution ont été développés en se basant sur des modèles statistiques ou par inversion directe, mais ces algorithmes se basent sur la supposition de l'invariance spatiale de la PSF pour simplifier et accélérer le processus. Dans certaines configurations optiques la PSF 3D change significativement en profondeur et ignorer ces changements implique des erreurs quantitatives dans l'estimation. Nous proposons un algorithme (EMMA) qui se base sur une hypothèse où l'erreur minimale sur l'estimation par un algorithme ne tenant pas compte de la non-invariance, se situe aux alentours de la position (profondeur) de la PSF utilisée. EMMA utilise des PSF à différentes positions et fusionne les différentes estimations en utilisant des masques d'interpolation linéaires adaptatifs aux positions des PSF utilisées. Pour obtenir des PSF à différentes profondeurs, un algorithme d'interpolation de PSF a également été développé. La méthode consiste à décomposer les PSF mesurées en utilisant les moments de Zernike pseudo-3D, puis les variations de chaque moment sont approximés par une fonction polynomiale. Ces fonctions polynomiales sont utilisées pour interpoler des PSF aux profondeurs voulues. / The 3-D fluorescence microscope has become the method of choice in biological sciences for living cells study. However, the data acquired with conventional3-D fluorescence microscopy are not quantitatively significant because of distortions induced by the optical acquisition process. Reliable measurements need the correction of theses distortions. Knowing the instrument impulse response, also known as the PSF, one can consider the backward process of convolution induced by the microscope, known as "deconvolution". However, when the system response is not invariant in the observation field, the classical algorithms can introduce large errors in the results. In this thesis we propose a new approach, which can be easily adapted to any classical deconvolution algorithm, direct or iterative, for bypassing the non-invariance PSF problem, without any modification to the later. Based on the hypothesis that the minimal error in a restored image using non-invariance assumption is located near the used PSF position, the EMMA (Evolutive Merging Masks Algorithm) blends multiple deconvolutions in the invariance assumption using a specific merging mask set. In order to obtain sufficient number of measured PSF at various depths for a better restoration using EMMA (or any other depth-variant deconvolution algorithm) we propose a 3D PSF interpolation algorithm based on the image moments theory using Zernike polynomials as decomposition base. The known PSF are decomposed into Zernike moments set and each moment's variation is fitted into a polynomial function, the resulting functions are then used to interpolate the needed PSF's Zernike moments set to reconstruct the interpolated PSF.

Esta dissertação consiste num estudo em forma de narrativa que permite percorrer o cotidiano das práticas dos profissionais de saúde, tendo como pano de fundo o Programa de Saúde da Família, do Ministério da Saúde. A opção pelo PSF se fundamenta no fato de que, desde sua institucionalização, ele vem assumindo relevância no discurso político, institucional e social, no âmbito da política nacional de saúde, o SUS concebido como uma estratégia importante para reorganização do modelo assistencial em saúde. Todo modelo inovador requer descobertas inevitáveis, em que idas e vindas, sucessos e fracassos nos permitem traçar um cenário das situações vivenciadas. O campo de estudo foi o Programa de Saúde da Família em Jardim Cinco Marias, localizado no bairro de Guaratiba, Zona Oeste do município do Rio de Janeiro. O processo de implantação do PSF nessa comunidade trouxe algumas inquietações a respeito das questões de demanda, trabalho e organização da equipe de saúde da família e do relacionamento e das expectativas da população em relação ao PSF. A partir desse olhar, o presente trabalho pretende apontar problemas e discutir questões relacionadas a esses três maiores temas, à luz da bibliografia apresentada. / This dissertation is a narrative studies that let us go through the daily practices of health professionals based on the Health Ministrys Family Health Program (PSF). The option for PSF is due to the fact that, since its implementation, it has become relevant in the political, institutional and social discourses, through the National Health System (SUS), conceived as an important strategy to reorganize the health care model. All innovation processes require inevitable findings, where up and downs help us delineate the scenery of experienced situations. The study field was the Jardim Cinco Marias Family Health Program, in Guaratiba, in the West Zone of Rio de Janeiro. The PSF implementation process in this community brought some concerns on demand, work, PSF team organization, relationship and expectation about the community to PSF. Based on the subjects views, this work aims to show problems and to discuss issues concerning these three major topics based on specific bibliography.

Esta dissertação consiste num estudo em forma de narrativa que permite percorrer o cotidiano das práticas dos profissionais de saúde, tendo como pano de fundo o Programa de Saúde da Família, do Ministério da Saúde. A opção pelo PSF se fundamenta no fato de que, desde sua institucionalização, ele vem assumindo relevância no discurso político, institucional e social, no âmbito da política nacional de saúde, o SUS concebido como uma estratégia importante para reorganização do modelo assistencial em saúde. Todo modelo inovador requer descobertas inevitáveis, em que idas e vindas, sucessos e fracassos nos permitem traçar um cenário das situações vivenciadas. O campo de estudo foi o Programa de Saúde da Família em Jardim Cinco Marias, localizado no bairro de Guaratiba, Zona Oeste do município do Rio de Janeiro. O processo de implantação do PSF nessa comunidade trouxe algumas inquietações a respeito das questões de demanda, trabalho e organização da equipe de saúde da família e do relacionamento e das expectativas da população em relação ao PSF. A partir desse olhar, o presente trabalho pretende apontar problemas e discutir questões relacionadas a esses três maiores temas, à luz da bibliografia apresentada. / This dissertation is a narrative studies that let us go through the daily practices of health professionals based on the Health Ministrys Family Health Program (PSF). The option for PSF is due to the fact that, since its implementation, it has become relevant in the political, institutional and social discourses, through the National Health System (SUS), conceived as an important strategy to reorganize the health care model. All innovation processes require inevitable findings, where up and downs help us delineate the scenery of experienced situations. The study field was the Jardim Cinco Marias Family Health Program, in Guaratiba, in the West Zone of Rio de Janeiro. The PSF implementation process in this community brought some concerns on demand, work, PSF team organization, relationship and expectation about the community to PSF. Based on the subjects views, this work aims to show problems and to discuss issues concerning these three major topics based on specific bibliography.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2017-05-17T12:31:09Z No. of bitstreams: 2 Dissertação - David Antonio Costa Barros - 2017.pdf: 4071063 bytes, checksum: ddb294c71acfa6cbe5dc316e1b8f74ec (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-05-17T12:31:41Z (GMT) No. of bitstreams: 2 Dissertação - David Antonio Costa Barros - 2017.pdf: 4071063 bytes, checksum: ddb294c71acfa6cbe5dc316e1b8f74ec (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-05-17T12:31:42Z (GMT). No. of bitstreams: 2 Dissertação - David Antonio Costa Barros - 2017.pdf: 4071063 bytes, checksum: ddb294c71acfa6cbe5dc316e1b8f74ec (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-03-15 / This study aims at assessing the risk of Chagas disease transmission in two risk endemic Municipalities after the local implementation of Triatoma infestans Eradication Program (PETI). To that end, a epidemiological, entomological and serological assessment of PETI was carried out in loco in the Municipalities researched. In the epidemiological context of Chagas disease, according to serological investigation conducted in 1980, seroprevalence amongst the population researched was around 0,82% in São Luís dos Montes Belos (SLMB) and 2,35% in Novo Brasil (NB). At present, a serological survey is underway in the region. In the first stage of serological investigation, about to be concluded, samples from 103 children residing in Novo Brasil rural area and from 303 children residing in São Luís dos Montes Belos rural area were collected on filter paper, and the results were negative; later, 60 test-tube samples were collected in both Municipalities for performing more specific techniques. The domiciliary infestation index in SLMB (rural area) raised from 8,80% to 10,6% (2004-2005), and from 0,84% (2004) to 0,39% (January-July 2005) in NB (rural area). The population under contagion risk is around 4109 inhabitants in SLMB and 1153 inhabitants in NB, due to the presence of vectors. Endemic zones are concentrated in rural area, where potential vectors such as Triatoma sordida are found (around 90% of the species captured in SLMB and 50% in NB in 2005). Health education is jointly conducted in São Luís dos Montes Belos and Novo Brasil by the National Health Foundation (FUNASA), the Family Health Program (PSF) and both Municipal Secretariats of Education, by means of expositions, consultations and the Minimum Surveillance Unit (UMV), which is also applied in the indoor detection of traces of Triatominae. In conclusion, the control of Chagas disease transmission lies on the joint effects of seroepidemiological surveillance, continuous sprinkling of residual insecticides and the implementation of housing improvement program in endemic areas, as well as the continuance and strengthening of Health Education efforts through Family Health Program (PSF). / A doença de Chagas transmitida pelo Trypanosoma cruzi (Chagas, 1909) era uma enzootia restrita ao ambiente silvestre (mamíferos e triatomíneos em perfeito equilíbrio). No Brasil, há evidências de que a doença humana surgiu após seu descobrimento, embora tenha sido encontrada uma múmia datada de ± 1200 anos. O relato mais antigo de triatomíneos (também chamados de “vinchuca”) no Brasil foi feito pelos jesuítas (1590). Sua introdução ocorreu possivelmente através da Argentina ou Uruguai. O “engasgo” (megaesôfago) e a “hidropsia” (constipação) (Saint-Hilaire, 1819; Longgaard, 1865) já existiam endemicamente no interior de Goiás e Minas Gerais. Embora a doença de Chagas tenha sido descoberta em 1909, somente a partir de 1960 seu controle foi pensado de forma profissional. Entretanto, efetivamente, apenas a partir de 1970 foram dados os primeiros passos com essa finalidade. Portanto, as medidas de controle devem dirigir-se à eliminação desses insetos do ambiente humano. Das mais de 120 espécies conhecidas, 48 foram identificadas no Brasil, das quais 30 já foram capturadas no ambiente domiciliar. Em Goiás, com a finalidade de realizar um estudo clínico-epidemiológico da doença de Chagas, em áreas onde a espécie vetora era o Triatoma infestans, foi montado o Projeto Mambaí. Iniciado em 1974, com o estudo eco-epidemiológico da região. Posteriormente, em 1979, após o levantamento triatomínico e devido ao requerimento do Projeto, foi solicitada a colaboração da SUCAM/ Ministério da Saúde, que forneceu apoio e infra-estrutura para a implementação de um sistema de controle e vigilância da doença de Chagas (ZAPATA, 1990). Hoje, com a estratégia de monitoramento entomológico, ações de combate utilizando inseticidas específicos, assim como as melhorias habitacionais realizadas nas áreas endêmicas, a doença encontra-se sob controle de acordo com o certificado da OMS, mas o risco de transmissão continua. No contexto epidemiológico da doença, Goiás ocupava a terceira colocação pelo inquérito nacional realizado em 1980. Com a implantação do Programa de Eliminação do Triatoma infestans em 1992, que é um projeto que faz parte do Programa de Controle da Doença de Chagas no Estado de Goiás, o índice de 7,4% de prevalência da doença, caiu consideravelmente e hoje o principal vetor não é detectado ou é encontrado em índices muito baixos em alguns municípios do Estado. No contexto epidemiológico da doença de Chagas, conforme o inquérito sorológico realizado em 1980, em São Luís dos Montes Belos (SLMB) a soroprevalência estava em torno de 0,82% e em Novo Brasil (NB) em torno de 2,35% dos pesquisados. O levantamento sorológico em escolares nascidos após a fase de controle nas regiões mostrou nenhuma delas estava com sorologia positiva para a moléstia. Nas 236 Unidades Domiciliares pesquisadas (150 em São Luís dos Montes Belos e 86 em Novo Brasil), todas infestadas por triatomíneos e nenhum triatomíneo capturado positivo para Trypanosoma cruzi. O objetivo deste estudo foi avaliar o risco de transmissão da doença de Chagas em dois municípios endêmicos de risco após a implantação do Sistema Único de Saúde (SUS). Para tal, foi realizado in locus uma avaliação sorológica, entomológica e epidemiológica do Programa de Erradicação do Triatoma infestans (PETI) nos municípios pesquisados. Os objetivos deste trabalho foram determinar o nível de conhecimentos, atitudes, práticas da população sobre o controle da doença de Chagas e seus vetores em uma população de crianças em fase escolar de uma zona endêmica dos municípios de risco em Goiás, Brasil. Através deste pretende-se implantar medidas alternativas de controle e vigilância e justificar a implantação das Unidades de Vigilância Longitudinal, para um combate mais abrangente da doença de Chagas no Estado. Apesar do controle do Triatoma infestans existe o considerável aumento dos vetores secundários como o Triatoma sordida, merecendo constante estado de Vigilância epidemiológica dentro do contexto do atual Sistema Único de Saúde (SUS) e da sua potencial inserção na rotina do Programa de Saúde da Família.

Light allows to non-invasively study the complex and dynamic biological phenomenon undergoing within cells and tissues in their native state. The development of super-resolution microscopes in recent years has helped to overcome the fundamental limitation imposed by Abbe’s diffraction limit, thereby revolutionizing the field of molecular and cellular biology. With the advancement of various super-resolution techniques (like STED, PALM, and 4Pi) it is now possible to visualize the nanometeric cellular structures and their dynamics in real time. The limitations of existing fluorescence microscopy techniques are: poor axial resolution when compared to their lateral counterpart, and their inability to produce high resolution images of dynamic samples. This thesis covers two broadly connected areas of fluorescence imaging techniques while addressing these limitations. First, the PSF engineering and spatial filtering technique for axial super-resolution microscopy and second, the integration of light sheet illumination PSF with microfluidic cytometry for imaging cells on-the-go. The first chapter gives an explicit description on the fundamentals of fluorescence imaging. This introductory chapter includes a variety of optical microscopes, PSF engineering, the resolution limit imposed by the wave nature of light, the photochemistry of the fluorescent dyes, and their proper selection for fluorescence experiments. In addition to the state-of-art imaging techniques, namely Laser Scanning Confocal Microscopy and Light Sheet Microscopy, this chapter also gives a brief explanation on the evolution of imaging cytometry techniques. Their high speed analytic capability (i.e sorting and counting) makes this technique an important tool in health care diagnosis and other various biomedical applications. The chapter ends with a discussion on the operating principle of the flow cytometers and their limitations. The second chapter in this thesis describes the spatial filtering technique for engineering the PSF to eliminate the side-lobes in the system PSF of the 4Pi Confocal Microscopes. Employing an amplitude mask with binary light transmission windows (also called binary filters), the incident light is structured to minimize the secondary lobes. These lobes are responsible for exciting the off-focal planes in the specimen, hence provide incorrect map of the fluorophore distribution in the object. The elimination of the side-lobes is essential for the artifact-free axial super-resolution microscopy. This second chapter describes the spatial filtering technique in details (its mathematical formulation, application in fluorescence microscopy for generation of desired PSF including Bessellike beam). Specifically, spatial filtering technique is employed in 4Pi type-C Confocal Microscope. The spatial mask used results in the reduction of the side-lobes in 1PE case while they are nearly eliminated in 2PE variant of the proposed technique. The side-lobes are reduced by 46% and 76% for 1PE and 2PE when compared to the existing 4Pi type-C Confocal Microscope system. Moreover, OTF of the proposed system confirms the presence of higher frequencies in the Fourier domain indicating high resolution imaging capability. Apart from the resolution in lateral and axial dimension, achieving high resolution while imaging dynamic samples is another challenge that is limiting the field of fluorescence microscopy to flourish. The third and fourth chapters are entirely dedicated towards the work that was carried out to develop imaging techniques on a microfluidic platform for imaging dynamic samples. The fusion of microscopy and flow cytometry has given rise to the celebrated field of imaging flow cytometry. In recent years, the focus has shifted towards miniaturized cytometry devices. Apart from the reduced cost of the sample reagents and the assays, portability and easy handling make the microfluidic devices more relevant to developing countries. The commercially available cytometers are bulky and quite costly. In addition to these practical concerns, they are complex in operation and limited in performance. Most of the existing cytometers use different inlets for sheath and sample flow to achieve the hydrodynamic focusing of the sample assays in a narrow and confined region. The laser beam in the illumination arm interrogates with the flowing samples at this region and the response is captured by the detection optics. The same principle is extensively used in most of the microfluidic based flow cytometers reported till date. Apart from the hydrodynamic force other effects like electro-osmotic, acoustic, and dielectrophoresis have also been exploited to achieve flow focusing in the microfluidic channel. Despite omitting the necessity of external syringe pump as required in pressure driven based cytometers, they all rely upon point-source based excitation scheme and thereby can not interrogate the cells flowing through the entire microfluidic channel. The third chapter describes the integration of light sheet illumination PSF with microfluidic flow cytometry for simultaneous counting and imaging cells on-the-go. The chapter starts with the description on photolithography procedure for preparing SU8 master and PDMS casting procedure adopted to prepare dedicated microfluidic chips for the developed imaging system. The research work reported here demonstrates the proof-ofprinciple of light sheet based imaging flow cytometer. A light sheet fills the entire microfluidic channel and thus omits the necessity of flow focusing and point-scanning based technology. Another advantage lies in the orthogonal detection geometry that totally cuts-off the incident light, thereby substantially reducing the background in the acquired images. Compared to the existing state-of-the-art techniques, the proposed technique shows marked improvement. Using fluorescently coated Saccharomyces cerevisiae cells, cell counting with throughput as high as 2090 cells/min was recorded. Overall the proposed system is cost-effective and simple in channel geometry. Apart from achieving efficient counting in operational regime of low flow rate, high contrast images of the dynamic samples are also acquired using the proposed cytometry technique. Further, visualization of intra-cellular organelles is achieved during flow in light sheet based high-throughput cytometry system. The fourth chapter demonstrates the proof of concept of light-sheet-based microfluidic cytometer in conjugation with 2π/3 detection system for high-throughput interrogation and high resolution imaging. This system interrogates the flow channel using a sheet of light rather than the existing point-scanning based techniques. This ensures single-shot scanning of specimens flowing through the microfluidic flow channel at variable flow rates. In addition to high throughput counting at low flow rate, visualization of the intra-cellular organelle (mitochondrial network in human cancerous cells) during flow is achieved with sub-cellular resolution. Using mitochondrial network tagged HeLa cells, a maximum count of 2400 cells/min at the optimized flow rate of 700 nl/min was recorded. The 2π/3 detection system ensures efficient photon collection and minimal background caused by scattered illumination light. The other advantage of this kind of detection system which includes 8f detection optics, is the capability to produce variable magnification using the same high NA objective. This thesis opens up in vivo imaging of sub-cellular structures and simultaneous cell counting in a miniaturized flow cytometry system. The developed imaging cytometry technique may find immediate applications in the diverse field of healthcare diagnostics, lab-on-chip technology, and fluorescence microscopy. The concluding chapter summarizes the results with a brief discussion on the future aspects of this field (e.g., live-cell imaging of infectious RBC in microfluidic device and 3D optical sectioning of flowing cells). The field of imaging flow cytometry has immense applications in the overlapping areas of physics and biology. The hydrodynamic forces which are used to achieve flow focusing of the sample assays can have an adverse effect in the cell morphology, thereby altering the cellular functions. Light sheet based cytometry system lifts off the requirement of flow focusing and ensures a single shot scanning of entire samples flowing through the microfluidic channel. The similar concept can be used to study the developmental biology of an entire organism, such as C. elegans. This enables the direct observation of developmental and physiological changes in the entire body. Such an organism can be kept alive for a longer duration in microfluidic chambers, and the neural development and mating behaviors can be extensively studied.