Resumo O objetivo deste artigo é refletir sobre as transformações do trabalho, as demandas de qualificação e de novas competências no âmbito da política de saúde primária, atribuindo especial destaque aos impactos no trabalho dos médicos nas unidades de saúde familiar em Portugal. A investigação de caráter qualitativo realizou-se por meio da consulta a fontes documentais: decretos, leis, planos de ação e relatórios referentes às políticas e à estrutura organizacional nas unidades de saúde, adotando-se a análise de conteúdo para o tratamento dos dados. Preconiza-se que o comprometimento com os processos de requalificação enseja novos movimentos instituintes, fortalecedores da (re)construção da identidade médica, não apenas compreendida como individuação/identificação, mas constituída como um processo contínuo vinculado à identidade pessoal, possibilitando a construção, desconstrução e a reconstrução de algo que permite dar sentido ao trabalho realizado. Para o trabalho em saúde, valoriza-se um novo perfil profissional dotado de elevada qualificação, integrando, de forma inseparável, teoria, saberes técnicos, práticos e sociais. A ‘prestação do serviço’ e a ‘assistência em saúde’ têm uma dimensão subjetiva e individual, mas, ao mesmo tempo, têm expressão em grupos e em populações, assim como são orientadas por valores culturais e pelos padrões clínicos reconhecidos pela ciência.

Abstract The aim of this paper is to discuss the transformations that have taken place in work, the demands of training, and new skills in the primary health policy, with particular emphasis on the impacts on the work of physicians in the family health units in Portugal. The qualitative survey was carried out by querying documentary sources: Decrees, laws, action plans, and reports on the policies and organizational structure in health facilities, adopting content analysis to process data. It recommends that the commitment to the renewal process entails new instituting movements, which empower the (re)construction of the medical identity, understood not only as individuation/identification, rather constituted as an ongoing process linked to personal identity, enabling the construction, deconstruction, and reconstruction of something that gives meaning to the work done. For work in health, we value a new professional profile provided with highly qualified, integrating, inseparably, theory, technical, practical, and social knowledge. ‘Service provision’ and ‘health care’ have a subjective and individual dimension; however, at the same time they are expressed in groups and populations, and are guided by cultural values and clinical standards recognized by science.

Resumen El objetivo de este artículo es reflexionar sobre las transformaciones del trabajo, las demandas de calificación y de nuevas competencias en el ámbito de la política de salud primaria, atribuyendo especial destaque a los impactos en el trabajo de los médicos en las unidades de salud familiar en Portugal. La investigación de carácter cualitativo se realizó por medio de la consulta a fuentes documentales: decretos, leyes, planes de acción e informes referentes a las políticas y a la estructura organizacional en las unidades de salud, adoptándose el análisis de contenido para el tratamiento de los datos. Se preconiza que el comportamiento con los procesos de recalificación entraña nuevos movimientos instituidores, fortalecedores de la (re)construcción de la identidad médica, no solo comprendida como individualidad/identificación, sino constituida como un proceso continuo vinculado a la identidad personal, permitiendo la construcción, desconstrucción y la reconstrucción de algo que permite dar sentido al trabajo realizado. Para el trabajo en salud, se valoriza un nuevo perfil profesional dotado de elevada calificación, integrando, en forma inseparable, teoría, saberes técnicos, prácticos y sociales. La ‘prestación del servicio’ y la ‘asistencia en salud’ tienen una dimensión subjetiva e individual, pero, al mismo tiempo, tienen expresión en grupos y en poblaciones, así como están orientadas por valores culturales y por estándares clínicos reconocidos por la ciencia.

A utilização do soro fetal bovino (SFB), embora bastante disseminada na produção in vitro (PIV) de embriões bovinos, apresenta limitações por ser um meio indefinido e por causar efeitos que prejudicam a qualidade desses embriões. Por esse motivo, nos últimos anos, grande parte das pesquisas relacionadas à PIV está voltada para a substituição do SFB por outros compostos nos meios de cultura. No presente estudo, foram utilizados como compostos protéicos a albumina sérica bovina livre de ácidos graxos (BSA-FAF) e um produto comercial denominado fluido embriônico (FE) de maneira isolada ou em diferentes combinações e concentrações, com objetivo de substituir ou diminuir a concentração do SFB durante a maturação in vitro (MIV). Para isso, oócitos bovinos foram maturados in vitro nos seguintes grupos (G) que foram delineados de acordo com a suplementação protéica recebida: G1 (controle) = 10% de SFB, G2 = 8mg/mL de BSA-FAF, G3 = 10% de FE, G4 = 6mg/mL de BSA-FAF + 5% de SFB, G5 = 6mg/mL de BSA-FAF + 3,5% de SFB + 1,5% de FE, G6 = 6mg/mL de BSA-FAF + 1,5% de SFB + 3,5% de FE, G7 = 6mg/mL de BSA-FAF + 5% de FE e G8 = 5% de SFB + 5% de FE. Após 24 horas de MIV, os oócitos foram classificados de acordo com a progressão meiótica e migração dos grânulos corticais (GC). As taxas de maturação foram avaliadas pelo teste do Qui-Quadrado (χ²) ou, quando apropriado, pelo teste exato de Fisher, e para o estudo dos efeitos dos suplementos foram realizados contrastes ortogonais. O grupo suplementado com BSA-FAF (G2) mostrou diminuição na taxa de oócitos que atingiram MII (75%) em comparação aos grupos G1, G4, G5 e G8 (88,9%, 89,6%, 87% e 86,8%, respectivamente), sem diferir do do G3 (79,8%), G6 (82,9%) e G7 (82,9%). Ademais, o G3 também apresentou diminuição na taxa de maturação nuclear quando comparado ao G4. Quanto à maturação citoplasmática, nos grupos G2, G7, G6 e G3, houve redução (p<0,05) das taxas para 43,9%, 43,2%, 43,1% e 36,5%, respectivamente, quando comparadas ao meio controle (G1), que permitiu a obtenção de valores médios de 62,4%. Por outro lado, nos grupos G8, G4 e G5, a taxa de maturação citoplasmática não foi afetada com a redução do SFB, onde 59,3%, 51,3% e 50,8% dos oócitos apresentaram os GC dispostos na periferia, respectivamente. Os resultados obtidos pelo teste de contrastes ortogonais complementam os obtidos na avaliação da maturação nuclear e migração de grânulos corticais, mostrando a necessidade do SFB durante a MIV, mesmo que em baixas concentrações, e a possibilidade de diminuir a sua concentração associando-o a BSA-FAF e/ou FE. Dessa forma, conclui-se que é possível reduzir a concentração de SFB no meio de MIV para até 3,5% sem prejuízo significativo aos índices de maturação nuclear e citoplasmática.

The use of fetal calf serum (FCS), although widely employed during in vitro production (IVP) of bovine embryos, has limitations. FCS is an undefined media and may have harmful effects on the quality of embryos. For this reason, in recent years, research efforts aimed at improving IVP of bovine embryos, have focused at the replacement of FCS by alternative compounds in culture media. In this study, fatty acid free bovine serum albumin (BSA-FAF) and embryonic fluid (EF) were used separately or in combination, in different concentrations, to replace or reduce the concentration of FCS during in vitro maturation (IVM). For this purpose, bovine oocytes were in vitro matured under different treatments and were assigned to one of the following groups (G) according to the protein supplementation: G1 (control) = 10% FCS, G2 = 8mg/mL BSA-FAF, G3 = 10% EF, G4 = 6mg/mL BSA-FAF + 5% FCS, G5 = 6mg/mL BSA-FAF + 3.5% FCS + 1.5% EF, G6 = 6mg/mL BSA-FAF + 1.5% FCS + 3.5% EF, G7 = 6mg/mL BSA-FAF + 5% EF, and G8 = 5% FCS + 5% EF). After 24 hours of IVM, oocytes were classified according to the meiotic progression and migration of cortical granules (CG) to the periphery. Maturation rates were evaluated by chi-square test (χ2) or, when appropriate, by Fisher's exact test, and orthogonal contrasts were performed to isolate effects of the compounds. The group supplemented with BSA-FAF (G2) had a lower number of oocytes that reached MII (75%) compared to the groups G1, G4, G5 and G8 (88.9%, 89.6%, 87% and 86.8%, respectively), with no difference in relation to G3 (79.8%), G6 (82.9%) and G7 (82.9%). Moreover, G3 also showed inferior nuclear maturation rate when compared to G4. Regarding cytoplasmic maturation, the rates were reduced to 43.9%, 43.2%, 43.1% and 36.5% in G2, G7, G6 and G3 groups, respectively, compared to the control group (G1; 62.4%). On the other hand, in the groups G8, G4 and G5, maturation rates were not affected by reduction of FCS, where 59.3%, 51.3% and 50.8% of the oocytes displayed CG arranged peripherally, respectively. The results obtained by the orthogonal contrast test are in accordance with the ones from the evaluation of the nuclear maturation and cortical granules migration. These data show the need of FCS on the MIV, even in low concentrations, and the possibility of decrease its concentration by associating it with BSA-FAF and/or EF. Therefore, we concluded that it is possible to reduce the concentration of FCS in IVM medium to a concentration of 3.5% without affecting nuclear and cytoplasmic maturation rates.

This study evaluated the influence of follicular fluid (FF) added to the maturation medium on the quality of bovine embryos produced in vitro. In the first experiment, oocytes were matured in media containing five different FF concentrations with different maturation times and classified according to meiotic progression and migration of cortical granules. In the second experiment, oocytes matured in the same media were fertilized at three different maturation times; thereafter, cleavage and blastocyst rates were evaluated. In the third experiment, oocytes were matured in media containing three different FF concentrations at two different maturation times, and embryo quality, inferred by the ratio of inner cell mass and trophectoderm cells compared with total cell number, was evaluated. Higher FF concentration (75 - 100% FF) slowed meiotic progression and CG migration (control - 78.13% vs. treated - 52.58% and control - 52.7% vs. treated - 11.59%, respectively, at 24 h of maturation). Also, FF at concentration of 75% or 100% had a negative influence on cleavage and blastocyst rates (control - 90.13% vs. treated - 82.64% and control - 35.73% vs. treated - 11.57%, respectively, at 24 h of maturation). The 50% FF resulted in embryos with increased inner cell mass numbers (control - 29.91 vs. treated - 35.49, at 24 h of maturation) and total cell numbers (control - 109.53 vs. treated - 120.67, at 26 h of maturation). Even though higher concentration of FF added to the maturation medium reduced embryonic development rates, in lower concentrations, FF slowed the meiotic progression and migration of CG and contributed to increases in inner cell mass number. Thus, FF added to the maturation medium enhances the number of cells in bovine embryos produced in vitro, especially for inner cell mass.

The objective of this study was to characterize the sexual development in Anglo-Nubian male goats raised in semi-intensive system. Eight animals were monitored every fifteen days, from the 12th to the 44th week for age at penis detachment, live weight, scrotal circumference, seminal parameters (volume, aspect, concentration, wave motion, progressive individual motility, vigor and spermatic abnormalities) and serum testosterone levels. Serum testosterone levels were determined in blood samples collected at the 20th, 28th and 38th weeks of age. Penis detachment occurred at 102.9 ± 15.4 days of age. Live weight and scrotal circumference at 20th and 44th weeks of age ranged from 25.9 ± 3.5 to 44.7 ± 4.7 kg and from 21.2 ± 1.6 cm to 26.0 ± 1.5 cm, respectively. The ejaculate volume ranged from 0.38 ± 0.05 to 0.96 ± 0.04 mL, concentration ranged from 1.33 ± 0.64 to 3.54 ± 0.14.10(9) mL-1 and the progressive individual motility varied from 48.0 ± 10.52% to 82.0 ± 3.74%, at the same age. The number of defective spermatozoa (major and minor) was 32.2 ± 5.8% vs. 8.80 ± 2.9% at the 20th and the 44th week of age, respectively. Serum testosterone level was 2.70 ± 1.40 ng.mL-1 at the 20th week, 8.50 ± 4.66 ng.mL-1 at the 28th week and 2.21 ± 2.28 ng.mL-1 at the 38th week of age. Age showed a correlation with live weight, scrotal circumference, and all the qualitative parameters of semen except for volume, with all other qualitative parameters of semen, and the correlation among sperm abnormalities and the other traits was negative. Serum testosterone levels and andrological parameters of Anglo-Nubian goats raised in semi-intensive system are closely related to age. In those animals, puberty is reached at the 20th week and sexual maturity is reached at the 38th week of age.