ABSTRACT The objective of this study was to evaluate the effect of either a limited forage intake or concentrate supplementation prior to the adaptation to high-concentrate diets on dry matter intake, ruminal pH, bacteria, and protozoa of Nellore cattle. The experiment was designed as a two 3×3 Latin square, and six cannulated Nellore steers were used. Each experimental period was composed by three feeding phases: pre-adaptation (14 days), adaptation (12 days), and finishing (seven days) diet, in a total of 33 days per period. The steers were assigned to one of three pre-adaptation dietary treatments: control (Tifton hay fed ad libitum + mineral supplement), restriction (Tifton hay fed at 1.4% of BW + mineral supplement), and concentrate (Tifton hay fed ad libitum + 0.5% of BW of a mix of concentrate feedstuffs and mineral supplement). The adaptation period consisted of two adaptation diets, which contained 72 and 79% concentrate for six days each. The finishing diet contained 86% concentrate. During the pre-adaptation phase, restricted cattle had higher pH than concentrate-fed cattle. There was a reduction in M. elsdenii relative population in cattle from either restriction or concentrate groups. During adaptation and finishing phases, cattle from concentrate group had smaller F. succinogenes populations compared with the control group. The previous nutritional backgrounds impact ruminal microbiota during adaptation and finishing phases without causing any negative effect on ruminal pH. Feeding concentrate prior to the adaptation positively impacted the transition to high-concentrate diets and promoted increased dry matter intake.

Abstract In the 1970s, in the suburbs of a US city, five sisters between thirteen and seventeen years of age committed suicide, starting with Cecilia, the youngest of the Lisbon sisters. A wave of sadness plagued with questions invaded the minds of those who lived with them and of all those who witnessed how little by little they lost their joy, their motivations and their essence until they became inexpressive shadows of what they once were. Given the peculiarities described between the deaths of the sisters in the Suicide Virgins of Sofia Coppola 1999, the expectation may ask several questions related to proper health approach and the role of health personnel to optimally address mental health in adolescence and of preventive measures recommended in both, individual and collective levels. This article is offered as an analysis of the fictional suicidal behaviors reported in the film, as if in some way, the Lisbon sisters could be treated with the resources and knowledge that contemporary doctors have in present time through the healthcare system, without ignoring the conditions in which their tragic deaths occurred.

Resumen En la década de 1970, en una ciudad norteamericana, cinco hermanas entre los trece y los diecisiete años cometieron suicidio, comenzado por Cecilia, la menor de las hermanas Lisbon. Una ola de tristeza plagada de interrogantes inundó las mentes de aquellos que convivieron con ellas y de todos aquellos fueron testigos de cómo poco a poco fueron perdiendo su alegría, sus motivaciones y su esencia hasta convertirse en sombras inexpresivas de lo que una vez fueron. Ante las peculiaridades descritas entre las muertes de las hermanas en las Vírgenes suicidas de Sofía Coppola 1999, el espectador puede plantearse diversas cuestiones relacionadas con el manejo sanitario adecuado y el papel del personal de salud para abordar de manera óptima la salud mental durante la adolescencia y de las medidas de prevención recomendables tanto en lo individual como en lo colectivo. El presente artículo se ofrece como un análisis a propósito de las conductas suicidas ficticias reportadas en el filme, como si de algún modo, las hermanas Lisbon pudiesen atenderse con los recursos y conocimientos que tienen en la actualidad los médicos contemporáneos a través del sistema sanitario, sin pasar por alto las condiciones en las cuales sucedieron sus trágicas muertes.

RESUMO Esta pesquisa analisou a dimensão estrutura das unidades para a atenção pré-natal em Niterói, realizada pela Estratégia Saúde da Família (ESF). O banco de dados foi o da avaliação externa do 1º ciclo do Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ-AB) do Ministério da Saúde. Foram entrevistados 69 profissionais, em 27 unidades de saúde. Com base nos resultados, propõe-se melhorar as condições de acessibilidade, qualificar os profissionais, estimular a permanência e o vínculo, ampliar a capacitação das equipes quanto ao gerenciamento do território e dos protocolos de risco. O PMAQ-AB foi corroborado como uma ferramenta para avaliações em saúde.

ABSTRACT This research evaluated the structure dimension of primary care centers offering prenatal care in the Family Health Strategy (ESF) of Niterói. The database came from an external National Program for Access and Quality Improvement in Primary Care (PMAQ-AB) evaluation, conducted by the Federal Ministry of Health, between 2012 and 2013. Data came from 69 interviews with health professionals, spread throughout all 27 primary health units of the ESF. Based on results, we propose the improvement of accessibility in health units, professional training, binding between patients and the team, and increase the health team's knowledge of territory management and risk guidelines. We corroborated PMAQ-AB as a tool for health evaluation.

RESUMO Esta pesquisa analisou a dimensão estrutura das unidades para a atenção pré-natal em Niterói, realizada pela Estratégia Saúde da Família (ESF). O banco de dados foi o da avaliação externa do 1º ciclo do Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ-AB) do Ministério da Saúde. Foram entrevistados 69 profissionais, em 27 unidades de saúde. Com base nos resultados, propõe-se melhorar as condições de acessibilidade, qualificar os profissionais, estimular a permanência e o vínculo, ampliar a capacitação das equipes quanto ao gerenciamento do território e dos protocolos de risco. O PMAQ-AB foi corroborado como uma ferramenta para avaliações em saúde.

ABSTRACT This research evaluated the structure dimension of primary care centers offering prenatal care in the Family Health Strategy (ESF) of Niterói. The database came from an external National Program for Access and Quality Improvement in Primary Care (PMAQ-AB) evaluation, conducted by the Federal Ministry of Health, between 2012 and 2013. Data came from 69 interviews with health professionals, spread throughout all 27 primary health units of the ESF. Based on results, we propose the improvement of accessibility in health units, professional training, binding between patients and the team, and increase the health team's knowledge of territory management and risk guidelines. We corroborated PMAQ-AB as a tool for health evaluation.