Decentralization and regionalization: dynamics and conditioning factors for the implementation of the Health Pact in Brazil

Decentralization and regionalization represent constitutional guidelines for the organization of the Unified Health System, which in the last 20 years has required the adoption of mechanisms to coordinate and accommodate federative tensions in Brazil's healthcare sector. This paper analyzes the national implementation of the Health Pact between 2006 and 2010 involving a strategy that reconfigures intergovernmental relations in the sector. The study involved the analysis of documents, official data and interviews with federal, state and municipal managers in the Brazilian states. The content of the national proposal is initially discussed, including its implications for health policy. The different rhythms and degrees of implementation of the Health Pact are then reviewed, with respect to adherence by states and municipalities and the formation of Regional Management Boards. Lastly, the conditioning factors for the multiplicity of experiences observed in the country are identified and the challenges facing progress toward a decentralized and regionalized health system in Brazil are discussed.

The influence of "C-factor" and light activation technique on polymerization contraction forces of resin composite

Objectives: This study evaluated the influence of the cavity configuration factor ("C-Factor") and light activation technique on polymerization contraction forces of a Bis-GMA-based composite resin (Charisma, Heraeus Kulzer). Material and Methods: Three different pairs of steel moving bases were connected to a universal testing machine (Emic DL 500): groups A and B - 2x2 mm (CF=0.33), groups C and D - 3x2 mm (CF=0.66), groups E and F - 6x2 mm (CF=1.5). After adjustment of the height between the pair of bases so that the resin had a volume of 12 mm(3) in all groups, the material was inserted and polymerized by two different methods: pulse delay (100 mW/cm(2) for 5 s, 40 s interval, 600 mW/cm(2) for 20 s) and continuous pulse (600 mW/cm(2) for 20 s). Each configuration was light cured with both techniques. Tensions generated during polymerization were recorded by 120 s. The values were expressed in curves (Force(N) x Time(s)) and averages compared by statistical analysis (ANOVA and Tukey's test, p<0.05). Results: For the 2x2 and 3x2 bases, with a reduced C-Factor, significant differences were found between the light curing methods. For 6x2 base, with high C-Factor, the light curing method did not influence the contraction forces of the composite resin. Conclusions: Pulse delay technique can determine less stress on tooth/restoration interface of adhesive restorations only when a reduced C-Factor is present.

Finite element analysis of stress distribution in anchor teeth in surgically assisted rapid palatal expansion

The treatment of a transverse maxillary deficiency in skeletally mature individuals should include surgically assisted rapid palatal expansion. This study evaluated the distribution of stresses that affect the expander's anchor teeth using finite element analysis when the osteotomy is varied. Five virtual models were built and the surgically assisted rapid palatal expansion was simulated. Results showed tension on the lingual face of the teeth and alveolar bone, and compression on the buccal side of the alveolar bone. The subtotal Le Fort I osteotomy combined with intermaxillary suture osteotomy seemed to reduce the dissipation of tensions. Therefore, subtotal Le Fort I osteotomy without a step in the zygomaticomaxillary buttress, combined with intermaxillary suture osteotomy and pterygomaxillary disjunction may be the osteotomy of choice to reduce tensions on anchor teeth, which tend to move mesiobuccally (premolar) and distobuccally (molar)

Hydro-physical characterization of soils under tropical semi-deciduous forest

The study of the hydro-physical behavior in soils using toposequences is of great importance for better understanding the soil, water and vegetation relationships. This study aims to assess the hydro-physical and morphological characterization of soil from a toposequence in Galia, state of São Paulo, Brazil). The plot covers an area of 10.24 ha (320 × 320 m), located in a semi-deciduous seasonal forest. Based on ultra-detailed soil and topographic maps of the area, a representative transect from the soil in the plot was chosen. Five profiles were opened for the morphological description of the soil horizons, and hydro-physical and micromorphological analyses were performed to characterize the soil. Arenic Haplustult, Arenic Haplustalf and Aquertic Haplustalf were the soil types observed in the plot. The superficial horizons had lower density and greater hydraulic conductivity, porosity and water retention in lower tensions than the deeper horizons. In the sub-superficial horizons, greater water retention at higher tensions and lower hydraulic conductivity were observed, due to structure type and greater clay content. The differences observed in the water retention curves between the sandy E and the clay B horizons were mainly due to the size distribution, shape and type of soil pores.

Investigação sobre as configurações sociais do subcampo do esporte paralímpico no Brasil: os processos de classificação de atletas

Este trabalho tem por objetivo investigar e delimitar formas de interação e disputas sociais presentes no movimento paralímpico brasileiro, relativos aos processos de classificação de atletas, com base em conceitos de Pierre Bourdieu. A metodologia utilizada fundamentou-se em entrevistas semiestruturadas com quatro atletas (com deficiência física ou visual, praticantes de diversas modalidades: natação, goalball, rugby e basquete em cadeira de rodas) e quatro dirigentes (2 atuantes em funções técnicas e 2 em funções administrativas do Comitê Paralímpico Brasileiro). A análise de dados apoiou-se no método Discurso do Sujeito Coletivo e suas ferramentas metodológicas (expressões-chave; ideias centrais; ancoragens; instrumentos de análise de discurso). Destacam-se como resultados: os protocolos de classificação, assim como a atuação e formação de novos classificadores, são motivo de tensões sociais neste espaço; Os classificadores exercem importante poder simbólico no subcampo; Demais agentes, como treinadores e atletas, têm suas possibilidades de ascensão diminuídas por condições sociais desfavoráveis..