Abordagem psicossociologica das implicações legais da infecção hospitalar e de seu controle

Pesquisas acerca das Infecções Hospitalares mostram a gravidade do problema na saúde e a existência de poucos profissionais das áreas do Direito e da Saúde especializados nas implicações jurídicas relacionadas com o controle das Infecções Hospitalares. Assim, este estudo multidisciplinar tem como objetivos: apreender as Representações Sociais das Implicações Jurídicas das Infecções Hospitalares e de seu Controle, elaboradas pelos profissionais do direito e da saúde e analisar o impacto destas representações sobre Infecções Hospitalares e seu controle no âmbito do Hospital Getúlio Vargas, em Teresina, no Estado do Piauí. Trata-se de um estudo de caráter exploratório, desenvolvido em hospital público com profissionais do Direito e da Saúde, subsidiado na Teoria das Representações Sociais, de Serge Moscovici. Os dados foram coletados através de entrevista em profundidade e da observação. As informações apreendidas foram processadas no software Alceste 4.8, possibilitando a análise lexical e estatística pela Classificação Hierárquica Descendente, que permitiu identificar no discurso classes representativas de palavras de interesse da investigação. Os resultados indicaram que os sujeitos do estudo, através das suas representações sociais, defendem os direitos dos usuários da saúde e conhecem a prática das políticas de saúde, prevenção das Infecções Hospitalares e de seu Controle. Porém, demonstraram pouca preocupação com as implicações jurídicas inerentes às sua práticas mesmo estando sujeitos a responder civil e penalmente pelas ocorrências geradas por iatrogenia no exercício da profissão

Efetividade do uso tópico de fluoreto e da escovação no controle de cáries produzidas "in vivo"

The objective of this clinical study was to evaluate the effectiveness of the toothbrushing with and without fluoride and the daily fluoride rinse (NaF 0.05%) on produced white spot, in vivo. This was a clinical study, controlled, randomized and triple blind. Thirty patients were selected for orthodontics reasons from Orthodontics Specialization Course at the Brazilian Dental Association - Section of Rio Grande do Norte. In this study it was used 4 bicuspid upper and lower. They had orthodontic reason for extractions, in 35 days, at least. The sample had one hundred and twenty teeth that received orthodontic bands. The bands were fixed with polycarboxylate cement, and there was a space standardized between bands and one surface of teeth. The four bicuspid of each patients were randomized and nominated as A, B, C and D. These nominations determinated the sequence of the extractions and what was done in each tooth. All the patients had been submitted to the toothbrushing with or without fluoride for 35 days. After this period, the A tooth of each patient was extracted to serve as control. The others teeth (B, C and D) were extracted one by each week. The entire sample was analyzed through the clinical examination and by laser fluorescence (DIAGNOdent®) in three different times: before orthodontic bands, 28 days after fixed and then removed the bands and, the last one, 07 days after one of the three treatments (toothbrushing with or without fluoride, tooth paste with fluoride and mouth rinse with fluoride). At the beginning all groups (A, B, C and D) had the same conditions, no significant difference was found. The same situation was found in a clinical examination. The results of the DIAGNOdent® for the groups that used tooth paste without fluoride, with fluoride and mouth rinse with fluoride, after 28 days, there was no significant difference. Clinically, the white spot was formed in all teeth after 28 days. When it was compared the three treated groups, the group without fluoride in tooth paste had worst result than the others groups. But there was no significant association between the number of active and inactive white spots and the type of treatment that the teeth had received. The demineralization of the enamel surface, under the orthodontic bands, it happened in a few weeks. The exposition of the white spots in oral environmental resulted in an improvement, but it was not enough to return to the values from the base line, either for the toothbrushing and/or the use of fluorite mouth rinse. Mouth rinse and toothpaste with fluoride have showed to reduce the incidence of demineralization in the enamel, but none seems to be superior to another one in an in vivo study

Impacto da variabilidade de peso no controle matebólico de pacientes transplantados cardíacos

Heart transplantation (HT) represents one of the greatest advances in medicine over the last decades. It is indicated for patients with severe heart disease unresponsive to clinical treatment and conventional surgery, poor short-term prognosis and a 1- year mortality rate over 40%. HT has improved survival worldwide (80% in the first year, 70% in five years and 60% in ten years). However, the procedure has been associated with weight change and increased risk of secondary conditions such as diabetes, hypertension, dyslipidemia and obesity due to immunosuppressive therapy following transplantation. The objective of this study was to determine the impact of weight change on the metabolic stability of HT patients. The study was retrospective with data collected from the records of 82 adult patients (83% male; average age 45.06±12.04 years) submitted to HT between October 1997 and December 2005 at a transplantation service in Ceará (Brazil). The selected outcome variables (biopathological profile, weight and body mass index―BMI) were related to biochemical and metabolic change. The results were expressed in terms of frequency, measures of central tendency, Student s t test and Pearson s correlation coefficients. The analysis showed that following HT the average global BMI increased from 23.77±3.68kg/m2 to 25.48±3.92kg/m2 in the first year and to 28.38±4.97kg/m2 in the fifth. Overweight/obese patients (BMI ≥ 25 kg/m2) had higher average levels of glucose, total cholesterol, low-density lipoprotein and triglycerides than patients with eutrophy/malnutrition (BMI < 25 kg/m2). In conclusion, overweight/obese patients were likely to present higher average levels of glucose, triglycerides, total cholesterol and fractions than patients with eutrophy/malnutrition, indicating a direct and significant relation between nutritional status and weight change in the metabolic profile of HT patients

Controle de qualidade físico-químico e biodisponibilidade relativa em ratos de suspensões orais de naproxeno sódico obtidas de farmácias de manipulação na cidade do Natal RN

Compounded medicines have been reported by the ANVISA due to decreased of the therapeutic response or toxicity of these formulations. The aim of this work was to investigate the physicochemical quality control among naproxen sodium oral suspensions 25 mg/mL obtained from six compounding pharmacies (A, B, C, D, E and F) and the manufactured suspension (R). In the quality control test, the tests of pH, content, homogeneity, volume and physical and organoleptic characteristics were performed according to the Brazilian Pharmacopoeia. The analytical method for determination of naproxen in suspensions was validate. This method showed excellent precision, accuracy, linearity and specificity. In the content test the suspensions B, C and E showed lower value and the F suspension showed a high value of the content. The products C and E were disapproved in the description of the physical and organoleptic characteristics test. In the pH test, three suspensions were outside specifications (C, E and F). Only the products R, A and D showed satisfactory results in these tests and therefore they were approved for relative bioavailability test. The R, A and D suspensions were orally administered to Wistar rats and the blood samples were taken at time intervals of 10, 20, 40, 60 min, 3, 4, 6, 24 and 48 h. The plasma samples were immediately stored at 80 ºC until analysis of HPLC. The bioanalytical method validation showed specificity, linearity (R2 0.9987), precision, accuracy, good recovery and stability. The chromatographic conditions were: flow rate of 1.2 mL.min-1 with a mobile phase of acetonitrile : sodium phosphate buffer pH 4.0 (50:50, v/v) at 280 nm, using a C18 column. The confidence interval of 90% for the Cmax and AUCt ratio was within the range of 80 - 125% proposed by the FDA. Only one suspension, obtained from the compounding pharmacy D, was considered bioequivalent to the rate of absorption under the conditions proposed by this study. Thus, the results indicate the need for strict supervision from the relevant authorities to ensure the patient safety and the quality of compounded drugs by pharmacies

Do controle de constitucionalidade dos atos jurisdicionais transitados em julgado

The following study aims to verify in which hypothesis res judicata, when it comes of an unconstitutional decision, shall not prevail over Constitution. It displayed the characteristics of formal and material constitutional systems. It debated the concepts of existence, validity and efficacy of juridical rules and acts. It dissertated about the idea of Constitution s superiority and about the birth of the judicial review of constitutionality. It focused some contemporary models of this judicial review and its historical evolution in Brazil, showing its effects towards the current Constitution. It sustained that the decision given by Supremo Tribunal Federal during abstract control of rules must bind even legislative bodies, preventing them to produce the same rules previously declared unconstitutional. It held up that all parts of the decision of Supremo Tribunal Federal oblige, even the juridical arguments employed, in both diffused and concentrated reviews. It showed that, despite these models of review live together in Brazil, our constitutional system preferred the concentrated one, considering one only court over the other constitutional organs. It discussed about res judicata with the purpose of clarifying its juridical nature, its objective and subjective limits and its regulation in collective demands. It explained that the material res judicata is an effect of a decision which cannot be reviewed, which makes the law s will free of discussion, binding the contendants and avoiding that other courts, judging future demands about the same object, may decide differently. It showed how the regulation of res judicata in collective demands, in respect oh their subjective limits, is useful to demonstrate that it is not the material law who must adapt itself to res judicata as traditionally thought, but res judicata, as a warranty of juridical certainty and security, who must be shaped from the debated rule. It presented to view the main doctrinal conceptions about res judicata s review in the hypothesis of unconstitutional judgement. It concluded that the decisions forged by unconstitutional rules or interpretations reputed not compatible to the Constitution by Supremo Tribunal Federal, in spite of it can make res judicata, may be reviewed beyond the term to file a recissory claim, since while the debated law is still valid, no matter if its decision was before or after the res judicata. At the end, it asserted that, when it is not legally authorized, the judicial review of res judicata is not admissible, after the term to file a recissory claim, under the argument that there was no direct violation to the constitutional principle or rule

O controle social do judiciário: a experiência do Observatório da Justiça e Cidadania no Estado do Rio Grande do Norte

This dissertation deals with the possibility of build an effective social control of the judiciary Brazilians. The theme was bounded by a cut geographic and secular: the experience of the Center of Justice and Citizenship in the state of Rio Grande do Norte (OJC/RN), which begins formally in august 2003. The research approach and leave of experience in judicial practice and policy specific substrates to theorize about the subject. We collected documents about cases, the judicial diagnoses, reports, news material, in addition to lifting bibliographic. Therefore, it is working with about notions of a democratic state of right in the light of the Brazilian Constitution of 1988, in order to contextualize the insertion of the judicial system, by the prospect of legitimacy, which is considered by a look formal and material. It is a brief analysis of the system of official control of the judiciary (internal and external), is emphasizing its shortcomings functional and its corporate character, which suffers from poor conformation democratic. Then there is a discussion about the need to establish the social control of the judiciary, through the prism of relations of power that are locked in the judiciary, the lack of formal criteria for the guarantee of obtaining the correct judgment (laws, precedents and conscience of the judge), the problems of impunity and justice class, and from the examination of some cases, as the body of search. From this conjuncture, prepares to be an outline of shapes and the limits of social control, consonant the proposal erected in certain sectors of organized civil society, represented by the movement s social OJC. In the end, considerations are made on the legitimacy and constitutionality of OJC

O Insituto do Amicus Curiae no controle de consitucionalide brasileiro: uma abordagem à luz da efetividade do princípio do acesso à justiça

It presents a study about the control of constitutionality, its requirements and beddings. It brings, at first, notions about the concept of constitution, in its most varied aspects, as well as the systems of Control of Constitutionality. It emphasizes, considering the actual Brazilian situation, which passes through constitutional reforms and, therefore, assenting the appearance of an enormous amount of ordinary laws, the legal instability that has formed itself within the national panoram. Because of this situation, the institute of the Control of Constitutionality gains inmportancy as a way of protection of our Great Letter, against possible violations which can unfortunately happen. More ahead in the difuse control of constitutionality argues the new trend of generalization, especially after the recent reform that introduced the general repercussion as new requirement of admissibilidade of the appeal to the Brazilian Supreme Court. In the final chapter brings an analysis on the institute of amicus curiae, arguing its historical origins and its evolution, in the comparative jurisprudence, and the Brazilian right. From then is gone deep the paper of amicus curiae in the constitutionality control and, after quarrel on the difficulties of the Brazilian population to materialize its right before the judiciary, as this new institute could contribute in basic way for the materialization of the constitutional rule of access to justice

O princípio constitucional da legalidade administrativa e os limites do controle das atividades-fim das agências reguladoras pelo Tribunal de Contas da União

Analysis of the role of the Union Accounts Court on the control of regulatory agencies, with the objective of identifying the limits of the Institution s acting on the aim activities of the agencies, particularly the control limits of the Court on the merits of discretionary administrative actions, taking into account the autonomy of these entities in the model of regulatory state. Analyzes the principle of administrative legality, the control of public administration, state s action in the economy and facing regulatory agencies, their emergence, evolution and characteristics. Includes the study of jurisprudence and doctrinal differences, as for the limits of the powers conferred by the constitutional legislator to Federal Court of Audit, regarding the control of agencies aim activities, or, in other terms, their regulatory and inspector missions of market, under the principle of administrative legality. Performs analysis, based on case studies involving Court s audits on regulatory agencies. Are appreciated differences within the Institution about the their decisions effects - imposed or not - as regards the arrangements to be adopted by regulatory agencies to correct the flaws and omissions found during Court s inspections, in which content of the act of public agent, despite their technical nature, can happen the criterion of convenience and opportunity

Repercussão geral e súmula vinculante: os efeitos no controle difuso

Brazil since its first republican constitution has adopted systems of laws control. The review activity was given to three state powers or functions state, Executive, Legislative and Judiciary. However, it appears that in the country along the constitutional history, has stood considerably the jurisdictional control of the most important control. Initially, back in 1891, Brazil adopted the jurisdictional control of diffuse from U.S, whose role in monitoring of standards is delivered to all organs of the judiciary, which may face a case, put on trial, ascertain whether or not the possibility of applying a law, removing its impact in case of unconstitutionality. In 1969, entered in the second legal model of judicial review, the concentrated control of constitutionality, whose inspiration comes from the positivist theory of Hans Kelsen, and was adopted by the Austrian Constitution of 1920. According to the abstract control the supervision of law is given to a Court or Constitutional Court, responsible for the analysis of the legal constitutionality independent of its application to a specific case. In Brazil the role of concentrated control was handed over exclusively to the Supreme Court, which serves as the Constitutional Court, which accumulates that function with other constitutionally provided jurisdiction. Throughout this period, from 1891 until today, Brazil has maintained a dual system of judicial control of legal constitutionality, where they coexist and harmonize the diffuse control exercised by any organ of the Judiciary, and concentrated control of competence the Supreme Court. However, one must recognize that with the advent of the Federal Constitution of 1988, the concentrated control has emerged on the national stage due to two important factors: the expansion of the legal capacity to sue and the inclusion of other ways control, besides the already known Direct Claim of Unconstitutionality. This concentrated control and projection of the Supreme Court s attempt to become a true constitutional court, led to a relative weakening of diffuse control even when performed by the Brazilian Constitutional Court. In order to become a true constitutional court, all decisions handed down by the Supreme in the exercise of constitutional jurisdiction should have the same weight and the same measure, or at least bring improvement to similar effects, once is the responsible for the final word when it comes to constitutional interpretation. Thus, the writs of certiorari and stare decisis were responsible for profound changes in the diffuse control, allowing the Supreme Court can strengthen its decisions even in the diffuse control. These two institutions have substantially changed the legal status of diffuse control, allowing an extension of the effects of decisions handed down by the Supreme Court, so that you can no longer be said that the effects of this control to restrict the disputing parties in the process

A revenda de combustível e os limites constitucionais para a sua regulação: uma análise aplicada aos aspectos concorrênciais e ao controle de preços

The gas retail represents the end of a section of the oil and natural gas derivative chain, for it is at this stage where the commercialization of those merchandises takes place towards the costumers. This process involves an enormous amount of economic agents, which reflects on an activity of great influence on the citizen's everyday. By the time of the gas retail price liberalization, in 2002, there were great expectations towards that measure, for the insertion of that segment in a competitive market was likely to create a decrease in prices. As there was not a drastic drop off in cost, the question was no longer the price itself, but, predominantly, the conduct taken by the economic agents that operate the market. Not in vain, the segment introduces a greater number of different procedures combined with the organs that compose the Brazilian System of Competition Protection. What is understood, however, is that many of these complaints are made in a lightly way, without a proper analysis of the market and its practices, that being why, in this paper, evidences the causes of these complaints and explained what, in fact, occurs in this market. Also, the organs that protect the free initiative in the sector use different methods to assess anticompetitive practices, which are counterproductive on the combat of anticompetitive practice, that being why the present paper analyzes the used methods on a critic perspective, choosing one which is believed to be the most adequate. The present work also tries to present the gas retail prices on a constitutional, free competition, free initiative and consumers defense perspective, analyzing the competition s aspects on the gas market; the shaping of the gas prices; the market boundaries; the anti-competitive practices under the gas market; and analyze the possibility, according to the defined economic standards in the constitutional text of existing a greater control or gas price indexing and/or regulation which limits the distributors and resellers profit on gas. Still, in consequence of this analysis, a study on Natal s market behavior will be developed in its competitive feature. That being said, moreover being a theoretical-descriptive study, data and statistics gathered is used, which will lead, willing to grasp an experiential study on a few aspects of the Potiguar gas retail market

Limites formais e materiais ao controle de constitucionalidade pelo Supremo Tribunal Federal

This document approaches the formal and material limits of the constitucionalidade control for the Supreme Federal Court, iniating with the study of the Constitution, detaching its evolution, nature and meanings, passing for its historical evolution, offering still a unconstitutionality concept. Is work the principles as material Constitution, making the distinction entere principles and rules, detaching the characteristics of the principles constitutional, and the basic principle of the Constituition. It analyzes metodologics the historical parameters and of the brazilian system of constitutionality control and detaches the paper of the Supreme Federal Court as positive legislator. It observes the beddings of the constitutionality control and the legitimacy of the Supreme Federal Court. Is examines the performance of the Supreme Federal Court in face of the principle of the legal security. Is offers a vision on the experience of the control of constitutionality in other constries. It still approaches the control of constitutionality in Brazil, detaching the critical points of its formal and material limits. Is verifies the application of the principles constitutional for the Supreme Federal Court in the diffuse control and the intent control of constitutionality, as well as the performance of the Supreme Federal Court ahead of the unconstitutional omissions. It brings to the debate the new perspectives how much to the formal and material limits of the control of constitutionality for the Supreme Federal Court. Objective to elaborate considerations concerning the limits of the constitutional jurisdiction from the model of Constituition, the character politican of the difficulties with respect to the definition of its formal and material limits from the performance of the Supreme Federal Court

Perfis do controle jurisdicional de políticas publicas: parâmetros objetivos e tutela coletiva

This paper focuses on a study of public policy jurisdictional control as some effectiveness mechanism for cultural, economical, and social fundamental rights. It investigates the juridical profile of public policies based on premises of the current (Neo)Constitutional State model and the assertion of an essentially constitutionalist Law paradigm from its genesis to its most peculiar elements, and through tormenting issues, such as: its position between Law and Politics, the difference with reflective subjective rights, and the problem of high financial costs. Once its object is identified, it moves forward into the theme itself, which is that of jurisdictional control, investigating its legitimacy based on paradigmatic judicial precedents and the facing of themes such as: current role of the Judicial Power, the splitting of state functions, administrative discretion, financial affordability, illegal omissions, and budget control. Finally, it examines, as its study central object, objective parameters for definition control, execution, and transparency of public policies, as well as identifying the most appropriate collective jurisdictional tutoring to its purposes together with some of its law process means. Therefrom, it shows new perspectives for the recent study on jurisdictional control of public policies, building foundations for the fundamental rights effectiveness

A objetivação do controle concreto de constitucionalidade nas decisões do Supremo Tribunal Federal

The independence of the United States and the revolutions that emerged in Europe in the eighteenth century led to the birth of the written constitution, with a mission to limit the power of the State and to ensure fundamental rights to citizens. Thus, the Constitution has become the norm and ultimate founding of the State. Because of this superiority felt the need to protect her, emerging from that constitutional jurisdiction, taking control of constitutionality of provisions his main instrument. In Brazil, the constitutionality control began with the Constitution of 1891, when "imported" the American model, which is named after incidental diffuse model of judicial review. Indeed, allowed that any judge or court could declare the unconstitutionality of the law or normative act in a concrete case. However, the Brazilian Constituent did not bring the U.S. Institute of stare decisis, by which the precedents of higher courts eventually link the below. Because of this lack, each tribunal Brazilian freely decide about the constitutionality of a rule, so that the decision took effect only between the parties to the dispute. This prompted the emergence of conflicting decisions between judicantes organs, which ultimately undermine legal certainty and the image of the judiciary. As a solution to the problem, was incorporated from the 1934 Constitution to rule that the Senate would suspend the law declared unconstitutional by the Supreme Court. With the introduction of abstract control of constitutionality, since 1965, the Supreme Court went on to also have the power to declare the invalidity of the provision unconstitutional, effectively against all without the need for the participation of the Senate. However, it remained the view that in case the Supreme Court declared the unconstitutionality of the fuzzy control law by the Senate would continue with the competence to suspend the law unconstitutional, thus the decision of the Praetorium Exalted restricted parties. The 1988 Constitution strengthened the abstract control expanding legitimized the Declaratory Action of Unconstitutionality and creating new mechanisms of abstract control. Adding to this, the Constitutional Amendment. No. 45/2004 brought the requirement of general repercussion and created the Office of Binding Precedent, both to be applied by the Supreme Court judgments in individual cases, thus causing an approximation between the control abstract and concrete constitutional. Saw themselves so that the Supreme Court, to be the guardian of the Constitution, its action should be directed to the trial of issues of public interest. In this new reality, it becomes more necessary the participation of the Senate to the law declared unconstitutional in fuzzy control by the Supreme Court can reach everyone, because such an interpretation has become obsolete. So, to adapt it to this reality, such a rule must be read in the sense that the Senate give publicity to the law declared unconstitutional by the Supreme Court, since mutated constitutional

A missão política do Supremo Tribunal Federal: análise de sua importância como corte constitucional para o controle do poder no Brasil

The following study proposes an analysis of the politic process which the brazilian constitutional justice faces, emphasizing the Supremo Tribunal Federal . For that purpose, we start by examining the intimate relationship between Politics and Law, in view of the most recent social systems theories, so that the political system is distinguished by the exclusiveness of using the physical force, intending to make coletive tying decisions, and the juridical system as a congruent generalization of the expectations towards the rules and principles, brought together under an interdependence by which both gather legitimacy and effectiveness. In this manner we can notice the political effects of the constitutional interpretation conducted by Judges as well as by other juridical professionals, because these ones decrease the overload of expectations which are pointed to the Judicature. Constitutional interpretation is democratized since the participative democracy arises and stablishes a permanent state of awareness around the exercise of power and favours the preservation of the pluralism (counter-majoritary principle) where we can find the origin of the democratic nature of constitutional courts, once, in most cases, their members are not elected by the people. After that, we analyse the historical posture of the Supremo Tribunal Federal as a constitutional court in Brazil, so we can realize the attempts to make it vulnerable to the appeals of governability and economical aims, agains which this court somehow has resisted, stressing its particularities. At the end, it s concluded that even the so-called acts of government, whose judiciary control is mostly repelled, are subjected to a constitutional analysis, last frontier to be explored by the Supremo Tribunal Federal in its role of exposing our republican Constitution

Os conselhos como mecanismos de democratização da política educacional :participação e poder de decisão nas ações do Conselho de Controle Social do FUNDEF no município de Parnamirim/RN

This study board the FUNDEF social control council implementation in Parnamirim/RN city, concerning their representatives participation in the accompaniment (decision power) in resort, in front of governmental politics of decentralization, unleashed in 90´s, seen in decentralization process needs the society participation in decisions of educative institutions and represent an efficient way of solve the problems difficult the educational management actions. For this, the council creation of Brazil manager configure, since the 80´s, detaching, and the single characterizing, in actual context. The objective is raise pertinent questions of thematic of representatives members participation of collegiate organs, evidencing the decision power of these, in public resource control. The theory-methodological referential the literature treat the participation and power decision of FUNDEF social control decision, such as politics directrix that rules this council. It utilizes as proceeding of collecting data the semi-structured interview and analyze of meeting register to understand the empirics of council implantation in this city, in view of that the electoral process configured in 2003, showed as a innovation, because the counselor is indicated by the local public power representatives (in this case the education municipal secretary). The research result show the representatives have difficult, to accompany the FUNDEF resources amount, particularly in concern in the financial resources (ratio) over plus. Finally, emphasize the importance of democratization in the relations between the state and civil society, elucidating and exciting reflections a: democratic participation in control of public recourses for education, educational management and civil society mobilization in access of public and cultural cash which the citizen has rights