O direito à saúde e a política nacional de atenção oncológica: uma análise a partir da crescente judicialização dos medicamentos antineoplásicos

The 1988 Federal Constitution of Brazil by presenting the catalog of fundamental rights and guarantees (Title II) provides expressly that such rights reach the social, economic and cultural rights (art. 6 of CF/88) as a means not only to ratify the civil and political rights, but also to make them effective and practical in the life of the Brazilian people, particularly in the prediction of immediate application of those rights and guarantees. In this sense, health goes through condition of universal right and duty of the State, which should be guaranteed by social and economic policies aimed at reducing the risk of disease and other hazards, in addition to ensuring universal and equal access to actions and services for its promotion, protection and recovery (Article 196 by CF/88). Achieving the purposes aimed by the constituent to the area of health is the great challenge that requires the Health System and its managers. To this end, several policies have been structured in an attempt to establish actions and services for the promotion, protection and rehabilitation of diseases and disorders to health. In the mid-90s, in order to meet the guidelines and principles established by the SUS, it was established the Política Nacional de Atenção Oncológica PNAO, in an attempt to sketch out a public policy that sought to achieve maximum efficiency and to be able to give answers integral to effective care for patients with cancer, with emphasis on prevention, early detection, diagnosis, treatment, rehabilitation and palliative care. However, many lawsuits have been proposed with applications for anticancer drugs. These actions have become very complex, both in the procedural aspects and in all material ones, especially due to the highcost drugs more requested these demands, as well as need to be buoyed by the scientific evidence of these drugs in relation to proposed treatments. The jurisprudence in this area, although the orientations as outlined by the Parliament of Supreme Court is still in the process of construction, this study is thus placed in the perspective of contributing to the effective and efficient adjudication in these actions, with focus on achieving the fundamental social rights. Given this scenario and using research explanatory literature and documents were examined 108 lawsuits pending in the Federal Court in Rio Grande do Norte, trying to identify the organs of the Judiciary behave in the face of lawsuits that seeking oncology drugs (or antineoplastic), seeking to reconcile the principles and constitutional laws and infra constitutional involving the theme in an attempt to contribute to a rationalization of this judicial practice. Finally, considering the Rational Use of health demands and the idea of belonging to the Brazilian people SUS, it is concluded that the judicial power requires ballast parameters of their decisions on evidence-based medicine, aligning these decisions housing constitutional principles that the right to health and the scientific conclusions of efficacy, effectiveness and efficiency in oncology drugs, when compared to the treatments offered by SUS

Aplicação dos royalties de petróleo e a garantia constitucional do desenvolvimento sustentável

This paper aims to demonstrate the connection between the application of revenues from oil royalties, exhaustible, even if the long term, and the importance of attempting to the constitutional goal of ensuring the sustainable development, including proposals of regulation. It aims to clarify the constitutional goal of ensure that national development, pointing out its relationship with the right to an ecologically balanced environment, also constitutional provision, demonstrating its important role as a mandatory vector to the Brazilian government. Search the legal nature of the oil royalties and analyzes the regulatory framework of oil royalties, which included extensive legislation, sparse and controversial, a fact that hinders the work of hermeneutist. Pays attention to some international experiences about the application of oil royalties, aiming to establish parameters of other models that can be followed. Exposes the oil royalties as a revenue differentiated, because of its exhaustible character, so that, imperatively, should be used in productive investments, according to intergenerational equity and sustainable development. Proposes a special regulation for revenues from oil royalties with clear criteria for the use of resources, restrictions for its application, as well as controls and sanctions

Apelação no código de processo civil: uma análise sob o prisma do princípio da efetividade

The present dissertation, elaborated is based on the deductive method, through the use of the General Theory of Resources concepts, by the main types of judgments existing in the Code of Civil Procedure, the interlocutory judgment and sentence, as well as the features and effects that challenge these decisions, we sought to identify on this theme one of the greatest evils facing the justice system in the world, which is the processing delays. This slowness in adjudication affects seriously the principle of effectiveness, one of the postulates of procedural law and society as a whole. Thus, the use of tort serves to fight the interlocutory decision and appeal which challenges the judge`s ruling. It is a resource for excellence in appellate system as it meets with the most awaited decision of the process. In weighing the importance of the appeal that seeks to oppose the court decision today by the numerous reforms that the procedural system has been through, it has ended up to transform the process ineffective or inconsistent, for it is much easier to have efficacy in a interlocutory decision for preliminary injunction than by judgment on the merits of the judge. This is due to the prevision of the resources and their effect to those decisions. That is, the interlocutory decision involves interlocutory appeal only in the devolved effect, allowing its provisional execution, and the sentence has as recourse to appeal the double effect, remanding and suspension, which necessarily prevents its provisional execution. But it undeniably shows a paradox, because as to give effect to a measure that is based on a mere probability by a summary cognition, partial and superficial, and stop it on a decision by a court that is closer to the truth and sure, for a full and depleting cognition? It is seriously affect the principle of effectiveness. Therefore, starting from this ineffectiveness, sought to defend the solution of this problem with the approval of the bill n. º 3.605/2004 or the new Code of Civil Procedure project that modifies the general rule the effects of appeal. That is, remanding and suspensive, as to merely remanding effect to and thereby enable the provisional execution of the judgment of the court of the first degree of jurisdiction, giving effectiveness and enhancing the decision of the magistrate, making a fair distribution of time in the process and better guaranteed principle of access to justice

A alteração do tipo penal de adulteração de combustíveis: reflexo da constitucionalização do direito penal no mercado de combustíveis

The neoconstitutionalism led to a process of ethical revaluation of the normative systems and the process of constitutionalization of the many fields of law. This study examines the consequences of this process in criminal law, so important a Law field for the protection of the most valuable assets by the society, including the fundamental guarantees, thus emphasizing the necessity of protection of the collective and individual rights, which are guided by the observance of the defendants individual rights in the course of criminal proceedings and the search for the best efficiency of penal protection, according to the corollaries of defense against the state (prohibition of the excess or Übermassverbot) and the provision of rights by the state (prohibition of insufficient protection or Untermassverbot). The offense of fuel adulteration is taken as an object of study, since it is a vital market to a nation dependent of people and good s movement for their living, driven by fossil and biofuels. Such a crime affects essential legal interests to the development of society, interests such as the environment, consumer relations and economic order, particularly the principle of free competition. This paper seeks to analyze the need of a greater efficiency of this particular criminal protection, once concluded the conduct harm and social fear as a consequence by it as growing, and therefore having its former crime type, engraved in Article 1 of Law No. 8.176/1991, rewritten in compliance with the criminal law s principle of legality. Thus, the reformation proposals and legislative creation involving this crime were observed, with emphasis on the bill No. 2498/2003, which keeps it as blank heterogeneous criminal norm, kind of penal normative whose constitutionality is raised, including the forethought of criminal responsibility in the perpetrating of the offense as culpable and subsequently increasing the applicable minimum penalty, as well as the inclusion of new activities in the typical nucleus

O direito coletivo prestacional à saúde e o poder judiciário: a concretização do art. 196 da Constituição de 1988 pela via jurisdicional

During the ninth century, owing to the process of industrialization, new social conflicts were showed, forcing the Government not to remain inert. The necessity of answer to these new demands requires from the State some actions that assure the new economic, cultural and social rights, able to exceed the formal equality, according to the principles of redistributive equality and well-being. Among the social rights, the right to health is showed up, which is placed at the Universal Declaration of Human Rights and the International Treaty for the Economic, Social and Cultural Rights, as a necessary term to promote the dignity and the free development of the human personality. Under the Constitutional Law, it is clear that the implementation of the right to health, placed at the 6th article of the Brazilian Constitution, demands a government activity, which usually requires a provision of material goods, depending on budgetary resources. The Legislative and Executive Branches have a very important role in compliance with the constitutional regulations about the satisfactory offer of health care services, besides the correct use of the resources at this area. The adoption of public policies is the way of Government action to the planning and realization of this right. Though, some public policies are usually made apart from the social compromises, to the detriment of the basic social rights. The government has a discretionary competence to manage the health services. That is the reason it is necessary the control of the political choices, through the popular control, the extrajudicial control by the Account Courts, or the judicial review. Owed to the constitutionalization of social rights, the constitutional justice has a very relevant role, concerning to the constitutional jurisdiction, in a way the Judiciary Branch assume your position as a player that transforms the society. On the control of the public health policies, there is a cast of official instruments, judicial or not, to the guarantee of the collective right to the public health services, and to allow the citizens to reach the real implementation of the right to health

Literatura e educação :ação argumentativa na discussão de histórias

The focus of this thesis is the discussion of stories from the fairy tales genre in reading classes of Children´s Literature. Its main purpose is to investigate the argumentative action in the mediation pedagogic process.The evidence from this study is that the argumentative action is a fundamental component of teacher´s mediation as far as story discussion is concerned. The concept of mediation in this thesis comes from principles of interacionist Psychology articulated with THE theory of argumentation. It is understood that argumentative action is a process that objectives to obtain and to intensify the interlocuter´s adhesion through speech. The analysis of the story discussion activity is based on Psycholinguistic, particularly on the study of prevision ability; on the Theory of reception with special reference to the theory of the aesthetic effect, which considers the reader´s reactions and reader´s replies to the text; and on sociocognitive conflict study highlighting conflicts modalities brought up by the discussion of texts. The corpus analysed is composed by discussion episodes of stories from reading classes of Children´s Literature realized through participative observation.The subjects were children aged five-six years old from a public pre-school located in Natal-RN, Brazil. The study highlights mediation acts of argumentative nature such as direct question; illustrations from the book; rereading that were used by the teacher-researcher in story discussion. Among its conclusions it is revealed that argumentative action in stories discussion favors and intensifies the agreement of children´s to the activity. It increases the interaction between text and reader; it favours children´s organization and explicitation of their thoughts. The analysed material shows children´s exposing their ability to argue when having adequade scaffolding by an argumentative mediator the teacher

Educação ambiental: mediações sociais e políticas e a indolência do Poder Público à sua inclusão no ensino formal

As a result of the prediction of irreversible changes on necessary conditions to maintain life, including human, on the planet, environmental education got the spotlight in the political scenario, due to social pressure for the development of individual and collective values, knowledge, skills, attitudes and competences towards environmental preservation. In Brazil, only in 1999 the right for environmental education was officially granted to people, having the status of essential and permanent component in the country s education. Since then, it has been Government s duty, in each federal branch, to plan actions to make it happen, in an articulate way in all levels and modalities of the education process, both formally and informally. This work of research has environmental education in the school as subject matter, and aims on analyzing social and political mediations established between this National Environmental Education policy and the contexts associated to the legislative production process, the political nature of the conceptions about environmental education that underlie Law 9.795/99 (Brazil, 2009c) and also Rio Grande do Norte Government s actions and omissions related to the imperative nature of the insertion of environmental education in the schools ran by the state, during the ten years this law has been in force. The investigation of the subject matter was led by a social and historical understanding of the social and environmental phenomena, as well as of the education system as a whole, considering that only through a dialectical view we can see the real world, by destroying the pseudo-concreteness that surrounds the topic. While analyzing, we assumed that in face of the dominance of a social organization in which market regulations rule on environmental ones, by developing individual and collective critical conscience, environmental education can become a threat to dominant economical interests in exploiting natural resources. The results of this research suggest that as an educational practice to be developed in an integrated, continuous and permanent fashion in all levels and modalities of formal education, environmental education has not yet come to pass in the state of Rio Grande do Norte, due to the neglect and disrespect of the government when facing the need of promoting the necessary and legally appointed measures to make it present in the basic education provided by the state. The legislators silence when it comes to approving a regulation on environmental education essential to define policies, rules and criteria to teaching the subject in the state and the omission from the public administration regarding critical actions in order to integrate in public schools the activities related to the National Environmental Education Policy, represent a political decision for not doing anything, despite the legal demand for an active position. This neglecting attitude for the actualizing of strategically concrete actions, urgent and properly planned for the implementation of environmental education in schools in a multidisciplinary way, exposes the lack of interest the predominant classes have in such kind of education being made available, as it could be developed based on a critic political view, becoming a political and educational action against dominance. When analyzing the basic principles and fundamental goals in Law 9.795/99 (Brazil, 2009c) the development of a critic environmental education is really possible and concurs with the National Environmental Education Policy, reflecting the social and political mediations established between this public policy and the contexts associated to its legislative production process, which are responsible for approving a regulation which also represents the mind of the people about environmental protection above anything else

Uma fonte chaveada de 50kW com correção de fator de potência para alimentação de uma tocha de plasma Indutiva utilizando técnicas de controle digital

This work deals with the development of an experimental study on a power supply of high frequency that provides the toch plasmica to be implemented in PLASPETRO project, which consists of two static converters developed by using Insulated Gate Bipolar Transistor (IGBT). The drivers used to control these keys are triggered by Digital Signal Processor (DSP) through optical fibers to reduce problems with electromagnetic interference (EMI). The first stage consists of a pre-regulator in the form of an AC to DC converter with three-phase boost power factor correction which is the main theme of this work, while the second is the source of high frequency itself. A series-resonant inverter consists of four (4) cell inverters operating in a frequency around 115 kHz each one in soft switching mode, alternating itself to supply the load (plasma torch) an alternating current with a frequency of 450 kHz. The first stage has the function of providing the series-resonant inverter a DC voltage, with the value controlled from the power supply provided by the electrical system of the utility, and correct the power factor of the system as a whole. This level of DC bus voltage at the output of the first stage will be used to control the power transferred by the inverter to the load, and it may vary from 550 VDC to a maximum of 800 VDC. To control the voltage level of DC bus driver used a proportional integral (PI) controller and to achieve the unity power factor it was used two other proportional integral currents controllers. Computational simulations were performed to assist in sizing and forecasting performance. All the control and communications needed to stage supervisory were implemented on a DSP

Identificação de modelos polinomiais narx utilizando algoritmos combinados de detecção de estrutura e estimação de parâmetros com aplicações práticas

A modelagem de processos industriais tem auxiliado na produção e minimização de custos, permitindo a previsão dos comportamentos futuros do sistema, supervisão de processos e projeto de controladores. Ao observar os benefícios proporcionados pela modelagem, objetiva-se primeiramente, nesta dissertação, apresentar uma metodologia de identificação de modelos não-lineares com estrutura NARX, a partir da implementação de algoritmos combinados de detecção de estrutura e estimação de parâmetros. Inicialmente, será ressaltada a importância da identificação de sistemas na otimização de processos industriais, especificamente a escolha do modelo para representar adequadamente as dinâmicas do sistema. Em seguida, será apresentada uma breve revisão das etapas que compõem a identificação de sistemas. Na sequência, serão apresentados os métodos fundamentais para detecção de estrutura (Modificado Gram- Schmidt) e estimação de parâmetros (Método dos Mínimos Quadrados e Método dos Mínimos Quadrados Estendido) de modelos. No trabalho será também realizada, através dos algoritmos implementados, a identificação de dois processos industriais distintos representados por uma planta de nível didática, que possibilita o controle de nível e vazão, e uma planta de processamento primário de petróleo simulada, que tem como objetivo representar um tratamento primário do petróleo que ocorre em plataformas petrolíferas. A dissertação é finalizada com uma avaliação dos desempenhos dos modelos obtidos, quando comparados com o sistema. A partir desta avaliação, será possível observar se os modelos identificados são capazes de representar as características estáticas e dinâmicas dos sistemas apresentados nesta dissertação

Estudo do equilíbrio líquido-vapor do sistema água+etanol+líquido iônico visando a separação do álcool anidro

Anhydrous ethanol is used in chemical, pharmaceutical and fuel industries. However, current processes for obtaining it involve high cost, high energy demand and use of toxic and pollutant solvents. This problem occurs due to the formation of an azeotropic mixture of ethanol + water, which does not allow the complete separation by conventional methods such as simple distillation. As an alternative to currently used processes, this study proposes the use of ionic liquids as solvents in extractive distillation. These are organic salts which are liquids at low temperatures (under 373,15 K). They exhibit characteristics such as low volatility (almost zero/ low vapor ), thermal stability and low corrosiveness, which make them interesting for applications such as catalysts and as entrainers. In this work, experimental data for the vapor pressure of pure ethanol and water in the pressure range of 20 to 101 kPa were obtained as well as for vapor-liquid equilibrium (VLE) of the system ethanol + water at atmospheric pressure; and equilibrium data of ethanol + water + 2-HDEAA (2- hydroxydiethanolamine acetate) at strategic points in the diagram. The device used for these experiments was the Fischer ebulliometer, together with density measurements to determine phase compositions. The experimental data were consistent with literature data and presented thermodynamic consistency, thus the methodology was properly validated. The results were favorable, with the increase of ethanol concentration in the vapor phase, but the increase was not shown to be pronounced. The predictive model COSMO-SAC (COnductor-like Screening MOdels Segment Activity Coefficient) proposed by Lin & Sandler (2002) was studied for calculations to predict vapor-liquid equilibrium of systems ethanol + water + ionic liquids at atmospheric pressure. This is an alternative for predicting phase equilibrium, especially for substances of recent interest, such as ionic liquids. This is so because no experimental data nor any parameters of functional groups (as in the UNIFAC method) are needed

Determinação do coeficiente de decaimento bacteriano em wetland - alagado construído

Wetlands systems are considered nowadays as a treatment method that uses simple, easy operation and low cost technology, which has been used in various parts of the world and also in Brazil. Used alone or as a complement to other types of treatment systems, once it effectively removes nutrients, pathogens and other pollutants in the water. Due to the high complexity found in wetlands, making it difficult to predict the response of the system to treat wastewater, one should consider as ideal to base the sizing of the wetland system over the necessary removal of this parameter instead of scaling it from empiricism. The study was conducted to determine the coefficient of bacterial decrease in the Wetland unit located at Ponta Negra Station Sewage Treatment, located in Natal, the coastal region of Rio Grande do Norte. The most representative model to determine the bacterial decrease in this system was the one from Chick for hydraulic piston system. Kb of 0.37 d-1 were found for the flow rate of 15m³/d, while for the system operating at maximum design flow, 30m³/d, the Kb of 0.98 d-1 was found

Incorporação do lodo de tanque séptico como matéria-prima de uma mistura asfáltica

In Natal/RN, 68% of the population uses some kind of individual system for their domestic sewers treatment, being that the most used it is septic tank, followed by sumidouro. Every treatment system of sewers, usually used, generates a by-product denominated sludge. That residue presents some components, in its constitution, undesirable under the environmental and sanitary point of view. In such case, to assure that the system treatment has satisfactory results, it is necessary to do the adjusted disposition of the sludge sewage. Several countries are looking for technical alternatives for the use and disposition of residues. Under technical and environmental conditions appropriate, these materials can be used, decreasing the consumption of the natural resources and the treatment need, storage or elimination of the wastes, what decrease the risks created. Some of the alternatives of recycling of the sludge sewage are: the application in the agriculture, in the production of energy and as raw material in the civil construction. This study evaluated asphalt mixtures behavior that partially substituted conventional aggregates by septic tank sludge. The septic tank sludge gave origin to two raw materials called raw sludge and sludge ash. The raw sludge was put as a small aggregate and the sludge ash as filler. In the first experiment it was made a comparison between the mixture with conventional aggregates and the mixtures that replaced sand by raw sludge in the proportions from 5% to 40%. In the second experiment, it was made comparison between mixtures with 1%, 2% and 3% of sludge ash and cement. The stages developed along the study were: physical characterization of the conventional materials; physical, chemistry, thermal, mineralogical characterizations and analysis of environmental risk of the raw sludge; physical characterization and analysis of environmental risk of the sludge ash; analysis of the mixtures performance through its volumetric and mechanical characteristics; forecast of the mixtures susceptibility in the moisture presence. For the grain size composition used and with the percentage asphalt adopted, the mixtures with up to 7,5% of raw sludge in his composition attend to the National Department of Transports Infrastructure (DNIT) specifications. However, in agreement with the mixtures susceptibility in the moisture presence, the mixtures with addition of raw sludge don't present satisfactory acting. In such case, they could be used in arid and semi-arid areas. The raw sludge application in mixtures increased their voids volume and their stability. However, it damaged mixtures adhesiveness. Mixtures with sludge ash and with cement presented similar behavior. However, mixtures with sludge ash presented a better performance than mixtures with cement as for their stability and their tensile strength ratio. The mixture with 1% of sludge ash is better. The wastes studied don't represent environmental risk

Dificuldades de aprendizagem em estequiometria: uma proposta de ensino apoiada na modelagem

In order to learn/teach chemistry some themes are relevant, like the stoichiometry, which consists in the study of the weight ratios in the combination of elements and compounds between themselves. This is an underlying subject in the understanding/representation/forethought of chemical reactions. Considering these aspects, our study presents a modeling-based proposal to develop the content of stoichiometry with prospective chemistry teachers. With this aim, we have made a review of literature, which we considered when tried to identify the learning difficulties using both quizzes and pedagogical tests, and then, from those difficulties we could propose a teaching unit for this concept and, consequently the evaluation of our proposal. The participants were chemistry undergraduates at the Universidade Federal do Rio Grande do Norte (UFRN) from assorted levels. As a methodological framework, we rely on the discursive textual analysis to characterize the speech of participants. As main results we observed ideas of appearance or disappearance of matter during chemical transformations, disregard of stoichiometric proportions when using drawings to represent the microscopic level of a reaction and confusion between the magnitude amount of matter and other magnitudes such as mass and volume. The final product is a sequence of instruction, based on the modeling previous research literature , with the goal of improving students ability to articulate the macroscopic and submicroscopic levels of representation of the matter

Simetria de invariância de escala discreta, log-periodicidade e singularidades em tempo finito

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Gestão de estoques: uma proposta de reposição contínua para material médico hospitalar e medicamentos em um hospital universitário federal do estado do Rio Grande do Norte

The inventory management in hospitals is of paramount importance, since the supply materials and drugs interruption can cause irreparable damage to human lives while excess inventories involves immobilization of capital. Hospitals should use techniques of inventory management to perform replenishment in shorter and shorter intervals, in order to reduce inventories and fixed assets and meet citizens requirements properly. The inventory management can be an even bigger problem for public hospitals, which have restrictions on the use of resources and decisionmaking structure more bureaucratized. Currently the University Hospital Onofre Lopes (HUOL) uses a periodic replacement policy for hospital medical supplies and medicines, which involves one moment surplus stock replenishment, the next out of stock items. This study aims to propose a system for continuous replenishment through order point for inventory of medical supplies and medicines to the hospital HUOL. Therefore, a literature review of Federal University Hospitals Management, Logistics, Inventory Management and Replenishment System in Hospitals was performed, emphasizing the demand forecast, classification or ABC curve and order point system. And also, policies of inventory management and the current proposal were described, dealing with profile of the mentioned institution, the current policy of inventory management and simulation for continuous replenishment order point. For the simulation, the sample consisted of 102 and 44 items of medical and hospital drugs, respectively, selected using the ABC classification of inventory, prioritizing items of Class A, which contains the most relevant items in added value, representing 80 % of the financial value in 2012 fiscal year. Considering that it is a public organization, subject to the laws, we performed two simulations: the first, following the signs for inventory management of Instruction No. 205 (IN 205 ), from Secretary of Public Administration of the Presidency ( SEDAP / PR ), and the second, based on the literature specializing in inventory management hospital. The results of two simulations were compared to the current policy of replenishment system. Among these results are: an indication that the system for continuous replenishment reorder point based on IN 205 provides lower levels of safety stock and maximum stock, enables a 17% reduction in the amount spent for the full replenishment of inventories, in other words, decreasing capital assets, as well as reduction in stock quantity, also the simulation made from the literature has indicated parameters that prevent the application of this technique to all items of the sample. Hence, a change in inventory management of HUOL, with the application of the continuous replenishment according to IN 205, provides a significant reduction in acquisition costs of medical and hospital medicine