Comércio internacional e meio ambiente: estímulo à produção sustentável ou mero protecionismo comercial a posição do Brasil em dois casos de litígio

The World Trade Organization (WTO) was established in 1994 as a result of the Uruguay Round, and has as its principal aim advocate for the maintenance of free trade between nations. The preamble of its Constitutive Agreement specifically cites as an institution the goal of achieving sustainable development and the pursuit of protecting and preserving the environment, bringing into the sphere of world trade the idea that concern for the environmental cause is not restricted only the group of environmentalists, but rather has entered the economic landscape in a way not only ideological, but also pragmatic. The General Agreement on Tariffs and Trade (GATT) 1947, part of the GATT 1994, contains a device that allows the adoption of trade restrictive measures, provided that such measures aimed at protecting the environment - Article XX. The Settlement Body (DSB) is part of the WTO and acts in dissolving disputes between the countries motivated by trade. It examines two cases where countries have imposed restrictive trade measures with environmental justification. The first case was closed in 1996, with award of damages given to Brazil, on the breakdown of U.S. environmental legislation imposed on imported gasoline from Brazil - and the second, begun in 2005 and closed in 2007, coming out victorious again Brazil is on the import ban on retreaded tires to Brazil. The objective is to answer the question: how the environment is treated in the midst of trade discussions - which is aimed at its protection or its use with economic objectives in disguise? For the preparation of this work, extensive documentary research was undertaken with the virtual site of the WTO to review the entire production of legal cases and subsequent analysis of the key issue for the work, and literature of authors who have studied the tense relationship between trade international environment. The first case, it could be seen that the political movement performed by the U.S. with the aim of achieving acceptable standards of air quality was an institutional effort to ensure the quality of air, and thus would be inappropriate to say that the regulation of gasoline was merely a disguised trade barrier.However, a careful analysis of the implementation and operation of gasoline regulation may reveal intentions disguised trade and U.S. environmental argument did not hold. The weight of this environment was relegated, since there were clearly outside interests to the environmental cause. The second case, it was realized that, despite clear attempts by the EC to promote ecological dumping, send when brought to Brazil, supposedly a country with weaker environmental structure on surveillance, a residue that, pursuant to internal policies, as could not be sent to their own landfills, the Brazilian discourse remained focused on the environmental cause, and this sort there was the existence of disguised trade barriers, but of importance, at least a priori, the discussion of foreign forces on the environment environment because there is no way to legally justify the reversal of the total understanding of the first judging body, the sight of all the arguments presented by Brazil and the nonsubmission of new facts upon appeal. Still, quite heartening to reflect on the role of trade liberalization on the environment in general, because, while they do not reach a definitive conclusion will reveal positions in both directions, both for and against, the that only adds to the discussions and makes this a very fertile topic for future research

Estratégias de desenvolvimento do turismo: em busca de uma tipologia

BEZERRA, Márcia Maria de Oliveira. Estrategias de desenvolvimento do turismo: em busca de uma tipologia. Economia e Sociedade, Campinas, v. 15, n. 2, p. 347-374, ago. 2006.

Humanização do atendimento à criança na atenção básica: visão dos profissionais

Objetivou-se compreender a humanização do atendimento à criança na Atenção Básica na visão dos profissionais. Estudo qualitativo, realizado em uma Unidade de Saúde da Família de Natal-RN, Brasil. Dezesseis profissionais responderam a um formulário contendo questões referentes ao atendimento à criança, à humanização e às práticas realizadas para humanizar o atendimento. Os dados foram categorizados por temas e analisados a partir dos princípios da Política Nacional de Humanização. Para os profissionais, humanizar o atendimento envolve acolher, escutar, aconselhar sobre o que está sendo realizado com a criança, valorizar a família, e tornar o sujeito ativo no atendimento, mesmo que de forma incipiente. A maioria dos profissionais descreveu atendimento que valorizava parte dos princípios da política de humanização, mesmo com dificuldades para implementá-los na rotina. Requer, portanto, estímulos e atualização dos profissionais para uma postura autocrítica sobre o atendimento

concepções de administração e administrador em tempos de capitalismo flexível: uma abordagem crítica

A tese trata de dois construtos sócio-históricos Administração e Administrador em face do capitalismo em sua fase flexível. Considerando as mudanças do capitalismo, o texto estabelece como objeto de estudo as concepções de Administração e Administrador, para o campo administrativo, na contemporaneidade. A tese é suportada por uma pesquisa de campo cujo objetivo foi compreender criticamente as concepções do campo administrativo sobre a Administração e o Administrador, em tempos de capitalismo flexível. Epistemologicamente, a pesquisa foi conduzida a partir da perspectiva crítica frankfurtiana, fundamentada em três pares categóricos dialéticos: (i) história versus naturalização; (ii) práxis social versus sistema; e (iii) alienação versus emancipação; privilegiando o pensamento crítico vinculado à primeira geração da Escola de Frankfurt. A literatura prevalente da área de Administração foi revisada mediada pelas duas questões ontológicas que suportam a tese: O que é Administração? e O que é Administrador? para autores como Taylor, Fayol, Drucker, Ohno, Deming, Champy e Mintzberg. Metodologicamente, foi realizada uma pesquisa integralmente qualitativa, com uso de três tipos de entrevistas: (i) entrevista narrativa com história de vida; (ii) entrevista com uso de elementos-estímulo; e (iii) entrevista narrativa ficcional. Para compreensão das narrativas, foi utilizada a técnica de análise hermenêutico-dialética. Os resultados indicam o predomínio da concepção pragmática-instrumental, no tocante à Administração, pela qual ela continua a ser pensada e discursada como uma ação tecnológica e teleológica, que utiliza saberes múltiplos e aprendizagens cambiantes como meios para alcance das finalidades do contexto organizacional mutante. Com relação ao Administrador, há a emergência da concepção estética para apresentá-lo, quando vinculado às organizações. Por esta concepção, há a migração do histórico estereótipo do Administrador controlador e vigilante para a representação do Administrador como um profissional performático. O segundo resultado, que se apresenta como o mais relevante em relação ao Administrador, é o da fuga da profissão. A partir dos pares categóricos dialéticos, esta tese propõe algumas sínteses provisórias críticas: (i) história-naturalização: os sujeitos tomam como naturais a organização empresarial e suas demandas, naturalizando as recentes mudanças que, entre outras coisas, reduzem os postos gerenciais; (ii) práxis social-sistema: pela concepção pragmática-instrumental, as experiências dos Administradores são concebidas a partir do confinamento funcionalista em uma organização-sistema; (iii) emancipação-alienação: tanto a forma naturalizada com que especificam as organizações e sua Administração quanto a práxis interrompida velada em uma experiência reificada mostram-se como fenômenos intrinsecamente e subjetivamente alienantes e contraemancipatórios. Por outro lado, através do movimento de fuga da profissão, os entrevistados parecem (re)significar o silêncio fundador da alienação associada à condição de Administrador: a de pensar como capital, e não se pensar como trabalho. Finalmente, o texto propõe que as possibilidades de emancipação deste profissional residem na tomada de consciência de sua condição como integrante da classe trabalhadora, mesmo em tempos de riscos e incertezas. Assumindo-se como trabalhador, o Administrador poderá lutar pelo seu trabalho, repensando-o em novos termos, em que as dimensões pragmáticas-instrumentais que envolvem sua profissão possam ser dosadas e sempre mediadas por conteúdos substantivos e emancipatórios

Percepções de maturidade em gerenciamento de projetos à luz da nova gestão pública: uma investigação com gestores das secretarias estaduais do Rio Grande do Norte

This study aimed to measure the perception of maturity project management of state boards of Rio Grande do Norte by the perception of its managers. Argues that project management has been highlighted as a critical factor for the success of any organization, because the projects are directly related to the set of activities that result in organizational innovation as products, services and processes and the improvement of project management is directly aligned with the main pillars of the New Public Management. Methodologically, this is a quantitative research of a descriptive nature in which 161 forms were applied with coordinators and subcoordinators of state departments of Rio Grande do Norte, culminating in a sampling error of less than 6% to 95% confidence according to the procedures finite sampling. The process of tabulation and analysis was done using the package Statistical Package for Social Sciences - SPSS 18.0 and worked with techniques such as mean, standard deviation, frequency distributions, cluster analysis and factor analysis. The results indicate that the levels of maturity in project management in state departments of Rio Grande do Norte is below the national average and that behavioral skills are the main problem for improving management in these departments. It was possible to detect the existence of two groups of different perceptions about the management of projects, indicating, according to the managers, there are islands of excellence in project management in some sectors of the state departments. It was also observed that there are eight factors that affect maturity in project management: Planning and Control , Development of Management Skills , Project Management Environment , Acceptance of the Subject Project Management , Stimulus to Performance , Project Evaluation and Learning , Project Management Office and Visibility of Project Managers . It concludes that the project management in state departments of Rio Grande do Norte has no satisfactory levels of maturity in project management, affecting the levels of efficiency and effectiveness of the state apparatus, which shows that some of the assumptions that guide the New Public Management are not getting the levels of excellence nailed by this management model

Modelo de decisão multicritério para seleções interciclo das universidades novas: estudo na Universidade Federal do Rio Grande do Norte

The discussions wherein develop proposals for university reform in Brazil include, among other things, the conception of the university titled "New University", whose structural origin comes from the bill of higher education reform and unification of the foundations of education European upper (Bologna process). At its core, the Bologna process has imposed a series of transformations, among which, the promotion of mobility, as a stimulus to interinstitutional cooperation to enable an better and bigger qualification of the students. Nevertheless, what we see is that this point is one of the main points made flawed by Brazilian institutions that have adopted this model of higher education. An example is the Bachelor of Science and Technology - BC&T, Federal University of Rio Grande do Norte - UFRN, where there are problems of the internal order, represented by the problem of the reusing of the disciplines, such also of external order, in cases of transfers interinstitutional. Because of this, and knowing that this is a typical problem in which multiple criteria are involved, the aim of this study is to propose a multicriteria model for selection of interciclo of the BC&T of the UFRN which addresses the issue of mobility. For this, this study was of exploratory and study case nature, use as tools of data collection, the bibliographic and documentary research, as well as semi-structured interviews. For the elaboration of the model, were used the five phases most commonly used in the modeling of problems in operational research in a sample of 91 students of BC&T. As a result, we obtained a model that addresses the issue of internal and external mobility of the school and that, moreover, was also more robust and fair than the current model of BC&T and also what is used in other courses of the UFRN, taking into consideration the expected results by the decision makers

Perfil de memória e ativação de linfócitos T na leishmaniose visceral

Visceral leishmaniasis (VL) in Brazil is a disease caused by Leishmania infantum chagasi (L.i.chagasi). The clinical evolution post-infection depends on the vertebrate host immune response, which is genetically mediated. This study aimed to evaluate the immune response of individuals living in endemic area for VL in the state of the Rio Grande do Norte, considering individuals with VL under treatment (n = 9), recovered VL <1 year post treatment (n = 10), > 10 years posttreatment (n = 9), uninfected individuals living in endemic areas (n = 7), individuals that lost DTH response (n=6) and asymptomatic individuals for VL (n=9). Peripheral blood cells were evaluated in the presence and absence of soluble Leishmania antigens (SLA) and ex vivo, to determine activation, presence of regulatory cells and memory cells. The Leishmania parasitemia and anti-Leishmania antibodies were determined respectively by qPCR and ELISA. Cells from individuals with VL under treatment showed less cell activation after stimulation with SLA for the markers CD4/CD69, CD8/CD69 and CD8/CD25 compared with VL post treatment treatment (p <0.001). Apparently uninfected individuals have a higher cell activation than symptomatic VL (p <0.001), with the exception of CD8/CD25 marker (p = 0.6662). On the other hand, in the ex-vivo group, significant differences were observed for CD4/CD69, CD8/CD69 and CD8/CD25 between the 4 groups due to increased cell activation present in cells of individuals symptomatic LV (p <0.001). VL cells under treatment, ex vivo, have a lower percentage of memory cells (CD4/CD45RO and CD8/CD45RO) than individuals VL post-treatment or control group (p = <0.01). Likewise, individuals with symptomatic VL have fewer regulatory cells when stimulated by SLA [CD4/CD25 (p = 0.0022) and CD4/FOXP3 (p = 0.0016)] and in the ex-vivo group (p = 0.0017). Finally, DNA isolated from recovered VL contained Leishmania DNA, supporting the hypothesis of non-sterile clinical cure for Leishmania infection. Recovered VL, even 10 years after treatment have high levels of memory cells, which may be due to the presence of stimulation, either by reexposure to Leishmania or non-sterile cure

Estado nutricional e efeito da vitamina A na resposta imune frente à infecção por Leishmania Infantum

Nutritional status is an important determinant to the response against Leishmania infection, although few studies have characterized the molecular basis for the association found between malnutrition and the disease. Vitamin A supplementation has long been used in developing countries to prevent mortality by diarrheal and respiratory diseases, but there are no studies on the role of vitamin A in Leishmania infection, although we and others have found vitamin A deficiency in visceral Leishmaniasis (VL). Regulatory T cells are induced in vitro by vitamin A metabolites and are considered important cells implicated T CD4+ cell suppression in human VL. This work aimed to examine the correlation of nutritional status and the effect of vitamin A in the response against Leishmania infantum infection. A total of 179 children were studied: 31 had active VL, 33 VL history, 44 were DTH+ and 71 were DTH- and had negative antibody to Leishmania (DTH-/Ac-). Peripheral blood monuclear cells were isolated in a subgroup of 10 active VL and 16 DTH-/Ac- children and cultivated for 20h under 5 different conditions: 1) Medium, 2) Soluble promastigote L. infantum antigens (SLA), 3) All-trans retinoic acid (ATRA), 4) SLA + ATRA and 5) Concanavalin A. T CD4+CD25highFoxp3+, T CD4+CD25-Foxp3- and CD14+ monocytes were stained and studied by flow cytometry for IL-10, TGF-β and IL-17 production. Nutritional status was compromised in VL children, which presented lower BMI/Age and retinol concentrations when compared to healthy controls. We found a negative correlation between nutritional status (measured by BMI/Age and serum retinol) and anti-Leishmania antibodies and acute phase proteins. There was no correlation between nutritional status and parasite load. ATRA presented a dual effect in Treg cells and monocytes: In healthy children (DTH-/Ac-), it induced a regulatory response, increasing IL-10 and TGF-β production; in VL children it modulated the immune response, preventing increased IL-10 production after SLA stimulation. Furthermore, we found a positive correlation between BMI/Age and IL-17 production and negative correlation between serum retinol and IL-10 and TGF-β production in T CD4+CD25highFoxp3+ cells after SLA stimulus. Our results show a potential dual role of vitamin A in the immune system: improvement of regulatory profile during homeostasis and down modulation of IL-10 in Treg cells and monocytes during symptomatic VL. Therefore, the use of vitamin A concomitant to VL therapy might improve recovery from disease status in Leishmania infantum infection

Influência do tempo e dose de heparina em modelo de peritonite aguda

In the last years, heparin has become target of many studies related to inflammation due its ability of biding to proteins involved on immune response. Recently, it was demonstrated, at our laboratory, using a thIoglycollate-induced peritonitis model, heparin s capacity of reduce cellular influx into the peritoneal cavity, 3 hours after the inflammatory stimulus. Once neutrophilic infiltration is highest around 8 hours after the inflammatory stimulus, at the present work, using the same peritonitis model, it was assessed heparin s ability of keeping the interference on leukocyte infiltration, 8 hours after inflammation induction. Moreover, using cellular differential count, it was evaluated how the cellular populations involved in the inflammatory process would be affected by the treatment. Eight hours after the inflammatory stimulus, only heparin dosage of 1 μg/Kg was able to reduce the cellular influx to peritoneum, 62.8% of reduction when compared to positive control (p < 0.001). Furthermore, heparin dosage of 15 μg/Kg presented a pro-inflammatory effect in whole blood verified by the increase of 60.9% (p < 0.001) and 117.8% (p < 0.001) on neutrophils and monocytes proportion, respectively, when compared to positive control. In addition, this dosage also presented a neutrophilic proportion on peritoneal fluid 27.3% higher than positive control (p < 0.05). This duality between anti- and pro-inflammatory effects at different times corroborates studies that attribute a pleiotropic immunomodulator role to heparin.

Efeitos da microgravidade em plantas de cana-de-açúcar

Sugarcane (Saccharum spp.) is a plant from Poaceae family that has an impressive ability to accumulate sucrose in the stalk, making it a significant component of the economy of many countries. About 100 countries produce sugarcane in an area of 22 million hectares worldwide. For this reason, many studies have been done using sugarcane as a plant model in order to improve production. A change in gravity may be one kind of abiotic stress, since it generates rapid responses after stimulation. In this work we decided to investigate the possible morphophysiological, biochemical and molecular changes resulting from microgravity. Here, we present the contributions of an experiment where sugarcane plants were submitted to microgravity flight using a vehicle VSB-30, a sounding rocket developed by Aeronautics and Space Institute teams, in cooperation with the German Space Agency. Sugarcane plants with 10 days older were submitted to a period of six minutes of microgravity using the VSB-30 rocket. The morphophysiological analyses of roots and leaves showed that plants submitted to the flight showed changes in the conduction tissues, irregular pattern of arrangement of vascular bundles and thickening of the cell walls, among other anatomical changes that indicate that the morphology of the plants was substantially influenced by gravitational stimulation, besides the accumulation of hydrogen peroxide, an important signaling molecule in stress conditions. We carried out RNA extraction and sequencing using Illumina platform. Plants subjected to microgravity also showed changes in enzyme activity. It was observed an increased in superoxide dismutase activity in leaves and a decreased in its activity in roots as well as for ascorbate peroxidase activity. Thus, it was concluded that the changes in gravity were perceived by plants, and that microgravity environment triggered changes associated with a reactive oxygen specie signaling process. This work has helped the understanding of how the gravity affects the structural organization of the plants, by comparing the anatomy of plants subjected to microgravity and plants grown in 1g gravity

Efeito anti-inflamatório do heparinóide isolado do camarão Litopenaeus vannamei sobre a peritonite aguda

In recent years the heparin has been the subject of several studies that aim to expand its use as a therapeutic agent, due to its ability to modulate the activity of various proteins that play important roles in the regulation of pathophysiological processes. In several experiments and preclinical trials, heparin has demonstrated an anti-inflammatory role. However, its clinical use is limited, due to its strong anticoagulant activity and hemorrhagic complications. For this reason, considerable efforts have been employed in discovery of heparin analogous (heparinoid) with reduced side effects, that retain the anti-inflammatory properties of heparin. In this context, a heparinoid obtained from the head of Litopenaeus vannamei shrimp, which presents a structural similarity to heparin, showed, in previous studies, anti-inflammatory activity in a model of acute peritonitis with reduced anticoagulant effect in vitro and low hemorrhagic activity. Thus, the present work had as objective to evaluate the effect the heparinoid of the cephalothorax of gray shrimp on the acute inflammatory response in different times (3 or 6 hours after the induction of inflammatory stimulus), using the model of acute peritonitis induced in mice. It was also analyzed the HL effect over the activity of elastase, an enzyme involved in leukocyte recruitment. Furthermore to check if the different doses of heparin and heparinoid change the hemostatic balance in vivo, was assessed the effect of these compounds on the plasma clotting time in animals submitted to inflammation. The results show that in 3 hours, all doses of heparinoid were able to prevent efficiently in the acute inflammatory process without any anticoagulant effects, unlike the extrapolation dose of heparin, which has induced a large hemorrhage due its high anticoagulant activity. However, 6 hours after induction of inflammation, only the dosages of 0.1 and 1.0 μg/Kg of heparin and 1.0 μg/Kg of heparinoid kept anti-migratory effect, without changing of the hemostatic balance. These results indicate that the anti-migratory effect of theses compounds depends on the dosage and time of inflammatory stimulus. The HL and heparin were also able to inhibit the activity of the enzyme elastase. The discovery of this bioactive compound in the cephalothorax of shrimps can arouse great interest in biotechnology, since this compound could be useful as a structural model interesting for the development of new therapeutic agents for peritonitis

Investigação do papel modulador do Haloperidol sobre os níveis de proteínas relacionadas à plasticidade e preferência por objetos novos em camudongos

Dopamine (DA) is known to regulate both sleep and memory formations, while sleep plays a critical role in the consolidation of different types of memories. We believe that pharmacological manipulation of dopaminergic pathways might disrupt the sleep-wake cycle, leading to mnemonic deficits, which can be observed in both behavioral and molecular levels. Therefore, here we investigated how systemic injections of haloperidol (0.3 mg/kg), immediately after training in dark and light periods, affects learning assessed in the novel object preference test (NOPT) in mice. We also investigated the hippocampal levels of the plasticity-related proteins Zif-268, brain-derived neurotrophic factor (BDNF) and phosphorylated Ca2+/calmodulin-dependent protein kinases II (CaMKII-P) in non-exposed (naïve), vehicle-injected controls and haloperidol-treated mice at 3, 6 and 12 hours after training in the light period. Haloperidol administration during the light period led to a subsequent impairment in the NOPT. In contrast, preference was not observed during the dark period neither in mice injected with haloperidol, nor in vehicle-injected animals. A partial increase of CaMKII-P in the hippocampal field CA3 of vehicle-injected mice was detected at 3h. Haloperidol-treated mice showed a significant decrease in the dentate gyrus of CaMKII-P levels at 3, 6 and 12h; of Zif-268 levels at 6h, and of BDNF levels at 12h after training. Since the mnemonic effects of haloperidol were only observed in the light period when animals tend to sleep, we suggest that these effects are related to REM sleep disruption after haloperidol injection

A Humanização e a Formação Médica na Perspectiva dos Estudantes de Medicina da Universidade Federal do Rio Grande do Norte

The aim of this study is to understand the perception of medical students at the Federal University of Rio Grande do Norte (UFRN) about humanization in the context of their medical formation, using a qualitative approach. The focus group and participant observation techniques were used, involving a multidisciplinary team composed of professionals from the areas of anthropology and psychology, as well as professors from the medical course, who studied two groups of nine students in their final year. The data were analyzed using the categorical thematic content analysis technique, from which emerged three categories: student/patient relationship, teaching/learning and student/professor relationship. The first allows us to identify that student-patient contact is an essential experience for adopting a more humanized view of the disease process. The second category shows that unqualified professors in the pedagogic practices inherent to the teaching profession and the theory the practical dichotomy hinder the autonomous and holistic formation of knowledge. Similarly, the lack of practices outside the academic environment and the absence of multiprofessional stimulation interfere in the construction of an integral view of the individual. From the third category, the student/professor relationship, emerge two opposing subcategories (professor model and assymetric relationships), which reflect the importance of the professor`s ethical humanist position, as opposed to an authoritarian attitude, to form the professional attitude of the student. The results point important aspects of the medical formation that may open a discussion about humanization, in the context of new national curricular guidelines

Representações sociais dos trabalhadores de saúde da atenção básica sobre envelhecimento e o atendimento ao idoso

This study aims to identify the social representations built on senior care health workers of Primary Care. This is an exploratory research within the subsidized social representations held in 100 Basic Health Units in the city of João Pessoa-PB, with a sample of n= 204 workers of both sexes, who agreed to participate. To collect the data used to set an interview in two parts: the first looked at the Test of Free Association of Words using the inductive stimulus "senior care". The interviews were analyzed with the help of a software for quantitative analysis of textual data ALCESTE (version 2010). The results were interpreted from the theoretical framework of social representations. The study included 178 women (87.25%) and 26 men (12.75%), working in Family Health Units in the city of João Pessoa, the majority are aged between 40-49 years of age ( 28.92%), and have higher education with 81.86%. The results of Alceste link to the term inducer six (6) where the hierarchical classes representing senior care workers as synonymous with care and attention, showing situations neglect of the elderly, for that patience is required to promote the increase of disease prevention and living with the elderly to generate humanization in health services. It is considered that the social representations of health workers on assistance to the elderly may support modeling of strategic actions in health services with health promotion programs for large groups, able to modify practices and behavior in elder care and strengthening the policy was directed at the elderly

Representações sociais de enfermeiros brasileiros e portugueses sobre o estresse em serviço de urgência

This study aimed to analyze the social representations of Brazilian and Portuguese nurses on stress in the emergency service. A semi-structured interview and the free word association test, with "stress" as the inductive stimulus, were used as research instruments. Data were collected from 120 nurses, being 60 from an emergency hospital in the city of Natal, Brazil and 60 from an urgency hospital in the city of Aveiro, Portugal. Data from the word association test were analyzed with the EVOC 2002 program, after thematic categorical content analysis, enabling construction of a data bank. Data gathered from the interview were analyzed by ALCESTE 4.8 software. Nurse represent the stress in the urgency department as a generation of physical and mental detrition where adaptation is unsatisfactorily, resulting in the onset of fatigne, irritability, lack of concentration, lack of motivation, pessimism, impaired interpersonal relationship and low productivity. The solution is part of a complex whole, which demands an integrated way of acting that has demanded increasingly professional attitudes based on multidisciplinarity