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

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

Caracterização da dinâmica ambiental da região costeira do município de Galinhos, litoral setentrional do Rio Grande do Norte

This doctorate thesis concerning on the Characterization of the Environmental Dynamics of the Coastal Area of the Municipal district of Galinhos, Septentrional Coast of Rio Grande do Norte State, is located in the influence area of the Guamaré Petroliferous Pole, having as general objective the understanding of the active coastal dynamics in the region of Galinhos, whose specific objectives were: To study the variation of the coast line in the decades of 1954, 1967,1988, 1996, 2000, from remote sensing products; To elucidate the hypothesis of the region of Galinhos to have been an old system of islands barriers, using as basic tool the penetration radar in the soil - GPR; To monitor and to characterize the coastal dynamics of the study area starting from monthly data of beach profiles, sedimentological analysis, hydrodynamic data and environmental characterization data; which were used to feed the database of the N-NE network of Environmental Monitoring of Areas under Influence of the Petroliferous Industry;(REDE05/FINEP/CNPq/CTPETRO/ PETROBRAS). This research is justified, of the environmental point of view, by involving the mangrove ecosystem considered one of the most delicated environments of the State. From the viewpoint of the petroleum exploration, the systems of islands barriers are favorable for hydrocarbons reservoirs and, consequently important targets to the oil and gas industry, becoming this region attractive in comparison with similar lithified environments. With the results of the variability study in the position of the coast line in the Municipal district of Galinhos/RN from the analysis of remote sensing images, it was possible to investigate the changes in the coast line in temporal scale; the use of directional filters allowed to emphasize linings in the direction NE and to identify submerged features such as sandwaves. The use of GPR enabled the confirmation of paleochannels existence and thus confirmed the hypothesis that the Galinhos spit was formed from an old system of islands barriers. The results of the granulometric analyses indicated that in the summer period the sediments in the profiles A and B in the foreshore portion were classified with the granulometry of sand with scattered gravel and in the shoreface were constituted by sand, but in the winter period these same morphologic compartments were constituted by sand with sparse gravel and siltic sand respectively. In the profile C, in the summer and in the winter, the shoreface and foreshore compartments presented predominantly constituted by sand with sparse gravel. The hydrodynamic results showed that the largest wave heights were registered in the month of February (62 cm) and the highest period of 1,00 m/s in the month of May, the sense of the coastal currents was kept among the quadrants SW and NW, and the winds coming from NE were predominant. The analysis of the beach profiles demonstrated that in the profile A, although it had occurred erosion and deposition during the monitored months, the morphology of the referred profile was kept constant. In the profiles B and C, there were abrupt changes in the morphology, during the monitored months, having been identified a cyclic pattern in the features of the foreshore zone sometimes forming longitudinal sandy bars and in other times forming berm. These results evidenced, therefore, that studies of this nature are of fundamental importance for the coastal zoning, aiming subsidies to the organs managers in the closing of decisions as for the implantation of enterprises in the area, and for the industry of the petroleum through generation of information that subsidize the implementation and location of petroliferous structures adequate to this environment

Fotografia e marketing: uma análise dos atrativos turísticos da cidade de João Pessoa-PB

Photography is a resourse of the most used and effective marketing, besides being an polysemic art, boundless sense; this allows for different readings. Nevertheless, there are those who, through the control and supervision, try to organize its meaning, such as the marketing companies. Others, such as artists, are the responsibility of the observers to give their work some understanding. Resorting a photographic iconography of the tourist attractions of the city of João Pessoa in Brazil from 2005 to 2010. This survey selected images published in catalogs supported by the Fundo de Incentivo a Cultura (FIC) and the Empresa Paraibana de Turismo (PBTUR). The central idea of this qualitative research is the assumption that, in general, tourists crave, even unconsciously, a reality of a tourist attraction motivated by photographic image conveyed the travel market, meanwhile, emphasizes that the art market, the same attraction is exposed and uncovered. Thus it is argued, by photos, such as environmental and sociocultural characteristics are commodified by these organs that have different purposes is not exclusive, given that the FIC supports art and PBTUR sponsors the tourism. Beyond the iconography used for cataloging and photographic analysis, interviews were conducted by the method of visual narratives in ordes to approximate the data with the view of tourists and photographers. In that resulted in a refletion on the current imagistic process involving the release of the tourist destinations in order to be allowed on a critical reading of photographic production and market resources to marketing and promoting the art of the city. It was observed that both the art and photography marketing acquire different symbolic values with respect to their markets promoted by the catalogs analyzed.

Evidências de validade do Millon Behavioral Medicine Diagnostic: avaliação de indicadores de adesão ao tratamento em pacientes com hipertensão

Systemic Arterial Hypertension – SAH – is defined as the syndrome which its main feature is the presence of high tensional levels, associated with alterations of functional or structural levels in the organs that it strikes. Its specific causes are not very well bounded and have an asymptomatic character. Due to its chronicity it requires adherence to the treatment plan in a systematic and permanent manner, implicating in lifestyle changes, combined or not with the use of medication. The personality inventories have been largely used in the lineation of indicative traits of difficulties with the adherence to the treatment. In this sense, developed by Theodore Millon, the Millon Behavioural Medicine Diagnostic – MBMD is an instrument made from the consensus among healthcare professionals, aiming at identifying psychological factors that may compromise medical treatment so that they can be conducted in a way to enable a better adherence. Objective: evaluation of the evidence of validity of the Millon Behavioural Medicine Diagnostic – MBMD for a public of patients with hypertension, aiming at investigating the indicators implicated in the adherence or not to the anti-hypertensive treatment. Method: there was a group of 200 participants in a university hospital in the city of Natal/RN, males and females, ranging from 20 to 70 years old. An interview protocol was administered in order to obtain information about socio-demographic data, clinical history, healthcare habits and way of conducting treatment, and after, the administration of the MBMD followed. Results: by means of Factor Analysis it was verified that the organization proposed by the factors is favorable and it adjusts to the theory, allowing the visualization of other underlying constructs to the scales, with adequate adjustment indexes and satisfactory Cronbach’s alpha indicators. Besides, the MBMD revealed itself sensitive to the intragroup differences relative to the sex, age, schooling, marital status, profession, income, SAH history, diagnostic time, medication use, comorbidity presence, hyposodic diet, social support and adherence criteria variables. The utilization of such instrument in the evaluation of the adherence to the anti-hypertensive treatment show, therefore, indicators of validity.