Problems and perspectives for Chagas disease control: in search of a realistic analysis

Chagas disease was an important medical and social problem in almost all of Latin America throughout the twentieth century. It has been combated over a broad swath of this continent over recent decades, with very satisfactory results in terms of vector and transfusional transmission. Today, a surveillance stage still remains to be consolidated, in parallel with appropriate care required for some millions of infected individuals who are today living in endemic and non-endemic areas. Contradictorily, the good results attained have generated excessive optimism and even disregard among health authorities, in relation to this disease and its control. The loss of visibility and priority may be a logical consequence, particularly in Latin American healthcare systems that are still disorganized and overburdened due to insufficiencies of financial and human resources. Consolidation of the victories against Chagas disease is attainable but depends on political will and continual attention from the most consequential protagonists in this struggle, especially the Latin American scientific community.

Perceptions of the usefulness of external support to immunization coverage in Guinea-Bissau: a Delphi analysis of the GAVI-Alliance cash-based support

INTRODUCTION: Although many countries have improved vaccination coverage in recent years, some, including Guinea-Bissau, failed to meet expected targets. This paper tries to understand the main barriers to better vaccination coverage in the context of the GAVI-Alliance (The Global Alliance for Vaccines and Immunisation) cash-based support provided to Guinea-Bissau. METHODS: The analysis is based on a document analysis and a three round Delphi study with a final consensus meeting. RESULTS: Consensus attributed about 25% of the failure to perform better to implementation problems; and about 10% to governance and also 10% to scarce resources. The qualitative analysis validates the importance of implementation issues and upgraded the relevance of the human resources crisis as an important drawback. The recommendations were balanced in their upstream-downstream focus but were blind to health information issues and logistical difficulties. CONCLUSIONS: It is commendable that such a fragile state, with all sorts of barriers, manages to sustain a slow steady growth of its vaccination coverage. Not reaching the targets set reflects the inappropriateness of those targets rather than a lack of commitment of the health workforce. In the unstable context of countries such as Guinea-Bissau, the predictability of the funds from global health initiatives like the GAVI-Alliance seem to make all the difference in achieving small consistent health gains even in the presence of other major bottlenecks.

The bussola study. Final results, conclusions and proposals

OBJECTIVE: To evaluate the use of thrombolytic and acetylsalicylic acid therapies in acute myocardial infarct patients as well as the availability of technical and human resources for the care of these patients in the emergency units of the city of Rio de Janeiro. Additional objectives were the evaluation of the use of primary angioplasty and the level of acceptance of SBC /RJ as an entity responsible for programs of continued medical education. METHODS: Interviews with physicians at 46 emergency units in the city of Rio de Janeiro. RESULTS: Of the 46 emergency units inspected, a policy of encouragement to use thrombolytic therapy was only prescribed in 6.5%. In 1/3 of the public wards no thrombolytic agents were available, and in none of them was access to primary angioplasty regularly available; 45.9% did not offer the minimal conditions required for the handling of cases of acute myocardial infarction; 60% of the physicians on-call (at both public and private emergency units), appeared not to know the importance of the use of acetylsalicylic acid in acute myocardial infarct patients; all physicians interviewed would participate in programs of continued medical education organized by the SBC/RJ. CONCLUSION: The study suggests there was: 1) the low probability of the use of thrombolytic therapy in the majority of the emergency units in of the city of Rio de Janeiro due to the inadequate policy of waiting for the transfer of the patient to coronary or intensive care unit; 2) a low awareness to the importance of early use of acetylsalic acid in acute myocardial infarct; 3) half of the emergency units of the public net do not have the minimal conditions required for the handling of cases of acute myocardial infarction; 4) a high level of credibility exists that would enable the SBC/RJ to set up programs for continued medical education to change the mentality regarding the use of thrombolytic therapy and of acetylsalicylic acid.

Organization of healthcare and assistance to the elderly indigenous population: synergies and particularities of the professional context

This study aimed to describe the effects of the organization of primary healthcare on the assistance provided to the elderly Kaingang population, according to the perception of health professionals that work in this area. It is a qualitative and descriptive study, supported by ethnography methodological references, and was conducted with ten healthcare professionals that work in Faxinal, an indigenous territory in the state of Paraná, in Brazil. Data was collected from November 2010 to February 2012 through participant observation and interviews. The results revealed that health professionals strive to meet the health needs of the elderly Kaingang people; however, there are negative effects that hinder the professional care, especially limited human resources, lack of training and material resources, heavy workload and high turnover rates. This study highlights the need to improve work conditions in order to provide better healthcare.

Direct Cost of Reprocessing Cotton-woven Surgical Drapes: a Case Study

OBJECTIVE Identify the direct cost of reprocessing double and single cotton-woven drapes of the surgical LAP package. METHOD A quantitative, exploratory and descriptive case study, performed at a teaching hospital. The direct cost of reprocessing cotton-woven surgical drapes was calculated by multiplying the time spent by professionals involved in reprocessing the unit with the direct cost of labor, adding to the cost of materials. The Brazilian currency (R$) originally used for the calculations was converted to US currency at the rate of US$0.42/R$. RESULTS The average total cost for surgical LAP package was US$9.72, with the predominance being in the cost of materials (US$8.70 or 89.65%). It is noteworthy that the average total cost of materials was mostly impacted by the cost of the cotton-woven drapes (US$7.99 or 91.90%). CONCLUSION The knowledge gained will subsidize discussions about replacing reusable cotton-woven surgical drapes for disposable ones, favoring arguments regarding the advantages and disadvantages of this possibility considering human resources, materials, as well as structural, environmental and financial resources.

Alguns aspectos da política nacional de ciência e tecnologia

The Brazilian industrialisation process, which occurred from World War II up to the early eighties, was almost totally based on imported technology and has thus not demanded local S&T capability. National S&T expenditures were limited to 0.7 % of the GNP, covering mainly expenses with basic research and training of scientists and engineers. Federal Government was then responsible for 90% of the national S&T expenditures. The globalisation of the economy, associated with the reduction of tariff barriers, has, since the early nineties, exposed Brazilian industries to international competition and, thus, forced them to invest in research and development. S&T policy fosters research activities, provides research infrastructure and human resources training. The goal is to raise national expenditures to 1.5% of GDP by 1999, with a share of the private sector of about 40%. In 1996, national S&T expenditures have already attained 1.1% of the GDP and private sector investments in this area reached a share of 30%.

O impacto do PADCT na química brasileira: uma visão acadêmica

An appraisal has been conducted of the impact PADCT (Support Program for Scientific and Technological Development) has caused on brazilian Chemistry and Chemical Engineering over a ten years period (1985-1995). During this time PADCT invested US$ 87.5 million dollars to support both scientific and technolgical development of chemistry. The main results, from an academic point of view, has been the strengthening of support services for academic research, including libraries and analytical facilities, and a consequent increase of the number and quality of human resources trained at the graduate level as well as a significant increase in the number of scientific publications.

Desenvolvimento da Química Inorgânica no Brasil

This article focuses on the development of Inorganic Chemistry in Brazil, including historical perspectives, scientific production (WEB-ISI data), international cooperation, teaching, literature and human resources, with particular emphasis on the last 25 years.

Avaliação dos programas de pós-graduação em química no Brasil: versão 2002

The graduate programs in Chemistry were evaluated and classified from the data collected for the period 1998-2000 by CAPES, the Minister of Education agency that is responsible for the regulation and support of this level of human resources formation. The next classification will be made in 2004, from the data of the period 2001-2003. The years in between, like the present year, are used for an evaluation without classification, from what comments are emitted to the programs to know how their data are improving or not, before the new ranking reporting. The progresses in the area of chemistry in Brazil are analysed from the confrontation of the present data with that of all previous evaluations, since 1983. The results confirm that the research and graduate formation in the area of Chemistry is continuously improving in Brazil, particularly during the last seven years.

A formação do Químico

Training of highly qualified personnel is the most transversal axis among those identified in the document "Mobilizing Axes in Chemistry", published by SBQ, in 2002, which demands to deep the discussions, initiated in the symposium "The Chemist's Education", whose main objective was to discuss the repercussions of that training in the teaching and in the industrial section. After the publication of an initial paper, a couple of meetings and workshops held in Rio de Janeiro, in December 2003, involving the national chemist community, discussed the "The role of the graduate degrees in the Chemist's Education" and "The Chemist's Education", and confirmed the need to invest in the formation of qualified human resources in profusion and in all levels. Actions to be taken were delineated. Presently, the graduate programs in Chemistry are showing expressive results. However, although these professionals are mostly absorbed by the academy (the absorption of the industry is less significant), only a few programs give special attention to the didactical and pedagogical training. The regional decentralization is actually a tendency in most programs, but the interaction academy-economic activities is still a challenge. It is necessary to establish with the industrial section, the highly qualified professional's profile in Chemistry that the industry can absorb. The undergraduation is growing in number and quality, however still excessively concentrated in the Southeast area. The national "Curricula Guidelines" for Chemistry Courses, through its flexible approach, propitiate the integral, interdisciplinary (non compartmentalized) and critical-reflexive training of the professionals as citizens and as entrepreneurs. However, deficiencies are still recognized. The evaluation system of undergraduate courses has been able to identify the most fragile modalities of courses and other indicators. It was also verified that Brazilian chemistry industry absorbs minimally the highly qualified professionals, which is attributed to the fact that the Federal Council of Chemistry is vertically organized and does not recognize the graduate degrees as professional qualification. In the conclusion, it stands out, among other aspects, the importance of the effective implantation of the national curricula guidelines, bringing out courses whose didactical and pedagogical projects may offer a solid formation in Chemistry, but comprehensive and general enough to enable the Chemistry professionals to develop varied skills.

Planejamento participativo no subprograma QEQ do PADCT

The development of the Brazilian chemistry sector, during the last 30 years, is nowadays being attributed to PADCT (Science and Technology Development Program). Since the seventies, the Government took notice of the importance of research in chemistry for the Brazilian economy, therefore creating PADCT to support chemistry and chemical engineering among other areas of science and technology. Planning and implementation of the second phase of this program represented a real joint strategic planning. Since then, academic research and human resources education have experienced significant improvements. However, in the chemical trade, the deficit continues to grow, in spite of an almost constant ratio between importation costs and export revenues. Continued investments for research in the area remain necessary.

Recursos humanos para novos cenários

The Brazilian Chemical Society - SBQ has made substantial contributions to the formation of qualified human resources at all levels since its foundation in 1977. Several papers addressing this subject have been published in Quimica Nova by different authors over the last years. In this paper, we discuss the present need for "Curriculum Guidelines" for undergraduate education in Chemistry with actions to be taken in accord with the Principles of Green Chemistry and Sustainability.

Óleo da castanha de caju: oportunidades e desafios no contexto do desenvolvimento e sustentabilidade industrial

The new millennium is marked by a growing search for renewable fuels and alternative raw materials from biomass in the petrochemicals industry. However, there are many challenges to overcome regarding technological and human resources aspects. In this scenario, cashew nut oil, which is rich in natural phenols, is considered to be very promising for the development of synthetic and functional products and as a feedstock for production of fine chemicals and a wide variety of new materials.

Produção científica e formação de recursos humanos na área de bioquímica em instituições federais do Rio Grande do Sul: fomento estadual

Brazilian scientific production in Biochemistry is growing impressively fast, and Rio Grande do Sul is outstanding in that context. This study aims to outline the state's scientific research profile, given its prominent position in the national scenario. Hence, researchers, laboratories, development of human resources and investments by Foundation for the Support to Research in the State of Rio Grande do Sul (FAPERGS) were identified and mapped. We observed that amount of financial support by FAPERGS decreases in last years. Therefore, there is the necessity to reestablish some of FAPERGS's programs, as well as to increase financial support to Biochemistry departments.

Epistemological anarchism of Paul Karl Feyerabend and medical education

The thoughts of the philosopher Paul Karl Feyerabend brought important contributions to the debate on Science in the 20th century. Most recently his views about non-existence of a single method for doing science have been employed to rethink science education and propose the use of multiple methods for effective teaching-learning process. This article employs the theoretical framework of the author expressed in the book Against Method, 1977, about the epistemological anarchism and the methodological pluralism and uses it in the contemporary discussion of medical education.