Brazil and the institutionalization of South America: from hemispheric estrangement to cooperative hegemony

This article argues that Brazil went from a posture of estrangement in relation to the hemispheric project represented by the Free Trade Area of the Americas (FTAA) to a strategy of cooperative hegemony aimed at institutionalizing the South American space and increasing the costs of the FTAA for the United States. Although Brazil was initially isolated, US lack of leadership combined with events at the subregional level ended up turning the tide in the direction of Brazilian interests. These factors help to understand the current institutional configuration of South America.

Reviewing horizontalization: the challenge of analysis in Brazilian foreign policy

Abstract This article presents the increasing demands over the Brazilian Ministry of Foreign Affairs (Itamaraty) for opening its doors to other actors. This discussion will be followed by relevant theoretical and methodological analysis. We will defend the need to overcome problems related to: 1) conceptual vagueness about what the concept of participation means; 2) lack of clarity in the baseline to which comparisons are made; 3) fragile empirical basis; 4) limitations on the use of sources; and 5) how to understand the impact exerted by systemic forces.

Glucosamine and chondroitin sulfate in the repair of osteochondral defects in dogs - clinical-radiographic analysis

Among the proposed treatments to repair lesions of degenerative joint disease (DJD), chondroprotective nutraceuticals composed by glucosamine and chondroitin sulfate are a non-invasive theraphy with properties that favors the health of the cartilage. Although used in human, it is also available for veterinary use with administration in the form of nutritional supplement independent of prescription, since they have registry only in the Inspection Service, which does not require safety and efficacy testing. The lack of such tests to prove efficacy and safety of veterinary medicines required by the Ministry of Agriculture and the lack of scientific studies proving its benefits raises doubts about the efficiency of the concentrations of such active substances. In this context, the objective of this study was to evaluate the efficacy of a veterinary chondroprotective nutraceutical based on chondroitin sulfate and glucosamine in the repair of osteochondral defects in lateral femoral condyle of 48 dogs, through clinical and radiographic analysis. The animals were divided into treatment group (TG) and control group (CG), so that only the TG received the nutraceutical every 24 hours at the rate recommended by the manufacturer. The results of the four treatment times (15, 30, 60 and 90 days) showed that the chondroprotective nutraceutical, in the rate, formulation and administration at the times used, did not improve clinical signs and radiologically did not influence in the repair process of the defects, since the treated and control groups showed similar radiographic findings at the end of the treatments.

Effects of levels of potassium and nitrogen on yields and post-harvest conservation of onions in winter

Potassium and nitrogen are the elements present in the highest percentage in the onion dry matter. The objective of this experiment was to evaluate yield and post-harvest conservation of Vale Ouro IPA-11 onion cultivar regarding to nitrogen and potassium levels. The experiment was carried out in Petrolina-PE, Brazil, from June to September 2009. The experimental design was a completely randomized block in a 4 x 3 factorial design, composed of four nitrogen levels (0, 60, 120 and 180 kg ha-1) and three potassium levels (0, 90 and 180 kg ha-1) with three replications. The highest yield of commercial bulbs was achieved at an estimated N level of 172.6 kg ha-1. The lowest yield of noncommercial bulbs was estimated at N level of 147.0 kg ha-1. Lower percentage of smaller bulbs (class 2) were obtained by increasing levels of N x K, with a quadratic effect at the dose of 90 kg ha-1 K2O and minimum production point with 127.6 kg N ha-1 (20.3%). Regarding larger caliber bulbs (class 4), linear effects were found both in the absence and for the level of 90 kg ha-1 of K2O as levels of N were increased. When the highest level of 180 kg ha-1 K2O was applied, the level of 92.8 kg ha-1 of N was estimated as the one that would promote the highest bulb yield of this class (35.4%), and 5.3% was found in the lack of potassium fertilization.

Contemporary issues in the government and administration of Latin American megacities

This paper is the first to systematically analyze and compare the structures of city governance and administration for seven major cities in Latin America, four of which are megacities (population of over 10 million), and three others are large national capitals. U.S. and U. K. models of city administration are reviewed as baseline models against which differences in Latin American may be explored. Structures of Government in Latin America show several important features and trends: 1) the lack of metropolitan (cross jurisdictional) authority; 2) the existence of strong mayors and weak councils"; 3) high levels of partisanship; 4) overlapping rather than interlocking bureaucracies; 5) pressures towards the privatization of city services, but continuing tension over the desirability of public versus private control; 6) greater fiscal responsibility and autonomy; and 7), a continuing marginalization of public participation in megacity governance.In spite of these features, many cities throughout the region (regardless of whether they are megacity size or national capitals), are actively intensifying their efforts to develop more effective, accountable and democratic governance structures.

How logrolling can explain the failure of the government coalition in Brazil

This article presents an analysis of the behavior of federal representatives in the Brazilian House of Representatives between 1995 and 1998, when a series of constitutional amendments were presented by the president to be voted on by Congress. The objective is to show that the lack of a stable government coalition resulted in costs to society that were not anticipated by the government. The study argues that a logroll - a trade of votes - was the strategy used by the government in order to guarantee the number of votes necessary to approve the amendments. This strategy created a vicious system in which representatives would only vote with the government if they had benefits in return.

Ensuring dynamic strategic fit of firms that compete globally in alliances and networks: proposing the Global SNA - Strategic Network Analysis - framework

In order to sustain their competitive advantage in the current increasingly globalized and turbulent context, more and more firms are competing globally in alliances and networks that oblige them to adopt new managerial paradigms and tools. However, their strategic analyses rarely take into account the strategic implications of these alliances and networks, considering their global relational characteristics, admittedly because of a lack of adequate tools to do so. This paper contributes to research that seeks to fill this gap by proposing the Global Strategic Network Analysis - SNA - framework. Its purpose is to help firms that compete globally in alliances and networks to carry out their strategic assessments and decision-making with a view to ensuring dynamic strategic fit from both a global and relational perspective.

The institutional configuration of sport policy in Brazil: organization, evolution and dilemmas

Brazil has become the center of the spotlight of the whole world recently, amongst many other reasons, one of them was because it was chosen to host a series of mega sporting events - Pan American Games in 2007, Confederations Football Cup in 2013, Fifa Football World Cup 2014 Games and 2016 Olympic and Paralympic Games in 2016. However, little is known about the country's administrative governmental structure focused on sport policy. The available studies focus their analysis on the sport policies content, but not on the arrangement of its structural decision-making. The main aim of this article is indeed to describe, based on official documentation, the evolution and the current arrangements of the government responsible for the administrative structure for the planning and implementation of sports policies in Brazil. Thus, we tried to list the main problems arising from the organization of the Brazilian sports' management. These problems are: (1) inappropriate institutional structure in terms of human resources and obstacles to participation by other social actors beyond the officials (parliament and members of the Ministry of Sports) in the sports policy; (2) disarticulation between public institutions generating redundancies and conflicts of jurisdiction due to the poor division of labor between bureaucracy agencies; and (3) inadequate planning proved by the lack of organization of some institutions, and by the lack of assessment and continuity of public policies over time. Therefore, we must emphasize those problems from above, and due to these administrative arrangements, Brazilian sports' policy has big challenges in the sport development in this country, which includes the creation of a national "system" for sports and a priority investment in sport education.

Nutritional status of children of urban low-income communities, Brazil (1986)

During the second half of 1986 the health and nutritional status of 254 children aged up to six years was studied, as well as the socio-economic situation of their parents in two favelas (shantytowns) in Belo Horizonte, Brazil. The nutritional status of the children was characterized by stunting (Z-score: 20.1% < -2) but not by wasting (Z-score: 3.7% < -2). Consideration was also given to how far stunting was caused by high morbidity such as acute respiratory infections (point prevalence: 38.5%), diarrheal diseases (point prevalence: 11.5%) and parasitosis (point prevalence: 70.3%). Furthermore, anemia (point prevalence: 29.7%) appeared as another health problem. The most important determinant of anthropometric indices turned out to be the mother's schooling. From the present data it can be hypothesized that the nutritional status of the children was limited less by the lack of food than by their poor health status.

Mortality among patients with non-affective functional psychoses in a metropolitan area of South-Eastern Brazil

High mortality rates among those suffering from schizophrenia and related psychoses have been consistently described in developed societies. However, to date there is a lack of data on this matter in Brazil. In order to examine this issue, a prospective 2-year follow-up study was carried out in S. Paulo. The sample consisted of 120 consecutive admissions to psychiatric hospitals in a defined catchment area, aged 18 to 44 years old, with clinical diagnoses of non-affective functional psychoses according to the ICD-9. After 2 years, 116 (96.7%) subjects were traced. During the study period there were 7 deaths (6.0% of those traced), 5 (4.3%) due to suicide. All but one of the suicides occurred in the first year after discharge from hospital. Age and sex Standardised Mortality Ratios (relative to rates for the population of the city of Sao Paulo) were 8.4 for overall mortality (95% confidence interval: 4.0-15.9) and 317.9 for deaths due to suicide (95% confidence interval: 125.2-668.3). These results are in agreement with previous studies, and show that in Brazil non-affective functional psychoses are life-threatening illnesses, which need adequate care, particularly when patients go back to live in the community after hospital discharge.

Comparative evaluation of underlying causes of death processed by the Automated Classification of Medical Entities and the Underlying Cause of Death Selection Systems

INTRODUCTION: The correct identification of the underlying cause of death and its precise assignment to a code from the International Classification of Diseases are important issues to achieve accurate and universally comparable mortality statistics These factors, among other ones, led to the development of computer software programs in order to automatically identify the underlying cause of death. OBJECTIVE: This work was conceived to compare the underlying causes of death processed respectively by the Automated Classification of Medical Entities (ACME) and the "Sistema de Seleção de Causa Básica de Morte" (SCB) programs. MATERIAL AND METHOD: The comparative evaluation of the underlying causes of death processed respectively by ACME and SCB systems was performed using the input data file for the ACME system that included deaths which occurred in the State of S. Paulo from June to December 1993, totalling 129,104 records of the corresponding death certificates. The differences between underlying causes selected by ACME and SCB systems verified in the month of June, when considered as SCB errors, were used to correct and improve SCB processing logic and its decision tables. RESULTS: The processing of the underlying causes of death by the ACME and SCB systems resulted in 3,278 differences, that were analysed and ascribed to lack of answer to dialogue boxes during processing, to deaths due to human immunodeficiency virus [HIV] disease for which there was no specific provision in any of the systems, to coding and/or keying errors and to actual problems. The detailed analysis of these latter disclosed that the majority of the underlying causes of death processed by the SCB system were correct and that different interpretations were given to the mortality coding rules by each system, that some particular problems could not be explained with the available documentation and that a smaller proportion of problems were identified as SCB errors. CONCLUSION: These results, disclosing a very low and insignificant number of actual problems, guarantees the use of the version of the SCB system for the Ninth Revision of the International Classification of Diseases and assures the continuity of the work which is being undertaken for the Tenth Revision version.

Epidemiological aspects of centipede (Scolopendromorphae: Chilopoda) bites registered in Greater S. Paulo, SP, Brazil

INTRODUCTION: The lack of basic knowledge on venomous arthropods and the benignity of the clinical manifestations contribute to the centipede bite victims' not being taken to a treatment reference center, leading to underestimation of the number of cases and minimizing the possibility of a broader epidemiological view. An inventory of the centipede bite occurrences in Greater S. Paulo, Brazil, and the therapeutic methods employed, by the main Brazilian medical center for the notification of poisoning by venomous animals, is presented. METHOD: All patient cards of the period 1980-1989 have been checked as to place, month and time of occurrence; sex, age, affected part of the body, signs and symptoms have been observed, as well as the therapeutic methods employed. The centipedes that caused the accidents were identified at the Arthropods Laboratory. RESULTS: It was registered 216 accidents, with a 69% predominance of the Greater S. Paulo and in only 63% of the cases (136) was the agent brought in by the victim for identification. The genera most frequently represented were Cryptops (58%), Otostigmus (33%) and Scolopendra (4%). Of the 136 cases, 87% showed erythema, edema, hemorrhage, burns, cephalalgia, and intense pain. There was a predominance of accidents in the warm rainy season, in the morning and for females between 21 and 60 years of age. Hands and feet were the parts of the body most affected. The benign evolution of the clinical picture (54%) made therapeutical treatment unnecessary. Only the victims of Scolopendra and Otostigmus (46%) were medicated with anesthetics (51%), analgesics (25%), antihistamines and cortisone (24%). CONCLUSION: The reproductive period of the centipedes, associated with their sinanthropic habits, contributes to the greater incidence of accidents in urban areas in the warm rainy season. Only patients bitten by Scolopendra and Otostigmus require therapeutical treatment.

Epidemiological methods for research with drug misusers: review of methods for studying prevalence and morbidity

Epidemiological studies of drug misusers have until recently relied on two main forms of sampling: probability and convenience. The former has been used when the aim was simply to estimate the prevalence of the condition and the latter when in depth studies of the characteristics, profiles and behaviour of drug users were required, but each method has its limitations. Probability samples become impracticable when the prevalence of the condition is very low, less than 0.5% for example, or when the condition being studied is a clandestine activity such as illicit drug use. When stratified random samples are used, it may be difficult to obtain a truly representative sample, depending on the quality of the information used to develop the stratification strategy. The main limitation of studies using convenience samples is that the results cannot be generalised to the whole population of drug users due to selection bias and a lack of information concerning the sampling frame. New methods have been developed which aim to overcome some of these difficulties, for example, social network analysis, snowball sampling, capture-recapture techniques, privileged access interviewer method and contact tracing. All these methods have been applied to the study of drug misuse. The various methods are described and examples of their use given, drawn from both the Brazilian and international drug misuse literature.

Effects of health decentralization, financing and governance in Mexico

OBJECTIVE: To identify the effects of decentralization on health financing and governance policies in Mexico from the perspective of users and providers. METHODS: A cross-sectional study was carried out in four states that were selected according to geopolitical and administrative criteria. Four indicators were assessed: changes and effects on governance, financing sources and funds, the final destination of resources, and fund allocation mechanisms. Data collection was performed using in-depth interviews with health system key personnel and community leaders, consensus techniques and document analyses. The interviews were transcribed and analyzed by thematic segmentation. RESULTS: The results show different effectiveness levels for the four states regarding changes in financing policies and community participation. Effects on health financing after decentralization were identified in each state, including: greater participation of municipal and state governments in health expenditure, increased financial participation of households, greater community participation in low-income states, duality and confusion in the new mechanisms for coordination among the three government levels, absence of an accountability system, lack of human resources and technical skills to implement, monitor and evaluate changes in financing. CONCLUSIONS: In general, positive and negative effects of decentralization on health financing and governance were identified. The effects mentioned by health service providers and users were related to a diversification of financing sources, a greater margin for decisions around the use and final destination of financial resources and normative development for the use of resources. At the community level, direct financial contributions were mentioned, as well as in-kind contributions, particularly in the form of community work.

Knowledge, attitude and practice of mammography among women users of public health services

OBJECTIVE: To evaluate knowledge, attitude and practice related to mammography among women users of local health services, identifying barriers to its performance. METHODS: A total of 663 women were interviewed at 13 local health centers in a city of Southeastern Brazil, in 2001. Interviewees were randomly selected at each center and they were representative from different socioeconomic conditions. The number of interviewees at each center was proportional to monthly mean appointments. For data analysis, answers were described as knowledge, attitude, practice and their respective adequacies and then they were correlated with control variables through the chi-square test. RESULTS: Only 7.4% of the interviewees had adequate knowledge on mammography, while 97.1% of women had an adequate attitude. The same was seen for the practice of mammography that was adequate in 35.7% of the cases. The main barrier to mammography was lack of referral by physicians working at the health center (81.8%). There was an association between adequacy of attitude and five years or more of education and being married. There was also an association between adequacy of mammography practice and being employed and family income up to four minimum wages. CONCLUSIONS: Women users of local health services had no adequate knowledge and practice related to mammography despite having an adequate attitude about this exam.