Medico-legal litigation in Obstetrics: a characterization analysis of a decade in Portugal

PURPOSE: It was to analyse the most critical areas in Obstetrics and to suggest measures to reduce or avoid the situations most often involved in these disputes. METHODS: Obstetrics cases submitted to the Medico-legal Council since the creation of the National Institute of Legal Medicine and Forensic Sciences in 2001 until 2011 were evaluated. A comprehensive characterization, determination of absolute/relative frequencies, hypothesis of a linear trend over the years and the association between each parameter was done. RESULTS: The analysis has shown no significantly linear trend. The most common reasons for disputes were perinatal asphyxia (50%), traumatic injuries of the newborn (24%), maternal sequelae (19%) and issues related to prenatal diagnosis and/or obstetric ultrasound (5.4%). Perinatal asphyxia showed no significantly linear trend (p=0.58) and was usually related to perinatal deaths or permanent neurologic sequelae in newborn children. Traumatic injuries of the newborn, mostly related to instrumented deliveries, shoulder dystocia or vaginal delivery in breech presentation, has shown a significantly increased linear trend (p<0.001), especially related to instrumented deliveries. The delay/absence of cesarean section was the clinical procedure questioned in a significantly higher number of cases of perinatal asphyxia (68.7%) and of traumatic lesions of the newborn due to instrumented deliveries (20.5%). CONCLUSION: It is important to improve and correct theoretical/practical daily clinical performance in these highlighted areas, in order to reduce or even avoid situations that could end up in medico-legal litigations.

Fatores de associados à anemia em gestantes da rede pública de saúde de uma capital do Nordeste do Brasil

OBJETIVO: Avaliar os fatores associados à anemia em gestantes atendidas pela rede pública de saúde de uma capital do Nordeste do Brasil.MÉTODOS: Estudo de caráter transversal, envolvendo amostra (n=428) obtida, considerando a prevalência de anemia em gestantes (50%), um intervalo de confiança (IC) de 95%, um erro de 5% e uma perda amostral de 20%, sendo elegíveis gestantes que residiam no município e que eram atendidas pela rede pública de saúde municipal, das quais foram coletados dados socioeconômicos, de estilo de vida, clínicos, de consumo de ferro dietético, antropométricos e medida de hemoglobina capilar. A anemia foi identificada por um nível de hemoglobina <11 g/dL e sua associação com os fatores de risco foi testada por meio de análise de regressão múltipla de Poisson, com os resultados expressos pela Razão de Prevalência (RP) e IC95%.RESULTADOS: A prevalência de anemia foi de 28,3%, sendo maior naquelas gestantes com mais membros no domicílio (RP=1,49; IC95% 1,01-2,22; p=0,046) e naquelas que viviam com insegurança alimentar (RP=1,43; IC95% 1,00-2,04; p=0,047).CONCLUSÃO: A prevalência de anemia nas gestantes atendidas pela rede pública de saúde do município é um problema moderado de saúde pública, tornando necessário o planejamento de medidas efetivas para o seu controle.

Occurrences of anti-Toxoplasma gondii and anti-Neospora caninum antibodies in sheep from four districts of Tocantins state, Brazilian Legal Amazon Region

Toxoplasmosis and neosporosis have been recognized as economically important diseases with considerable impact on the livestock industry. Little is known concerning the occurrence of Toxoplasma gondii and Neospora caninum in sheep from Tocantins state, Brazil. Here, we investigated antibodies against these parasites and associated factors in 182 sheep from Araguaína, Santa Terezinha do Tocantins, Arguianópolis and Palmeiras do Tocantins districts, Tocantins. Sheep sera were assayed for T. gondii and N. caninum IgG antibodies by indirect fluorescence antibody test (IFAT), using cut-off point at a dilution of 1:40 and 1:25 respectively. The prevalence of seropositive animal for T. gondii was 13.74% and 13.74% for N. caninum. None of the characteristics studied including reproductive problems, presence of cats, presence of dogs and veterinary care (p>0.05) was associated with occurrence of T. gondii or N. caninum infection. Only breed was identified as associated factor for the occurrence of toxoplasmosis in sheep (p<0.05). The present study is the first report on serum occurrence of T. gondii and N. caninum in sheep from the state of Tocantins, Brazil.

Investimento direto externo, acumulação de capital produtivo e distribuição de renda: uma abordagem pós-keynesiana

It is developed a macrodynamic model in the post-keynesian tradition of political economy of the productive capital accumulation and income distribution to analyze some of the impacts of the (flow of) foreign direct investment and the (stock of) foreign productive capital on capital accumulation, economic growth and functional income distribution in a stylized economy. Alongside a usual demand effect, the impacts of such an internationalization of local capital through labor productivity and market concentration are taken into account as well.

Estrutura de propriedade e de controle das empresas de capital aberto no Brasil

This paper has as its main objective to measure the magnitude of deviations between control rights and cash-flow rights for the ultimate shareholder with the largest voting rights of limited liability companies in Brazil. Furthermore, it pinpoints how these discrepancies are generated, evaluating the relative importance of the issuance of preferred stocks with no voting rights, pyramidal arrangements of ownership, and cross-shareholdings. The data set embraces 602 companies that in 2001 complied with the mandatory requirement of filing to the CVM.

O efeito da liberalização da conta de capital sobre a política fiscal: uma avaliação do caso brasileiro recente

In recent years there has been some agreement that capital account liberalization have provided restriction on economic policies. This paper provides some evidence for Brazil. I find evidence that capital account liberalization provided limits to fiscal policy in Brazil and its effects can depend on exchange rate policy.

Cooperation, social capital and economic performance

The objective of this paper is to define social capital as social infrastructure and to try to include this variable in an economic growth model. Considering social capital in such a way could have an impact on the productivity of production factors. Firstly, I will discuss how institutional variables can affect growth. Secondly, after analyzing several definitions of social capital, I will point out the benefits and problems of each one and will define social capital as social infrastructure, aiming to introduce this variable into an economic growth model. Finally, I will try to open the way for subsequent empirical studies, both in the area of measuring the stock of social infrastructure as well as those comparing economies, with the idea of showing the impact of social infrastructure on economic growth.

Capital intangível e direitos de propriedade intelectual: uma análise institucionalista

This paper deals with the main evolutions that explain the emergence of new institutional arrangements that characterize the post-fordism. (i) Hence, I will show that the property rights modifications bring forth new forms of competition;(ii) Also, I will make explicit the concrete expressions of this new competition, as well as how it translates itself in a sub-optimum allocation in the framework of the market game; (iii) I will study the modifications of externalities nature produced by technical progress; (iv) Finally, I will analyze the macroeconomic implications in regard to growth mechanisms and to capital nature.

Rethinking the economics of capital mobility and capital controls

This paper reexamines the issue of international financial capital mobility, which is today's economic orthodoxy. Discussion is often framed in terms of the impossible trinity. That framing distorts discussion by representing capital mobility as having equal significance with sovereign monetary policy and control over exchange rates. It also distorts discussion by ignoring possibilities for coordinated monetary policy and exchange rates, and for managed capital flows. The case for capital mobility rests on neo-classical economic efficiency arguments and neo-liberal political arguments. The case against capital mobility is based on Keynesian macroeconomic inefficiency arguments, neo-Walrasian market failure arguments, and neo-Marxian arguments regarding distortion of the social structure of accumulation. Close examination shows the case for capital mobility to be extremely flimsy, pointing to the ideological dimension behind today's policy orthodoxy.

A relação capital-trabalho na economia do conhecimento

Capital-labor relations in the knowledge economy. The knowledge economy arises by the promotion of abstract and cooperative labor. This social labor is a product of intellectual and linguistic energy, which leads to mutations about capital accumulation and capital labor relations.

Keynes e o conceito de capital: reflexões epistemológicas a respeito das premissas sraffianas da teoria geral

Keynes and the concept of capital: some epistemological observations in regard to the Sraffian premises of the General Theory. This article aims to examine the conception of the nature of capital used by Keynes in the General Theory, to show to what extent this concept is similar to Sraffa's conception, and to highlight the implications related to this concept, in terms of structural instability. So I will study the mechanisms that explain the investment decision in an environment with strong uncertainty, the modalities of aggregation of different generations of capital and the instability of equilibrium. The convergence between the keynesian and the Sraffian approaches comes from this common conception of capital. Finally, i will examine the implications in regard to the structure of the aggregate models.

Neoliberalism and global capital mobility: a necessary reconsideration of textbook trade theory

Textbook theory ignores capital flows: trade determines exchange rates and specialisation. Approaches taking the effects of capital movements adequately into account are needed, and a new theory of economic policy including measures to protect the real economy from external volatility. Equilibrating textbook mechanisms cannot work unless trade-caused surpluses and deficits set exchange rates. To allow orthodox trade theory to work one must hinder capital flows from destroying its very basis, which the IMF and wrong regulatory decisions have done, penalising production and trade. A new, real economy based theory is proposed, a Neoclassical agenda of controlling capital flows and speculation.

Dr Brasilia and Mr. Nacala: the apparent duality behind the Brazilian state-capital nexus

In August 2010 Brazil decided to limit foreign direct investments (FDIs) in land, and attracted the attention of politicians as much as the fears of businessmen. However, few months before, in September 2009, it had concluded a trilateral agreement with Japan and Mozambique to implement agribusiness and contract farming on an area of ten million hectares in the Mozambican region of Nacala. In light of that, the paper analyses the apparent duality of the Brazilian politics, and concludes that, exactly like in the case of the novel by Robert Louis Stevenson, it is not a matter of pathology, but a voluntarily induced double personality which is strategic in positioning Brazil at the core of the global capitalist system.