Reelection incentives and political budget cycle: evidence from Brazil

This article tests the presence of political budget cycle (PBC) in municipal elections in Brazil and checks whether mayors who adopt such policy have greater probability of reelection. Based on fiscal and electoral data of 5,406 Brazilian municipalities and applying the difference-in-differences econometric method as well as logistic regressions, the results provide some evidence of PBC in Brazil, although its magnitude and consistency varies depending on the years used as electoral and non-electoral years. On average, reelectable mayors spend close to 3% more in election years than nonreelectables. Moreover, reelectables who do run for reelection present a variation in spending which is close to 5% superior to that of non-reelectables and non-runners. Additionally, the results suggest that mayors who increase public spending during electoral periods have greater chances of being reelected, as long as such spending is done within deficit limits acceptable by voters.

Entre a dominação simbólica e a emancipação política no Ensino Superior em Enfermagem: Between symbolic domination and political emancipation

Nesta reflexão, problematizamos a atividade de cuidar e de ensinar a cuidar em enfermagem e, para tanto, vamos tomar por base alguns conceitos sobre a dominação e o poder simbólicos de Pierre Bourdieu. Nosso pressuposto foi pensar a saúde como um constituinte fundamental para a produção da nossa existência sobre a Terra. A educação, neste texto, é abordada, tendo por referência as ideias de Pedro Demo, entendidas como uma construtora de sujeitos políticos e bem mais amplas que o manejo do conhecimento formal. A educação é a base primeira sobre a qual se constrói a autonomia humana e, assim, permite a constante ampliação das oportunidades para o exercício da cidadania, qualificando a nossa existência cotidiana. No contexto acadêmico, no qual se cruzam a saúde, a educação e a enfermagem, o trabalho docente competente, crítico e, sobretudo, reflexivo, pode se tornar uma práxis altamente instituinte.

Heparan sulfate and cell division

Heparan sulfate is a component of vertebrate and invertebrate tissues which appears during the cytodifferentiation stage of embryonic development. Its structure varies according to the tissue and species of origin and is modified during neoplastic transformation. Several lines of experimental evidence suggest that heparan sulfate plays a role in cellular recognition, cellular adhesion and growth control. Heparan sulfate can participate in the process of cell division in two distinct ways, either as a positive or negative modulator of cellular proliferation, or as a response to a mitogenic stimulus.

Spatialization of climate, physical and socioeconomic factors that affect the dairy goat production in Brazil and their impact on animal breeding decisions

Brazil has high climate, soil and environmental diversity, as well as distinct socioeconomic and political realities, what results in differences among the political administrative regions of the country. The objective of this study was to determine spatial distribution of the physical, climatic and socioeconomic aspects that best characterize the production of dairy goats in Brazil. Production indices of milk per goat, goat production, milk production, as well as temperature range, mean temperature, precipitation, normalized difference vegetation index, relative humidity, altitude, agricultural farms; farms with native pasture, farms with good quality pasture, farms with water resources, farms that receive technical guidance, family farming properties, non-familiar farms and the human development index were evaluated. The multivariate analyses were carried out to spatialize climatic, physical and socioeconomic variables and so differenciate the Brazilian States and Regions. The highest yields of milk and goat production were observed in the Northeast. The Southeast Region had the second highest production of milk, followed by the South, Midwest and North. Multivariate analysis revealed distinctions between clusters of political-administrative regions of Brazil. The climatic variables were most important to discriminate between regions of Brazil. Therefore, it is necessary to implement animal breeding programs to meet the needs of each region.

Fads and fashions in management: the case of ERP

This article discusses the Enterprise Resource Planning (ERP) rage. ERP represents immense investments for companies around the globe and has been promoted as a management panacea. Not surprisingly, many implementations fail to match expectations. In this study, we propose a broader perspective to comprehend the substantive, institutional, and political factors involved in the ERP phenomenon, as an alternative to the "techno-reductionism" that has characterized the prevailing approach on the subject, and present an exploratory survey of 28 implementation experiences, concentrating on the process of adoption, chosen implementation approaches and outcome assessment.

Beyond the income inequality hypothesis and human health: a worldwide exploration

OBJECTIVE: To analyze whether the relationship between income inequality and human health is mediated through social capital, and whether political regime determines differences in income inequality and social capital among countries. METHODS: Path analysis of cross sectional ecological data from 110 countries. Life expectancy at birth was the outcome variable, and income inequality (measured by the Gini coefficient), social capital (measured by the Corruption Perceptions Index or generalized trust), and political regime (measured by the Index of Freedom) were the predictor variables. Corruption Perceptions Index (an indirect indicator of social capital) was used to include more developing countries in the analysis. The correlation between Gini coefficient and predictor variables was calculated using Spearman's coefficients. The path analysis was designed to assess the effect of income inequality, social capital proxies and political regime on life expectancy. RESULTS: The path coefficients suggest that income inequality has a greater direct effect on life expectancy at birth than through social capital. Political regime acts on life expectancy at birth through income inequality. CONCLUSIONS: Income inequality and social capital have direct effects on life expectancy at birth. The "class/welfare regime model" can be useful for understanding social and health inequalities between countries, whereas the "income inequality hypothesis" which is only a partial approach is especially useful for analyzing differences within countries.

Federalism and health policy: the intergovernmental committees in Brazil

OBJECTIVE To analyze the dynamics of operation of the Bipartite Committees in health care in the Brazilian states.METHODS The research included visits to 24 states, direct observation, document analysis, and performance of semi-structured interviews with state and local leaders. The characterization of each committee was performed between 2007 and 2010, and four dimensions were considered: (i) level of institutionality, classified as advanced, intermediate, or incipient; (ii) agenda of intergovernmental negotiations, classified as diversified/restricted, adapted/not adapted to the reality of each state, and shared/unshared between the state and municipalities; (iii) political processes, considering the character and scope of intergovernmental relations; and (iv) capacity of operation, assessed as high, moderate, or low.RESULTS Ten committees had advanced level of institutionality. The agenda of the negotiations was diversified in all states, and most of them were adapted to the state reality. However, one-third of the committees showed power inequalities between the government levels. Cooperative and interactive intergovernmental relations predominated in 54.0% of the states. The level of institutionality, scope of negotiations, and political processes influenced Bipartite Committees’ ability to formulate policies and coordinate health care at the federal level. Bipartite Committees with a high capacity of operation predominated in the South and Southeast regions, while those with a low capacity of operations predominated in the North and Northeast.CONCLUSIONS The regional differences in operation among Bipartite Interagency Committees suggest the influence of historical-structural variables (socioeconomic development, geographic barriers, characteristics of the health care system) in their capacity of intergovernmental health care management. However, structural problems can be overcome in some states through institutional and political changes. The creation of federal investments, varied by regions and states, is critical in overcoming the structural inequalities that affect political institutions. The operation of Bipartite Committees is a step forward; however, strengthening their ability to coordinate health care is crucial in the regional organization of the health care system in the Brazilian states.

Biological drugs for the treatment of psoriasis in a public health system

OBJECTIVE To analyze the access and utilization profile of biological medications for psoriasis provided by the judicial system in Brazil.METHODSThis is a cross-sectional study. We interviewed a total of 203 patients with psoriasis who were on biological medications obtained by the judicial system of the State of Sao Paulo, from 2004 to 2010. Sociodemographics, medical, and political-administrative characteristics were complemented with data obtained from dispensation orders that included biological medications to treat psoriasis and the legal actions involved. The data was analyzed using an electronic data base and shown as simple variable frequencies. The prescriptions contained in the lawsuits were analyzed according to legal provisions.RESULTS A total of 190 lawsuits requesting several biological drugs (adalimumab, efalizumab, etanercept, and infliximab) were analyzed. Patients obtained these medications as a result of injunctions (59.5%) or without having ever demanded biological medication from any health institution (86.2%), i.e., public or private health services. They used the prerogative of free legal aid (72.6%), even though they were represented by private lawyers (91.1%) and treated in private facilities (69.5%). Most of the patients used a biological medication for more than 13 months (66.0%), and some patients were undergoing treatment with this medication when interviewed (44.9%). Approximately one third of the patients discontinued treatment due to worsening of their illness (26.6%), adverse drug reactions (20.5%), lack of efficacy, or because the doctor discontinued this medication (13.8%). None of the analyzed medical prescriptions matched the legal prescribing requirements. Clinical monitoring results showed that 70.3% of the patients had not undergone laboratory examinations (blood work, liver and kidney function tests) for treatment control purposes.CONCLUSIONS The plaintiffs resorted to legal action to get access to biological medications because they were either unaware or had difficulty in accessing them through institutional public health system procedures. Access by means of legal action facilitated long-term use of this type of medication through irregular prescriptions and led to a high rate of adverse drug reactions as well as inappropriate clinical monitoring.

Immunoprecipitation techniques and Elisa in the detection of anti-Fonsecaea pedrosoi antibodies in chromoblastomycosis

Chromoblastomycosis (CBM) is a chronic subcutaneous infection caused by several dematiaceous fungi. The most commonly etiological agent found in Brazil is Fonsecaea pedrosoi, which appears as thick walled, brownish colored cells with transverse and longitudinal division in the lesions, called "muriform cells". This disease is found worldwide but countries like Madagascar and Brazil have highest incidence. Diagnosis is made by clinical, direct and histopathologic examination and culture of specimens. Serological tests have been used to identify specific antibodies against Fonsecaea pedrosoi antigens, as well as immunotechniques have been used for CBM serological identification and diagnosis. In the present study double immunodiffusion (DID), counterimmunoelectrophoresis (CIE) and immunoenzymatic test (ELISA) have been used to evaluate humoral immune response in patients with CBM caused by F. pedrosoi. Metabolic antigen was used for immunoprecipitation tests (DID and CIE) while somatic antigen for ELISA. Our results demonstrated 53% sensitivity and 96% specificity for DID, while CIE presented 68% sensitivity and 90.5% specificity. ELISA demonstrated 78% sensibility and 83% specificity. Serological tests can be a useful tool to study different aspects of CBM, such as helping differential diagnosis, when culture of the pathogenic agent is impossible.

Low transmission areas of schistosomiasis in Venezuela: consequences on the diagnosis, treatment, and control

Schistosomiasis low transmission areas as Venezuela, can be defined as those where the vector exists, the prevalence of active cases is under 25%, individuals with mild intensity of infection predominate and are mostly asymptomatic. These areas are the consequence of effective control programs, however, "silent" epidemiological places are difficult to trace, avoiding the opportune diagnosis and treatment of infected persons. Clinic and abdominal ultrasound have not shown to discriminate infected from uninfected persons in areas where besides Schistosoma mansoni, intestinal parasites are the rule. Under these conditions, serology remains as a very valuable diagnostic tool, since it gives a closer approximation to the true prevalence. In this sense, circumoval precipitin test, ELISA-SEA with sodium metaperiodate, and alkaline phosphatase immunoassay joined to coprology allow the identification of the "schistosomiasis cases". In relation to public health, schistosomiasis has been underestimated by the sanitary authorities and the investment on its control is being transferred to other diseases of major social and political relevance neglecting sanitary efforts and allowing growth of snail population. Some strategies of diagnosis and control should be done before schistosomiasis reemergence occurs in low transmission areas.

Political-ethical skill development in nursing undergraduates

This research aimed to identify political-ethical skills developed in a training process compatible with the expected profile set by the National Curriculum Guidelines for the Undergraduate Nursing Degree. A case study was conducted with units represented by 32 former students from a particular religious teaching institution who already were in the job market. The content of the interviews was analyzed using the thematic analysis technique, which resulted in the following categories: "Political-ethical skills in the formative process" and "Political-ethical skills as a product of the educational process." From the former students’ perspective, these categories reinforced the social role of the nurse and the need for students to be reflective, understanding and participative in the transformation of society.

Costs of reusable and disposable aprons in a public teaching hospital

Objective To analyze the direct cost of reusable and disposable aprons in a public teaching hospital. Method Cross-sectional study of quantitative approach, focusing on the direct cost of reusable and disposable aprons at a teaching hospital in northern Paraná. The study population consisted of secondary data collected in reports of the cost of services, laundry, materials and supplies division of the institution for the year 2012 Results We identified a lower average cost of using disposable apron when compared to the reusable apron. The direct cost of reusable apron was R$ 3.06, and the steps of preparation and washing were mainly responsible for the high cost, and disposable apron cost was R$ 0.94. Conclusion The results presented are important for hospital managers properly allocate resources and manage costs in hospitals
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Information literacy - historical and conceptual bases: constructing meanings

Recent years have witnessed the increasing interest in studies focused on information literacy, which is reflected mainly in the number of publications on the subject and goes beyond the fields of Librarianship and Information Science. The purpose of this paper is, therefore, to offer an outlook, historical and conceptual, of international researches on information literacy, trying to show some of the different ramifications which the discussion on the subject has exhibited in past few years in countries where its process of legitimation is already well established, in order to illuminate possible areas of research and action for the librarian professional. This research indicates that if the initial studies on this topic tended to be devoted to conceptualize it, discussing its relevance and determine the skills and knowledge related to information literacy, in the last decade can be noticed a proliferation of researches aimed at describing initiatives or proposing models in areas beyond the usual field such as Medical Sciences, Law, Politics or Computers, among others. The first results of this research refer to a philosophical and educational perspective of information literacy, which suggests the need for deeper understanding and characterization of information literacy in four dimensions: technical, aesthetic, ethical and political, serving both to competence as to information.