O ministério público e o controle das políticas públicas para enfrentamento da crise hídrica na região metropolitana de São Paulo

O controle social das políticas públicas vem ao longo dos tempos aprimorando o debate democrático e colocando luz sobre um dos principais problemas contemporâneos que é a relação público-privada na administração pública. A crise hídrica que se instalou na Região Metropolitana de São Paulo reacendeu a necessidade de mais transparência e controle sobre as políticas públicas implementadas pelo Governo do Estado de São Paulo e pela SABESP no seu enfrentamento. É analisado o perfil institucional do Ministério Público, como órgão capaz de desempenhar este papel. Ao final são apresentados três casos nos quais o MP ingressou com ações civis públicas em face da SABESP e de outras agências estatais questionando judicialmente as políticas que estão sendo levadas à efeito em decorrência da falta de água.

Determinantes de uso de serviços de saúde: análise multinível da região metropolitana de São Paulo

OBJETIVO: Analisar os determinantes individuais e contextuais do uso de serviços de saúde na Região Metropolitana de São Paulo. MÉTODOS: Foram utilizados os dados do estudo São Paulo Megacity, a versão brasileira da pesquisa multicêntrica World Mental Health Survey. Foram analisados 3.588 indivíduos adultos residentes em 69 áreas da Região Metropolitana de São Paulo, SP (38 municípios adjacentes e 31 subprefeituras do município de São Paulo), selecionados por meio de amostragem multiestratificada da população não institucionalizada. Foram ajustados modelos multinível logísticos Bayesianos para identificar os determinantes individuais e contextuais do uso de serviços de saúde nos últimos 12 meses e a presença de médico de referência para cuidados de rotina. RESULTADOS: As características contextuais do local de residência (desigualdade de renda, violência e renda mediana) não apresentaram associação significativa (p > 0,05) com o uso de serviços ou com a presença de médico de referência para cuidados de rotina. A única exceção foi a associação negativa entre residir em uma área com alta desigualdade de renda e a presença de médico de referência (OR 0,77; IC95% 0,60;0,99) após controle das características individuais. O estudo apontou uma forte e consistente associação entre algumas características individuais (principalmente escolaridade e presença de plano de saúde) com o uso de serviços de saúde e ter médico de referência. A presença de doenças crônicas e mentais associou-se fortemente com o uso de serviços no último ano (independentemente de características individuais), mas não com a presença de médico de referência. CONCLUSÕES: Características individuais como maior escolaridade e ter plano de saúde foram determinantes importantes do uso de serviços de saúde na Região Metropolitana de São Paulo. A melhor compreensão desses determinantes é necessária para o desenvolvimento de políticas públicas que permitam o uso equitativo dos serviços de saúde.

Cooperativa habitacional autofinanciável :uma alternativa de mercado à escassez de financiamento

As an example of what happened in Brazil in the 90s, it s noticed in Natal a new system of cooperative housing production which is done by advancing the users resources selffinancing. This system comes as an alternative for the real state market performance since the end of the National Housing Bank (BNH), in 1986. Self-financed housing cooperatives play an important social role by contributing to own housing acquisition by low-income population, without, however, becoming a mechanism of social interest housing production. It is important to consider that Brazil registers a housing deficit of 6.6 million housing units (IBGE 2000/Census), which, compared to 1991, shows an increment of 21.7% to a growth rate of 2.2% a year. This deficit figure has been deepening, mainly with the end of the National Housing Bank (BNH). The self-financed cooperative housing production broadens around the Metropolitan Region of Natal (RMN) and remains as an alternative to the lack of financing in the housing / real state market. In general, the aim of this work is to analyze the role of self-financing housing cooperatives on the housing production in the RMN, in order to identify their role in the real state market, in the own housing promotion and in the housing policy. The Universe of this study is performance of four housing cooperatives - CHAF-RN, COOPHAB-RN, MULTHCOOP e CNH - that work through self-financing. It is considered here an amount of 38 undertakings launched between 1993 and 2002, including 8143 housing units. The methodology adopted consists of bibliographic, documental and field research. As a result, actions like brokerage, marketing, speculation, and the criteria to define places for undertakings and final products, show how close they are to the housing market production. As a matter of fact, this short distance explains why the self-financed cooperative production for social interest housing is still limited. This reinforces the theory that it is necessary to define and implement a subsidized housing policy to serve the low-income Brazilian population

Prevalência da infecção por papilomavírus humano, herpes simplex tipo 1 e 2 e Chlamydia trachomatis em um segmento da população feminina da grande Natal/RN

Sexually transmitted diseases (STDs) are among the largest public health problems, especially in developing countries. The acquisition of these infections during early sexual activity is common and many infections have a benign course. However, in some pathogens remain in the state of latency can be reactivated and cause productive infection that may progress to severe forms. In addition, some of them are transmitted vertically resulting in congenital infection, causing immediate damage or long-term child. The classic risk factors for sexually transmitted agents are: early onset of sexual and reproductive health, multiple sexual partners throughout life, use of oral contraceptives and co-infections with different pathogens. We present the results of a cross-sectional study aimed to estimate the prevalence of genital infection by human papillomavirus (HPV), Herpes simplex virus (HSV) and Chlamydia trachomatis (CT) in a segment of the female population of the metropolitan area Christmas, among those who enrolled voluntarily sought, Basic Health Units for the examination of cancer screening cervix in the period 2008 to 2010. All participants, a total of 261 women answered a standard questionnaire by which identified the socio-demographic characteristics, classical risk factors for STDs, reproductive and sexual activity and smoking. Of each patient were obtained two samples, one for the completion of the Pap test for detection of cellular changes and the other processed for DNA extraction and analyzed by PCR (polymerase chain reaction) to detect the three pathogens studied. The population of the study was composed of sexually active women aged between 13 and 79 years, mean 38.7 years, most of them being married, low education levels and low incomes. The majority (87%) had normal results on cytology and only 2.7% had low-grade cytological abnormalities. Prevalence rates were 37.9% for HPV, 4.6% for CT and 26% for HSV. HPV prevalence was higher in women under 25, unmarried and in those who had multiple sexual partners. Women with simultaneous infection by HSV-1 and 2 had higher prevalence of HPV infection. The prevalence of HSV infection showed no association whatsoever with the risk factors analyzed and HSV-1 was the predominant type among the cases of genital HSV infection. The overall prevalence of C. Trachomatis was relatively low, thus providing greater value in younger women aged less than or equal to 20 years

Emprego formal na região nordeste brasileira: seus efeitos na inclusão social

This work aims to study the problem of the formal job in the Brazilian Northeast region and its effect in the social inclusion, taking for base the analysis of variables defined in the Atlas of Social Exclusion, which is based on the 2000 Brazilian Census, choosing the county as unit of analysis. As methodological options, an exploratory data analysis was performed, followed by multivariate statistical techniques, such as weighted multiple regression analysis, cluster analysis and exploratory analysis of spatial data. The results pointed out to low rates of formal job for the active age population as well as low indexes of social inclusion in the Northeast region of Brazil. A strong association of the formal job with the indicators of social inclusion under investigation, was evidenced (schooling, inequality, poverty, youth and income form government transfers), as well as a strong association of the formal job with the new index of social inclusion (IIS), modified from the IES. At the Federative Units, in which better levels of formal job had been found, good indexes of social inclusion are also observed. Highlights for the state of the Rio Grande do Norte, with the best conditions of life, and for the states of the Maranhão and Piauí, with the worst conditions. The situation of the Northeast region, facing the indicators under study, is very precarious, claiming for the necessity of emphasizing programs and governmental actions, specially directed to the raise of formal job levels of the region, reflecting, thus, in improvements on the income inequality, as well as in the social inclusion of the population of Northeastern natives.

Tornar-se, ser e viver do professorado: entre regularidades e variações identitárias

The main aim of this research has been to analyze the identity patterns of the teacher s staff of fundamental education public schools in the Metropolitan Area of Natal-RN. It sets out from the hypothesis that being a teacher within this context grows out of the regularities of a specific habitus, which, according to Bourdieu, develops into mental schemes of thought and action within a specific social group. This habitus forms the basis on which is built the social representation of being a teacher prevailing in the group, as well as the symbolic differences that typify its identity variations. Three data sources have been fundamental in building up this thesis: (a) formative essays of students graduating from a Higher Teacher s Formation Course, as well as observing some of the public defense of these essays during field work; (b) a questionnaire aimed at classifying economically, socially, and culturally a sample of public teachers of the Natal-RN county; and (c) submitting a sub-sample of this group to the process of Multiple Classification Procedures (MCP). The analysis of data was done according to the multidimensional, non-parametric statistical procedures of both the Category Content Analysis and Enunciation Analysis methods. The results of the analysis took into account an ample set of variables, its associations and implications, the cultural and social profile of the population under scrutiny, their life styles, as well as the strategies they developed in the process of becoming a teacher, and the social representation of being a teacher . We came to the conclusion that the social identity of the teachers corps, or as we prefer to say it being a teacher , is a result of a set of regularities produced by the habitus that gives social shape and meaning to the existence of the group proper. We note the existence of identity variations caused by the variables (a) educational level; and (b) mode of action in fundamental education (if these are the first or last grades where the subjects operate). However, these variations will not break the power of the regularities that give shape, meaning, and social visibility to the group. The social representation of being a teacher points to the tensions, ambiguities, and trends inherent to common sense, as well as to a strong tendency to reassign a new meaning to being a teacher. Our thesis, therefore, is that the identity configuration of the teachers corps under scrutiny is characterized by an integrative synthesis, by-product of a habitus that is superimposed, and at the same time co-exists with different identity variations

Herdabilidade de preditores do risco cardiovascular

genetic and environmental factors contribute to the development of cardiovascular risk and that influence can be differentiated by factors characteristic of each population, age and sex. Aim: To investigate the heritability of anthropometric and biochemical markers as predictors of cardiovascular risk in men and women of different age groups, using the method of twins. Methods: A sample of 88 subjects and of these 52 children and adolescents (08-17 years old) 32 monozygotic (20 female and 12 male) and 20 dizygotic (12 female and 08 male) and 36 adults (18-28 years age) 24 monozygotic (08 female and 16 male) and 12 dizygotic (06 female and 06 male), living in the metropolitan region of Natal / RN, Brazil. Anthropometric measures were taken as the height, body mass, waist circumference (WC), sum of skinfolds (ΣDC), fat percentage CUN-BAE, BMI and conicity. Biochemical markers analyzed were: fasting glucose (GLU), total cholesterol (COL), HDL-C, LDL-C and triglycerides (TG). After processing the data the index of heritability (h2) = (S ² MZ) / S ² DZ (DZ S ²) X100 was applied disaggregated by sex and age. Results: The variables showed differential heritability of behavior for men and women, depending on age. The variables with the highest heritability values were ΣDC, GLU, HDL, TG, in men and BMI, WC, ΣDC, GLU, HDL-C and TG in women. And more influenced by the environment variables were: body mass, BMI, Chol, LDL-C in men; body mass and LDL-C in women. Conclusion: Differences index of heritability by gender for cardiovascular risk predictors may assist in planning specific intervention strategies according to gender and stage of life of that individual. It is from the level of environmental influence that can run interventions for changes of components related to cardiovascular risk