Rawls and Health Care

John Rawls’s A Theory of Justice (1971), his first major work articulating his theory of justice as fairness, was immediately recognized as a fundamental contribution to political philosophy in the twentieth century. Working within the tradition established by previous philosophers such as Kant and Locke, Rawls employed the contract theory approach. Taking it to a higher order of abstraction, he sought to determine not what the structure of social organization would be, but what the principles which governed social institutions would be under a hypothetical contracting situation. Rawls uses this contract theory approach to construct a society in which the morally irrelevant contingencies of nature and social arrangements are mitigated by principles of justice which govern the basic institutions of society. A common observation has been that Rawls left out any discussion of health care and how it might fit into his conception of a just society. Several philosophers have articulated expansions of the theory to account for health care. In the chapters that follow I will continue this tradition and consider how justice as fairness might be expanded to account for just health care allocation. In doing so, I hope to answer a particularly strong critique of the theory brought up by Amartya Sen and Martha Nussbaum, and to argue for a broadened conception of health care which takes into account the complex causal relationship between society and human health.

Development Of Water Pollution Early Warning System For Oyster Harvesting Areas

The objective of this study is to develop a Pollution Early Warning System (PEWS) for efficient management of water quality in oyster harvesting areas. To that end, this paper presents a web-enabled, user-friendly PEWS for managing water quality in oyster harvesting areas along Louisiana Gulf Coast, USA. The PEWS consists of (1) an Integrated Space-Ground Sensing System (ISGSS) gathering data for environmental factors influencing water quality, (2) an Artificial Neural Network (ANN) model for predicting the level of fecal coliform bacteria, and (3) a web-enabled, user-friendly Geographic Information System (GIS) platform for issuing water pollution advisories and managing oyster harvesting waters. The ISGSS (data acquisition system) collects near real-time environmental data from various sources, including NASA MODIS Terra and Aqua satellites and in-situ sensing stations managed by the USGS and the NOAA. The ANN model is developed using the ANN program in MATLAB Toolbox. The ANN model involves a total of 6 independent environmental variables, including rainfall, tide, wind, salinity, temperature, and weather type along with 8 different combinations of the independent variables. The ANN model is constructed and tested using environmental and bacteriological data collected monthly from 2001 – 2011 by Louisiana Molluscan Shellfish Program at seven oyster harvesting areas in Louisiana Coast, USA. The ANN model is capable of explaining about 76% of variation in fecal coliform levels for model training data and 44% for independent data. The web-based GIS platform is developed using ArcView GIS and ArcIMS. The web-based GIS system can be employed for mapping fecal coliform levels, predicted by the ANN model, and potential risks of norovirus outbreaks in oyster harvesting waters. The PEWS is able to inform decision-makers of potential risks of fecal pollution and virus outbreak on a daily basis, greatly reducing the risk of contaminated oysters to human health.

Paradigms in health care and its relationship to the nursing theories: an analytical test

DANTAS, Rodrigo Assis Neves; NÓBREGA, Walkíria Gomes da; MORAIS FILHO, Luiz Alves; MACÊDO, Eurides Araújo Bezerra de ; FONSECA , Patrícia de Cássia Bezerra; ENDERS, Bertha Cruz; MENEZES, Rejane Maria Paiva de; TORRES , Gilson de Vasconcelos. Paradigms in health care and its relationship to the nursing theories: an analytical test . Revista de Enfermagem UFPE on line. v.4,n.2, p.16-24.abr/jun. 2010. Disponível em < http://www.ufpe.br/revistaenfermagem/index.php/revista>.

Investigação e gerenciamento de áreas contaminadas por postos revendedores de combustíveis em Natal

Activities that have fuel subterranean storage system are considered potentially polluting fuels by CONAMA Resolution 273, due to the possibility of leak, outpouring and overflow of fuel into the ground. Being even more worrying when contaminate groundwater for public supply, as the case of Natal City. For this reason, the Public Ministry/RN, in partnership with UFRN, developed the project environmental suitability of Gas stations in Natal, of which 36% showed evidence of contamination. This paper describes the four stages of the management of contaminated areas: preliminary assessment of environmental liabilities, detailed confirmatory investigation of the contamination, risk analysis to human health (RBCA), as well as the remediation plan of degraded areas. Therefore it is presented a case study. For the area investigated has been proposed a mathematical method to estimate the volume of LNAPL by a free CAD software (ScketchUp) and compare it with the partition method for grid area. Were also performed 3D graphics designs of feathers contamination. Research results showed that passive benzene contamination in groundwater was 2791.77 μg/L, when the maximum allowed by CONAMA Resolution 420 is 5 μg/L which is the potability standards. The individual and cumulative risks were calculated from 4.4 x10-3, both above the limits of 1.0 x10-5 or by RBCA 1.0 x10-6 by the Public Ministry/RN. Corrective action points that remediation of dissolved phase benzene is expected to reach a concentration of 25 μg/L, based on carcinogenic risk for ingestion of groundwater by residents residential, diverging legislation. According to the proposed model, the volume of LNAPL using the ScketchUp was 17.59 m3, while by the grid partitioning method was 14.02 m3. Because of the low recovery, the expected removal of LNAPL is 11 years, if the multiphase extraction system installed in the enterprise is not optimized

Sintered Sewage Sludge As Support Material Used In Drinking Water Filtration

The processing of industry and domestic effluents in wastewater treatment plants reduces the amount of polluted material and forms reusable water and dehydrated sludge. the generation of hazardous municipal sludge can be decreased, as well as the impact on surface and underground water and the risk to human health. The aim this study is to verify the possibility to use sintered sewage sludge as support material after thermal treatment in the production of a filtering material to water supply systems. After thermal treatment the sewage sludge ash was characterized by X-ray fluorescence (XRF), leaching test and water solubilization. Dehydration of sludge was performed by controlled heating at temperatures of 180 degrees C, 350 degrees C, 600 degrees C, 850 degrees C and 1000 degrees C for 3 hours.

Sistemas de informação geográfica e análise espacial de dados como ferramentas para determinação de agregação espacial de doenças: a hanseníase como modelo

This work demonstrates the importance of using tools used in geographic information systems (GIS) and spatial data analysis (SDA) for the study of infectious diseases. Analysis methods were used to describe more fully the spatial distribution of a particular disease by incorporating the geographical element in the analysis. In Chapter 1, we report the historical evolution of these techniques in the field of human health and use Hansen s disease (leprosy) in Rio Grande do Norte as an example. In Chapter 2, we introduced a few basic theoretical concepts on the methodology and classified the types of spatial data commonly treated. Chapters 3 and 4 defined and demonstrated the use of the two most important techniques for analysis of health data, which are data point processes and data area. We modelled the case distribution of Hansen s disease in the city of Mossoró - RN. In the analysis, we used R scripts and made available routines and analitical procedures developed by the author. This approach can be easily used by researchers in several areas. As practical results, major risk areas in Mossoró leprosy were detected, and its association with the socioeconomic profile of the population at risk was found. Moreover, it is clearly shown that his approach could be of great help to be used continuously in data analysis and processing, allowing the development of new strategies to work might increase the use of such techniques in data analysis in health care

Virulence properties and antimicrobial susceptibility of Shiga toxin-producing Escherichia coli strains isolated from healthy cattle from Parana State, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Reaproveitamento e caracterização dos resíduos orgânicos provenientes do Programa MESA DA SOLIDARIEDADE da CEASA/RN

As an auxiliary tool to combat hunger by decreasing the waste of food and contributing for improvement of life quality on the population, CEASA/RN has released from August/03 to August/05 the program MESA DA SOLIDARIEDADE. Despite of the positive results of this program, that has already distributed around 226 tons of food, there is still food being thrown in the trash as the deliver of the same food in its natural form would be a health risk to those who would consume it and only the correct processing of this food can make it edible. This work has as a goal the reuse of solid residues of vegetal origin generated by the CEASA/RN, through the Program MESA DA SOLIDARIEDADE and the characterization of the product obtained so it might be used as a mineral complement in the human diet. To the collecting of samples (from September until December /2004) it was developed a methodology having as a reference the daily needs of mineral salts for infants at the age of seven to ten. The sample was packed in plastic bags and transported in an ambient temperature to the laboratory where it was selected, weighted, disinfected, fractionated and dried to 70ºC in greenhouse. The dry sample was shredded and stored in bottles previously sterilized. The sample in nature was weighted in the same proportion of the dry sample and it was obtained a uniform mass in a domestic processor. The physical-chemical analyses were carried out in triplicate in the samples in nature and in the dry product, being analyzed: pH, humidity, acidity and soluble solids according to IAL (1985), mineral salts contents (Ca, K, Na, Mg, P and Fe) determined by spectrophotometry of Atomic Absorption, caloric power through a calorimetric bomb and presence of fecal traces and E. coli through the colilert method (APHA, 1995). During this period the dry food a base of vegetables presented on average 5,06% of humidity, 4,62 of pH, acidity of 2,73 mg of citric acid /100g of sample, 51,45ºBrix of soluble solids, 2.323,50mg of K/100g, 299,06mg of Ca/100g, 293mg of Na/100g, 154,66mg of Mg/100g, 269,62mg of P/100g, 6,38mg of Fe/100g, caloric power of 3,691Kcal/g (15,502KJ/g) and is free of contamination by fecal traces and E..coli. The dry food developed in this research presented satisfactory characteristics regarding to its conservation, possessing low calories, constituting itself a good source of potassium, magnesium, sodium and iron that can be utilized as a food complement of these minerals

Avaliação de diferentes processos oxidativos avançados no tratamento de resíduos de petróleo

The petroleum industry deals with problems which are difficult to solve because of their relation to environmental issues. This is because amounts of residue are generated which vary in type and danger level. The soil contamination by non aqueous liquid phase mixtures, specifically hydrocarbon petroleum has been a reason for great concern, mainly the aromatic and polycyclic aromatic, which present risk to human health due to its carcinogenic and mutagenic character. The Advanced Oxidative Processes (AOP) are efficient technologies for destruction of organic compounds of difficult degradation and, often, they are present in low concentrations. They can be considered clean technologies, because there is no formation of solid by-products or the transfer of pollutor phases. This work focuses on the study of the degradation of petroleum industrial waste, by Advanced Oxidation Processes. Treatments tackling petroleum residues, contaminated soil, and water occurring in the production of petroleum reached the following Polycyclic Aromatic Hydrocarbons (PAH) degradation levels: solid residues 100% in 96 treatment hours; water residue - 100% in 6 treatment hours; soil contamination (COT degradation) - 50.3% in 12 treatment hours. AOP were effective in dealing with petroleum residues thus revealing themselves to be a promising treatment alternative

Atividade inseticida das plantas e aplicações: revisão

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Alterações ambientais em Parelhas, Rio Grande do Norte: metais pesados em sedimentos de drenagens e percepção de comunidades rurais em relação a mudanças na paisagem

The conservation of natural resources is essential and constitutes the main subject of many researches, which characterize important aspects concerning the environmental alterations in the ground, water, landscape and socioeconomic information. This study aimed to investigate the anthropogenic input of heavy metals in the environment, in the area of the Parelhas dump site and in part of the Seridó River and to determine the concentration of heavy metals in the sediments. This can result in risk to the environment and human health. In addition, we sought to establish the socioeconomic profile of rural communities adjacent to Seridó River and to comprehend the perception of these dwellers about the changes in the places they live. The area of this study is located in the city of Parelhas/RN, in the centralsouthern part of the State, in the micro-region of the Oriental Seridó. This area comprehends the place where the dump site is located, next to RN 086, the Caldeirão dam, the Quintos river called by local citizens Caldeirão creek and part of Seridó river, perpetuated by the Boqueirão dam, which crosses the city and it includes the rural communities of Almas, Domingas, Sussuarana II and Colonos. Regarding the study with bottom sediments, the samples were collected and taken to the laboratory of geochemistry, where they were dried, sieved, weighted and submitted to weak acid attack. The analysis of heavy metals was held by Atomic Absorption Spectrophotometer - Flame AAS. We applied 23 closed questionnaires constituted by 38 questions to collect informations in the rural communities, oriented to establish the socioeconomic profile and the environmental perception of the participants. The participants were distributed in the communities of Almas (1), Domingas (2), Sussuarana II (10) and Colonos (10). Most of them presented similar socioeconomic profiles. They are from 45 to 60 years old and live in these localities for 20 to 30 years or more. The families are composed by 3 or 4 people; the agriculture is the main activity, livestock is the secondary and 48% of them earn the minimal wage. Regarding the environmental perception, the participants can realize some changes in vegetation, soil, water and landscape. People living longer in the community, and with more years of experience on the local reality can perceive the depletion of the soil, pastures and changes in the landscape. These changes portray how the place was previously and what it represents today. The perception of these changes, besides the environmental ones, includes others concerning the increasing number of dwellers in the last years, as well as the number of houses. The changes happened through activities developed by the dwellers over the years, including agricultural practices, livestock, grass planting and even the cultivation of cotton. The study provided the acquisition of new data about the environmental reality of this region. It can subsidize the definition of public policies that can be implemented from the perspective of conservation of water resources and of the coexistence and survival of man in the semi-arid

Metais pesados no caranguejo Ucides cordatus (Linnaeus, 1763) e ecotoxicologia de sedimentos do estuario dos Rios Jundiai e Potengi - RN

This study is conducted in the estuary of the rivers Jundiaí and Potengi, one of the most important estuaries of Rio Grande do Norte, which suffers a strong anthropogenic influence from neighboring cities. According to Resolution 344/2005 environments that have high concentrations of metals such as arsenic, cadmium, lead and mercury need ecotoxicological tests. This study aims to evaluate the heavy metals contamination in the estuary through analysis of sediment collected at four points distributed from Macaíba to Natal city, and in the crab Uçá, Ucides cordatus. The study aims also to evaluate the effects of sediment toxicity in the tests organisms Leptocheirus plumulosus. To obtain data about the concentrations of heavy metals in the environment, sediments were collected in January and May 2011 and crab Uçá was collected in June 2011. On the other hand the monitoring was carried out through toxicological tests with sediment collected from July to October 2011. During the collection of sediment samples the physico-chemical parameters of water (dissolved oxygen, pH, chloride, turbidity, conductivity and temperature) were measured by using multi-parametric probe (TROLL 9500). It was possible to identify contamination by metals such as lead, cadmium, arsenic and copper both in the sediment and in the Uçá crab, which characterizes that the consumption of this crustacean may be a risk to human health. Once the concentrations of metals were identified, toxicology tests were performed and revealed toxic effect to organisms in at least one of the four months studied. Point 2 was classified as toxic in three of the four months studied . The heavy metal contamination is a risk to the environment, to aquatic organisms and to the community which survives of resources taken from the environment

Avaliação do potencial de toxicidade de florações de cianobactérias como subsídio para ações de gestão ambiental em açudes do semiárido potiguar

Blooms negatively compromise the aquatic environment, plants, animals and human health.Some species are toxin-producing, such as the neurotoxin saxitoxin and the hepatotoxin microcystin, which may contaminate water reservoirs, as those existing in the semiarid region of Rio Grande do Norte (Brazil) which are used to supply the population, fishing, aquiculture and recreational activities, thereby providing the risk of human exposure through water intake, dermal contact and respiratory tract. Thus, it is recommended a constant monitoring of the density of cyanobacteria with the quantification of cyanotoxins. One goal with this work was the monitoring of water in four reservoirs in semiarid of RN through the identification and enumeration of cyanobacteria and through the identification and quantification of cyanotoxins by ELISA. Furthermore, we intended to assess the environmental perception of farmers and artisanal fishers in reservoirs of semiarid of RN through semi-structured interviews with questions mostly related to water and eutrophication. Through these objectives the aim was the development of management strategies for aquaculture and prevention of risks to public health. The results showed that the highest values of microcystins were found in the rainy season. Standards for drinking water, according to the guidelines of Ministry of Health 2914/2011 and CONAMA 357/05, setting the maximum values for raw water density of cyanobacteria: 50,000 cel.mL-1; microcystin: 1 μg. L-1 and saxitoxin: 3 μg. L-1. The values found for microcystin ranged between 0.00227 μg. L-1 and 24.1954 μg. L-1. From 128 samples analyzed, 27% were above the limit. There was no clear seasonal pattern for saxitoxins and their values ranged between 0.003 μg. L-1 and 0.766 μg. L-1 with none of the values above the limit. Furthermore, 76% of the densities of cyanobacteria values were above the limit. About environmental perception, 52 interviews were conducted and the results show that the respondents recognize the main uses of water of the rervoirs, recognize the importance and have a positive view about the reservoirs. They also realize that the water has a poor quality and can cause health problems. The results provide data showing the persistence of cyanobacteria and cyanotoxins, many times over the limit, reinforcing the importance of constant monitoring. The assessment of environmental perception gives foundation for later proposed environmental education linked to public health management into the context of this particular population, making it more effective

Assessment of genetic damage induced by dental bleaching agents on mouse lymphoma cells by single cell gel (comet) assay

Dental bleaching is a simple and conservative procedure for aesthetic restoration of vital discoloured teeth. However, dental bleaching agents may represent a hazard to human health, especially by causing DNA strand breaks. Genotoxicity tests form an important part of cancer research and risk assessment of potential carcinogens. In the current study, the genotoxic potential associated with exposure to dental bleaching agents was assessed by the single cell gel (comet) assay in vitro. Six commercial dental bleaching agents (Clarigel Gold - Dentsply; Whitespeed - Discus Dental; Nite White - Discus Dental; Magic Bleaching - Vigodent; Whiteness HP - FGM and Lase Peroxide - DMC) were exposed to mouse lymphoma cells in vitro. The results pointed out that all dental bleaching agents tested contributed to the DNA damage as depicted by the mean tail moment. Clear concentration-related effects were obtained for DNA damaging, being the strongest effect observed at the highest dose of the hydrogen peroxide (Whiteness HP and Lase Peroxide, at 35% concentration). on the contrary, Whitespeed (Discus Dental) induced the lowest level of DNA breakage. Taken together, these results suggest that dental bleaching agents may be a factor that increases the level of DNA damage as detected by the single cell gel (comet) assay.

No relationship between subchronic fluoride intake and DNA damage in Wistar rats

Fluoride has been widely used in dentistry because it is an effective caries prophylactic agent. However, excess fluoride may represent a hazard to human health, especially by causing injury on the genetic apparatus. Genotoxicity tests form an important part of cancer research and risk assessment of potential carcinogens. In the current study, the potential DNA damage associated with exposure to fluoride was assessed by the single cell gel ( comet) assay in peripheral blood, oral mucosa and brain cells in vivo. Male Wistar rats were exposed to sodium fluoride (NaF) at a 0, 7 and 100 ppm dose for drinking water during 6 weeks. The results pointed out that NaF did not contribute to the DNA damage in all cellular types evaluated as depicted by the mean tail moment and tail intensity. These findings are clinically important since they represent an important contribution to the correct evaluation of the potential health risk associated with dental agents exposure. Copyright (C) 2004 S. Karger AG, Basel.