Conselhos locais de saúde : caminhos e (des)caminhos da participação social no Sistema Único de Saúde

A partir da descentralização, novas instâncias de negociação e novas alternativas de ordenamento da estrutura organizacional do Sistema Único de Saúde (SUS) foram criadas. Dentre estas alternativas, podemos citar os conselhos de saúde, importantes canais de participação social. Todavia, frente às limitações destes canais tradicionais de articulação entre Estado e sociedade, destacamos os ideais da gestão participativa e os Conselhos Locais de Saúde (CLS) como alternativa de renovação e criação de instâncias mais flexíveis, porosas e efetivas às complexas demandas sociais. Neste sentido, buscamos analisar o processo de criação e implementação dos CLS do município de Anchieta/ES, a partir de uma abordagem quali-quantativa. Inicialmente, traçamos o perfil socioeconômico e político dos conselheiros eleitos, a partir de um questionário aplicado a uma amostra de 54 conselheiros; dados que foram categorizados e analisados por meio do emprego de estatísticas descritivas. Em seguida, entrevistamos treze conselheiros, de dois conselhos distintos do município, procedendo à análise de conteúdo do material, a partir dos ideais de Bardin (2000). Os resultados demonstraram que os conselhos foram criados a partir da iniciativa da gestão municipal em 2011, e que simplesmente institucionalizá-los como espaço de participação social não foi suficiente para promover a mobilização social e o envolvimento comunitário. Quanto ao perfil dos conselheiros locais, 78% são mulheres, com predominância de raça/cor branca, idade entre os 20 e 39 anos e funcionárias públicas; 57% possuem Ensino Médio e participaram como conselheiro por dois anos, e 60% destes já tiveram outras experiências de participação similares aos CLS. Do material oriundo das entrevistas, emergiram quatro categorias de análise, a saber: 1) Ser ou não ser conselheiro de saúde? Eis a questão!; 2) O não pertencimento e a não-participação; 3) Conselhos Locais de Saúde: elos, meios e mediações; e 4) A exogenia da administração e os obstáculos à participação social. Os entraves ao funcionamento dos conselhos de saúde, mesmo em nível local, ainda são desafios a serem superados, para que estas instâncias sejam mais influentes na gestão pública, conforme os princípios de sua criação. A participação social e a democracia são fundamentais para a construção de políticas de saúde que correspondam às reais demandas da comunidade. Contudo, para garantir a democracia na sociedade não basta promover a descentralização. É necessário que os sujeitos políticos resistam às relações de dominação, opressão e subordinação. Para isso, torna-se imprescindível os programas de educação para cidadania dos sujeitos envolvidos nestes fóruns de participação. O que nos motiva, enfim, é notarmos a existência, entre os conselheiros eleitos, de sujeitos protagonistas de seu próprio devir; sujeitos que atuam como agentes transformadores, motivadores de sonhos e projetos em prol da saúde pública e de sua comunidade.

Remoção do herbicida 2,4 diclorofenoxiacético (2,4-D) no tratamento convencional de água e associado à adsorção em carvão ativado em pó (CAP) em escala piloto

O aumento do uso de agrotóxicos no Brasil tem causado muitas preocupações, tanto em relação à questão ambiental quanto a saúde pública. Muitos desses compostos não são eficientemente removidos das águas por tratamento convencional, sendo necessárias alternativas que os removam das águas de abastecimento. Dentre as tecnologias existentes, a adsorção em CAP é considerada uma das mais efetivas e confiáveis, cujas vantagens incluem alta eficiência de remoção e facilidade de operação. O objetivo desta pesquisa é avaliar a remoção, em escala piloto, do agrotóxico 2,4-D e o seu principal metabólito 2,4-DCP em amostras de águas tratadas por adsorção em CAP associado ao tratamento convencional. Os testes foram realizados em instalação piloto na áreada ETA Carapina/CESAN. A água bruta foi a proveniente do rio Santa Maria da Vitória contaminadaatravés da adição de agrotóxico em sua fórmula comercial. Foram realizados quatro ensaios, dois sem adição de CAP e dois com adição de CAP junto à unidade de mistura rápida. Os agrotóxicos foram detectados e quantificados através da cromatografia líquida de alta eficiência, em metodologia validada. As amostras coletadas foram caracterizadas de acordo com os parâmetros: temperatura, turbidez, condutividade elétrica, absorbância em 254 nm, cor real, cor aparente, alcalinidade, carbono orgânico total, além e concentração dos agrotóxicos 2,4-D e ácido 2,4,5-T e do metabólito 2,4-DCP. Os diferentes ensaios foram avaliados em termos da taxa de remoção destes parâmetros. Como resultado no TCVcom adição de CAP o composto de interesse foi removido abaixo de 30 μg. L-1,Valor Máximo Permitido, estabelecido pela Portaria do MS n° 2.914/2011 para dosagem de 100μg.L-1e mostrou-se eficiente, também, na remoção de matéria orgânica. Em nenhum dos testes foi detectado o composto 2,4-DCP e 2,4,5-T.

Análise fatorial de uma medida de estratégias de enfrentamento

O objetivo do estudo foi investigar a estrutura fatorial da Escala Modos de Enfrentamento de Problemas - EMEP, na versão adaptada para a população brasileira por Gimenes e Queiroz (1997), para mensurar estratégias de enfrentamento em relação a estressores específicos. A amostra foi composta por 409 adultos de ambos os sexos, onde 252 consideraram como estressor um problema atual que estivesse ocasionando estresse, enquanto 157 foram pessoas portadoras de enfermidades crônicas, que responderam à escala com base no problema de saúde que estavam apresentando. Foram extraídos quatro fatores pelo método dos eixos principais, rotação ortogonal: estratégias de enfrentamento focalizadas no problema, estratégias de enfrentamento focalizadas na emoção, práticas religiosas/pensamento fantasioso e busca de suporte social. A análise dos achados nas duas sub-amostras, diferenciadas quanto aos estressores dominantes, sugere possibilidades positivas de aplicação em contextos de pesquisa e de intervenção profissional, em especial a atuação clínica voltada para manejo do estresse junto a diferentes clientelas. _______________________________________________________________________________ ABSTRACT

Brazil: an emerging military power? The problem of the use of force in Brazilian international relations in the 21st century

The central goal of this paper is thinking about the Brazilian military power and its linking to the international ambitions of the country in the 21st century. After a comparative analysis to other BRICs and with a historical one about Brazil's strategic irrelevance, we aim to establish what the minimum military capacity Brazil would need in order to meet the country's latest international interests. Similarly, it will be discussed if the National Strategy of Defense, approved in 2008, and the recent strategic agreements signed with France represent one more step toward this minimum military capacity.

Color Models and Illumination Changes

Color model representation allows characterizing in a quantitative manner, any defined color spectrum of visible light, i.e. with a wavelength between 400nm and 700nm. To accomplish that, each model, or color space, is associated with a function that allows mapping the spectral power distribution of the visible electromagnetic radiation, in a space defined by a set of discrete values that quantify the color components composing the model. Some color spaces are sensitive to changes in lighting conditions. Others assure the preservation of certain chromatic features, remaining immune to these changes. Therefore, it becomes necessary to identify the strengths and weaknesses of each model in order to justify the adoption of color spaces in image processing and analysis techniques. This chapter will address the topic of digital imaging, main standards and formats. Next we will set the mathematical model of the image acquisition sensor response, which enables assessment of the various color spaces, with the aim of determining their invariance to illumination changes.

Zinc supplementation, production and quality of coffee beans

Besides its importance in the coffee tree nutrition, there is almost no information relating zinc nutrition and bean quality. This work evaluated the effect of zinc on the coffee yield and bean quality. The experiment was conducted with Coffea arabica L. in "Zona da Mata" region, Minas Gerais, Brazil. Twelve plots were established at random with 4 competitive plants each. Treatments included plants supplemented with zinc (eight plots) and control without zinc supplementation (four plots). Plants were subjected to two treatments: zinc supplementation and control. Yield, number of defective beans, beans attacked by berry borers, bean size, cup quality, beans zinc concentration, potassium leaching, electrical conductivity, color index, total tritable acidity, pH, chlorogenic acids contents and ferric-reducing antioxidant activity of beans were evaluated. Zinc positively affected quality of coffee beans, which presented lower percentage of medium and small beans, lower berry borer incidence, lower potassium leaching and electrical conductivity, higher contents of zinc and chlorogenic acids and higher antioxidant activity in comparison with control beans.

Cold storage of peaches cv. Aurora grown in the Zona da Mata Mineira, Minas Gerais State, Brazil

This study aimed to evaluate the postharvest behavior of peach cv. Aurora 1 harvested in the Zona da Mata region of Minas Gerais in two ripening stages and kept under different storage temperatures. Fruits on mid-ripe and fully ripe stages were stored at three temperatures: 5.6 ± 1.57 °C and 72.8 ± 3.8% RH; 10.4 ± 0.5 °C and 95.8 ± 5.5% RH; 21.04 ± 1.63 °C and 96.9 ± 2.6% RH up to 28 storage days (SD) . During storage, fruits stored at 21.04 ± 1.63 °C were evaluated every two days until 8 SD, and every four days for fruits stored at other temperatures. The harvest day was assigned as day zero. The variables evaluated were CO2 production, color of the pericarp and pulp, fresh mass loss, flesh firmness, total soluble solids, titratable acidity, contents of ascorbic acid and carotenoids. The fresh mass loss increased during storage, peaking at 5.6 °C. The reduction in ascorbic acid content was higher in fully ripe fruits at all temperatures. Mid-ripe fruits reached the end of the storage period with better quality. The temperature of 10.4 °C was the most efficient in keeping postharvest quality of peach cv. Aurora 1 harvested in the Zona da Mata region.

Influence of strawberry jam color and phenolic compounds on acceptance during storage

The objective of this study was to evaluate the influence of the color and phenolic compounds of strawberry jam on acceptance during storage. Jams were processed, stored for 120 days and evaluated monthly for chromatic characteristics, total phenolic compounds, total anthocyanins (ANT), total ellagic acid (TEA), flavonoids and free ellagic acid (FEA), and sensory acceptance as well. Data were submitted to analysis of variance (ANOVA) and the means were compared by the Least Significant Difference (LSD). Cluster Analysis and Partial Least Square Regression (PLS) were performed to investigate the relationships between instrumental data and acceptance. Contents of ANT, TEA and redness decreased during storage. Other chemical characteristics and sensory acceptance showed a nonlinear behavior. Higher acceptance was observed after 60 days, suggesting a trend of quality improvement followed by decline to the initial levels. The same trend was observed for lightness, non-pigment flavonoids and FEA. According to PLS map, for consumers in cluster 2, acceptance was associated to jams at 60 days and to luminosity, FEA, and non-pigment flavonoids. For cluster 1, a positive association between flavor liking, jam at initial storage, and the contents of TEA and ANT was indicated. Jams at 120 days were positively associated to hue and negatively associated to color liking, for cluster 1. Color and texture were positively correlated to overall liking for cluster 2, whereas for cluster 1, overall acceptance seemed to be more associated to flavor liking. Changes in color and phenolic compounds slightly influenced the acceptance of strawberry jams, but in different ways for consumers clusters.

A blockmodel study of managerial hierarchies, verbal networks, and organizational culture in four hospitals

This study demonstrates and applies a social network methodology for studying the dynamics of hierarchies in organizations. Social network (blockmodel) analysis of verbal networks in four hospitals contrasted hierarchical and structurally equivalent partitions of the sociomatrices of frequent ties and perceptions of organizational culture. It was found that the verbal networks in these organizations follow a center periphery pattern rather than a hierarchical logic and that perceptions of culture vary more by verbal network than by formal hierarchy. The perceptions of culture of central groups in one organization are much like those of peripheral groups in another. In all four hospitals, structurally equivalent social networks are more important in predicting subcultures than are hierarchical groupings and hierarchy has a limited impact on the development of verbal networks. These findings suggest the value of an amoeba rather than a pyramid metaphor in interpreting the cultures and relational structures of organizations.

Possible consequences of increasing life expectancy in Brazil: the perspective of a European historical demographer

Those over sixty years of age accounted for 6.6% of the total population of Brazil in 1985, in the Federal Republic of Germany this proportion was 20.3% in 1984. As early as 1950 it had been 14.5%. This proportion will not even be reached in Brazil in the year 2000 when persons aged sixty years and older are only projected to make up 8.8% of the total population. Similarly, in 1982/84 life expectancy at birth in the Federal Republic was 70.8 years for men and 77.5 for women; in Brazil the figures for 1980/85 were, by contrast, "only" 61.0 and 66.0. Against this background it is easy to understand why the discussion concerning an ageing society with its many related medical, economic, individual and social problems has been so slow in coming into its own in Brazil. As important as a more intensive consideration of these aspects may be in Brazil at present, they are, nevertheless, only one side of the story. For a European historical demographer with a long-term perspective of three of four hundred years, the other side of the story is just as important. The life expectancy which is almost ten years lower in Brazil is not a result of the fact that no one in Brazil lives to old age. In 1981 people sixty-five years and older accounted for 34.4% of all deaths! At the same time infants accounted for only 22.1% of total mortality. They are responsible, along with the "premature" deaths among youths and adults, for the low, "average" life expectancy figure. In Europe, by contrast, these "premature" deaths no longer play much of a role. In 1982/84 more than half of the women (52.8%) in the Federal Republic of Germany lived to see their eightieth birthdays and almost half of the men (47.3%) lived to see their seventy-fifth. Our biological existence is guaranteed to an extent today that would have been unthinkable a few generations ago. Then, the classic troika of "plague, hunger and war" threatened our forefathers all the time and everywhere. The radical transition from the formerly uncertain to a present-day certain lifetime, which is the result of the repression of "plague, hunger and war", led to unexpected consequences for our living together. Our forefathers were forced to live in closely knit Gemeinschaften in the interest of physical survival and to subordinate their egoistic goals to a common value, but now these pressures have, for the most part, fallen away. Correspondingly, this much more certain EGO has taken center stage. An ever greater number of us chooses to live life as single beings: the number of marriages is lower every year; the number of divorces is on the increase; in Berlin (West) more than half (sic! 52.3%) of all households are already composed on only one person. For the last dozen years the annual number of births in the Federal Republic has been insufficient to ensure population replacement. Not a population explosion but rather the opposite, a population implosion, is our problem. Human beings do not appear to be "social animals", as was axiomatically assumed for so long. They were only forced to behave as such for as long as "plague, hunger and war" forced them to do so. When these life endangering conditions no longer exist and life becomes certain even without their being integrated into a Gemeinschaft then humans suddenly show themselves more and more to be independent single beings. It is not the percentage of the population that is over sixty or sixty-five that is decisive in this context but rather how certain adults perceive their biological lives to be, since they are the ones who organize their lives, who build communities or who are ever more often willing only to enter into means-to-an-end personal unions without lasting or close ties and mutual responsibilities. There are many signs which seem to point to a development in this direction in Brazil as well. More and more adults in Brazil are caught up in the deep-seated transition from an uncertain to a certain lifetime. A third of them die after having reached their sixty-fifth birthday. It therefore seems to me to be high time that one began to give more consideration to the other side of the story in Brazil as well. And who is more suited intensively to consider the long-term perspectives than those engaged in the public health sector in whose competence, after all, such aspects, as "life certainty", "life expectancy" and "age at death" belong?

On the Problem of Balancing the DC Capacitor Voltage Divider in Back-to-Back Multilevel Converters

This paper presents a new generalized solution for DC bus capacitors voltage balancing in back-to-back m level diode-clamped multilevel converters connecting AC networks. The solution is based on the DC bus average power flow and exploits the switching configuration redundancies. The proposed balancing solution is particularized for the back-to-back multilevel structure with m=5 levels. This back-to-back converter is studied working with bidirectional power flow, connecting an induction machine to the power grid.

Formaldehyde in indoor air: a public health problem?

Formaldehyde was the first air pollutant, which already in the 1970s emerged as a specifically non-industrial indoor air quality problem. Yet formaldehyde remained an indoor air quality issue and the formaldehyde level in residential indoor air is among the highest of any indoor air contaminant. Formaldehyde concentrations in 4 different indoor settings (schools, office buildings, new dwellings and occupied dwellings) in Portugal were measured using Photo Ionization Detection (PID) equipment (11,7 eV lamps). All the settings presented results higher than the reference value proposed by Portuguese legislation. Furthermore, occupied dwellings showed 3 units with results above the reference. We could conclude that formaldehyde presence is a reality in monitored indoor settings. Concentration levels are higher than the Portuguese reference value for indoor settings and these can indicate health problems for occupants.

Image and color recognition using amorphous silicon p-i-n photodiodes

Large area hydrogenated amorphous silicon single and stacked p-i-n structures with low conductivity doped layers are proposed as monochrome and color image sensors. The layers of the structures are based on amorphous silicon alloys (a-Si(x)C(1-x):H). The current-voltage characteristics and the spectral sensitivity under different bias conditions are analyzed. The output characteristics are evaluated under different read-out voltages and scanner wavelengths. To extract information on image shape, intensity and color, a modulated light beam scans the sensor active area at three appropriate bias voltages and the photoresponse in each scanning position ("sub-pixel") is recorded. The investigation of the sensor output under different scanner wavelengths and varying electrical bias reveals that the response can be tuned, thus enabling color separation. The operation of the sensor is exemplified and supported by a numerical simulation.

The problem of estimating the volatility of zero coupon bond interest rate

Financial literature and financial industry use often zero coupon yield curves as input for testing hypotheses, pricing assets or managing risk. They assume this provided data as accurate. We analyse implications of the methodology and of the sample selection criteria used to estimate the zero coupon bond yield term structure on the resulting volatility of spot rates with different maturities. We obtain the volatility term structure using historical volatilities and Egarch volatilities. As input for these volatilities we consider our own spot rates estimation from GovPX bond data and three popular interest rates data sets: from the Federal Reserve Board, from the US Department of the Treasury (H15), and from Bloomberg. We find strong evidence that the resulting zero coupon bond yield volatility estimates as well as the correlation coefficients among spot and forward rates depend significantly on the data set. We observe relevant differences in economic terms when volatilities are used to price derivatives.

Fungal contamination of poultries litter: a public health problem

Exposure to certain fungi can cause human illness. Fungi cause adverse human health effects through three specific mechanisms: generation of a harmful immune response (e.g., allergy or hypersensitivity pneumonitis); direct infection by the fungal organism; by toxic-irritant effects from mold byproducts, such as mycotoxins. In Portugal there is an increasingly industry of large facilities that produce whole chickens for domestic consumption and only few investigations have reported on fungal contamination of the poultry litter. The material used for poultry litter is varied but normally can be constitute by: pine shavings; sawdust of eucalyptus; other types of wood; peanut; coffee; sugar cane; straw; hay; grass; paper processed. Litter is one of the most contributive factors to fungal contamination in poultries. Spreading litter is one of the tasks that normally involve higher exposure of the poultry workers to dust, fungi and their metabolites, such as VOC’s and mycotoxins. After being used and removed from poultries, litter is ploughed into agricultural soils, being this practice potentially dangerous for the soil environment, as well for both humans and animals. The goal of this study was to characterize litter’s fungal contamination and also to report the incidence of keratinophilic and toxigenic fungi.