O direito à saúde e a política nacional de atenção oncológica: uma análise a partir da crescente judicialização dos medicamentos antineoplásicos

The 1988 Federal Constitution of Brazil by presenting the catalog of fundamental rights and guarantees (Title II) provides expressly that such rights reach the social, economic and cultural rights (art. 6 of CF/88) as a means not only to ratify the civil and political rights, but also to make them effective and practical in the life of the Brazilian people, particularly in the prediction of immediate application of those rights and guarantees. In this sense, health goes through condition of universal right and duty of the State, which should be guaranteed by social and economic policies aimed at reducing the risk of disease and other hazards, in addition to ensuring universal and equal access to actions and services for its promotion, protection and recovery (Article 196 by CF/88). Achieving the purposes aimed by the constituent to the area of health is the great challenge that requires the Health System and its managers. To this end, several policies have been structured in an attempt to establish actions and services for the promotion, protection and rehabilitation of diseases and disorders to health. In the mid-90s, in order to meet the guidelines and principles established by the SUS, it was established the Política Nacional de Atenção Oncológica PNAO, in an attempt to sketch out a public policy that sought to achieve maximum efficiency and to be able to give answers integral to effective care for patients with cancer, with emphasis on prevention, early detection, diagnosis, treatment, rehabilitation and palliative care. However, many lawsuits have been proposed with applications for anticancer drugs. These actions have become very complex, both in the procedural aspects and in all material ones, especially due to the highcost drugs more requested these demands, as well as need to be buoyed by the scientific evidence of these drugs in relation to proposed treatments. The jurisprudence in this area, although the orientations as outlined by the Parliament of Supreme Court is still in the process of construction, this study is thus placed in the perspective of contributing to the effective and efficient adjudication in these actions, with focus on achieving the fundamental social rights. Given this scenario and using research explanatory literature and documents were examined 108 lawsuits pending in the Federal Court in Rio Grande do Norte, trying to identify the organs of the Judiciary behave in the face of lawsuits that seeking oncology drugs (or antineoplastic), seeking to reconcile the principles and constitutional laws and infra constitutional involving the theme in an attempt to contribute to a rationalization of this judicial practice. Finally, considering the Rational Use of health demands and the idea of belonging to the Brazilian people SUS, it is concluded that the judicial power requires ballast parameters of their decisions on evidence-based medicine, aligning these decisions housing constitutional principles that the right to health and the scientific conclusions of efficacy, effectiveness and efficiency in oncology drugs, when compared to the treatments offered by SUS

Finanças públicas na nova ordem constitucional brasileira: uma análise comportamental dos municípios potiguares, nos anos antecedentes e posteriores à lei de responsabilidade fiscal LRF

The object of the present dissertation is to analyze the behavior of the public finances of the districts of the state of Rio Grande do Norte (RN), taking as reference a period fundamentally previous to the implementation of the Fiscal Responsibility Law LRF, comparatively to the first years, immediately after the advent of the mentioned institutional milestone. The central hypothesis of this study proposes that, from the institutions' viewpoint, the LRF sets securely consistent rules, in the orchestration of the behavior of the municipal revenues and expenses. These regulations, on the other hand, might be effective and reach the districts of the RN indiscriminately, apart from stabilizing tendencies and which are sustainable in the long run. In spite of this, the indicators calculated reveal that the districts researched show, during all the period under analysis, a diminished capacity of self-tax collection , and consequently, a high participation of the intergovernmental transfers in the composition of the current revenues. This behavior indicates that the goal of strengthening the municipal public finances, forecast in the LRF, tends to be only partially accomplished, due to the fiscal decentralism. The analysis and interpretation of the data are conducted from the literature of institutionalist orientation and in descriptive statistical tools applied to the municipal strata of the state of Rio Grande do Norte. Further on, it's used the econometrical method Pooled OLS, which demands the elimination of the municipal strata in order to allow the use of the model, in the attempt to strengthen and/or ratify the results of the research. Finally, the evidence reached in the dissertation show that the LRF brings better conditions to the potiguar municipal public finances, predominantly to the economically stronger districts; whereas the less dynamic municipal entities show rather divergent evidence, that is, their economies seem to be more oriented to a more pronounced state participation; therefore, it generates in the state of RN a certain antithesis in the results reached in the dissertation

Aspectos biológicos do ácaro Brevipalpus phoenicis vetor da leprose dos citros em plantas de buva (Conyza canadensis)

O ácaro Brevipalpus phoenicis, vetor da leprose dos citros, é uma espécie polífaga que tem ampla gama de hospedeiros alternativos nos pomares cítricos, nos quais se pode manter e/ou incrementar suas populações. O objetivo deste trabalho foi estudar a sobrevivência, a oviposição e o modo de alimentação do ácaro B. phoenicis em plantas de buva (Conyza canadensis) com diferentes tamanhos. Para avaliação da sobrevivência e oviposição do ácaro B. phoenicis, foi utilizado o delineamento estatístico inteiramente casualizado, com cinco tratamentos e doze repetições. Os tratamentos estudados foram: (1) secções de caules de plantas menores que 20 cm, (2) entre 21 e 50 cm, (3) entre 51 e 100 cm e (4) maiores que 101 cm de altura; e (5) secções de ramos de laranja. Dez fêmeas adultas de B. phoenicis, procedentes de uma criação-estoque, foram transferidas para cada secção de caule de buva e ramos de citros como testemunha. Avaliou-se a sobrevivência e a oviposição dos ácaros até 120 horas após a transferência. Alguns aspectos comportamentais do ácaro B. phoenicis foram fotomicrografados, utilizando-se microscópico eletrônico de varredura. Verificou-se que as plantas de maior altura de buva foram mais favoráveis à sobrevivência do ácaro B. phoenicis do que as de menor tamanho. Contudo, a quantidade de ovos postos pelo ácaro não diferiu em relação à altura das plantas de buva. Com base nas fotomicrografias, constatou-se a preferência do ácaro B. phoenicis por se alimentar na base dos tricomas presentes na superfície do caule da planta de buva, justificado, possivelmente, pela maior turgescência das células encontradas nessa região da planta. Esses resultados reforçam a importância do manejo de buva nos pomares cítricos, pois a sua presença no campo pode favorecer a sobrevivência e o desenvolvimento do ácaro B. phoenicis, servindo, portanto, como hospedeira alternativa, o que pode contribuir para a disseminação do ácaro e, consequentemente, da leprose nos pomares cítricos.

Molecular characterization of group A bovine rotavirus in southeastern and central-western Brazil, 2009-2010

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

Morphology of beak and tongue of partrigde Rhynchotus rufescens

Vinte perdizes Rhynchotus rufescens foram utilizadas para estudar a morfologia do bico e da língua. Os comprimentos do bico e da língua foram avaliados, e secções histológicas foram coradas com Hematoxilina-Eosina (HE), ácido periódico de Schiff (PAS) e tricromo de Masson, posteriormente analisadas e descritas. O bico da perdiz em ambos os sexos são curvos, duros e com uma extremidade pontiaguda tendo em média de 4,90cm de comprimento para as fêmeas e 4,80 para os machos. A língua é caracterizada por um formato triangular e possui em média 1cm de comprimento para ambos os sexos, sendo sua extremidade pontiaguda. A organização histológica da língua apresenta epitélio estratificado queratinizado com papilas filiformes em toda a superfície, glândulas mucosas com ductos que se projetam na superfície epitelial e cartilagem hialina em todo o comprimento, localizada sobre a musculatura esquelética, a qual é orientada em várias direções.

Acesso e permanência na universidade federal do rio grande do Norte sob o ponto de vista do docente e do estudante com deficiência Natal-RN

Inclusion of students with disabilities is a recent case that has been discussed in school contexts, but the current policy of inclusion for access and retention of students in higher education is still a problem face there is much to do, therefore, are incipient studies in which this student body is involved. Accordingly, what is happening is that the most studies deal with on these students and little is said about them. For inclusive education thus the institution should prepare to receive students, having as one of its premises their point of views about what actually experience aiming at promoting education for all. Therefore, this study deals with the process of inclusion of students with disabilities regularly enrolled in undergraduate courses at the Universidade Federal do Rio Grande do Norte - UFRN.They were used the assumptions of qualitative research enabled by the case study method and semi-structured interviews. It has been analyzed by guiding actions and teaching practices, under the views of disabled students and teachers, the conditions of access and permanence offered by UFRN. Twelve students with physical, visual, hearing disabilities participated and five teachers from the acedemic centers that in academic year 2008 taught to these students. For data analysis it was used the technique of content analysis. It was extracted two themes: access and retention of students with disabilities in UFRN, in which emerged the categories described and analyzed in the course of this work. The results show the difficulties of access and retention of students with disabilities within the UFRN, such as attitudinal, pedagogical and architectural barriers. However, as it has also turned out, initial advances in the quest for achieving more effective actions to guarantee access and permanence of these students in UFRN. It has concluded that the scope for the exercise of citizenship in the pupils with disabilities who need this Higher Education Institution has an inclusive education Project, wide and consolidated, for the actions undertaken by the Ministry of Education - MEC, by itself, are not guaranteed to all students due to mobility, autonomy and security. It has hoped this work will bring benefits for new studies to develop features that were located, but were not our focus, because then the UFRN may advance the inclusive process of disabled students

É preciso estar atento: um estudo da relação entre desenvolvimento da atenção e aprendizagem

Se discute en este estudio la relación entre o desarrollo de la atención y el aprendizaje de la lengua escrita realizada con los alumnos del 5º grado de la Enseñanza Primaria, compuesta de 25 alumnos, con la edad entre 9 e 13 años, de la Escola Municipal Professor Arnaldo Monteiro Natal/RN. Para el desarrollo de este proceso investigativo, utilizamos como aporte teórico el materialismo histórico-dialéctico, pues ese método posibilita el análisis de los fenómenos y, a través de esa lógica, se revelan los elementos que dieron sustentación a la mediación pedagógica y comprensión de los fenómenos con mayor eficacia. También fueron usados los estudios de Vigotski (1991), Rubinstein (1973), Ferreira (2003), Ibiapina (2007), y otros que convergen con ese posicionamiento. Se adoptó la pesquisa colaborativa que supone la construcción de un objeto del conocimiento entre investigador y profesor y también asocia al mismo tiempo actividades de producción del conocimiento y de desenvolvimiento profesional, proponiéndose una mediación entre comunidad de investigadores y comunidad de profesores. Utilizamos como elementos metodológicos el diagnóstico de la atención, el diagnóstico de la producción escrita del texto narrativo, siguiendo las etapas elaboradas por Infante (1998), los diarios reflexivos, el planeamiento y las sesiones reflexivas (con alumnos y con los pares). Para análisis del desarrollo de la atención, utilizamos las categorías definidas por Luria (1991): volumen de la atención, estabilidad de la atención, oscilación de la atención. El análisis de la producción textual tuve como parámetros las categorías de cohesión y coherencia (COSTA VAL, 1999). Para esto, se reflexionó con ellos sobre la importancia del desenvolvimiento de la atención para aprendizajes más efectivas. Propusimos situaciones de aprendizajes que posibiliten el desarrollo de la atención de esos alumnos y el dominio de la producción textual; y se analizaron las interrelaciones entre desenvolvimiento de la atención y la producción de textos narrativos. Los resultados presentados en los textos permiten afirmar que es notoria la relación entre la atención y el aprendizaje de la escritura. Vale resaltar que la reflexión no puede tener un fin en si mismo o entonces ser usada apenas para justificar una acción, mas debe tener como objetivo mejorar la enseñaza y tornar los profesores más conscientes y, por lo tanto, más capacitados para ejercer su profesión

Avaliação morfométrica da área do epidídimo e dos dúctulos eferentes e ductos epididimários da codorna doméstica, no decorrer do ano

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

Os jogos com regras na perspectiva do desenho universal: contribuições à educação matemática inclusiva

To think about a school that is for everyone has been a challenge for many people connected to education worldwide demanding from researchers of each level of knowledge an association to such effort. The study presented on this paper unites itself to the voices, movements and researches of these scholars, seeking to contribute on building possibilities on which mathematics can be thought and worked on schools in order for every student to learn, whether they have some sort of deficiency, disorders, syndromes or not. This essay has the goal to investigate the possibilities of inclusive pedagogical practices mediated by math games with rules, developed and used throughout the Universal Design perspective; a qualitative research took place with a collaborative methodology that involved managers, teachers and students from a public school situated on the city of Natal/Brazil. On the investigation math games with rules were developed and made according to the Universal Design concept, starting from initial studies which articulated theoretical groundings to the reality of school and the teacher s conceptions. After that, classes using these tools were planned collectively which oriented inclusive pedagogical practices of classes from the 1st to the 4th year of elementary school. Throughout the process many instruments such as: tape recording, video footages, notes from the researcher; the teachers and the students were used for constant work evaluation and also to record the research data. In the end, the data indicated effective contributions of the mediated pedagogical practices by games with rules under the perspective of Universal Design for Inclusive Mathematics Education

Alfabetização de crianças e jovens: superando desafios da inclusão escolar

This work has its genesis in the life of a teacher. It contemplates the report of a great story that expresses the political will of anonymous people who sought/seek to overcome challenges and prejudices, a joint effort to make real the right to literacy. The reported story was developed in the Pedagogic Clinic Teacher Heitor Carrilho, Natal-RN which, concerned about the sentence of 'unable to learn the written language' attributed to children and young public school students, decided to invest in overcoming prejudices and fight against school failure of these underprivileged. The problem that motivated the study was thus set up: What particularities characterize a pedagogical practice which aims to teach literacy to children and youth from public schools, considered not capable of learning the written language? What theoretical and methodological procedures are shown as a boost to literacy in the development of a pedagogical practice systematically targeted to reflect the perspective of educating those students in public schools? Aiming to answer these questions, we conducted a qualitative research having as methodology, Life Stories and Research/Formation. For the construction of the data, it was decided to use the participative observation, semi-structured interviews and document analysis. Guided by the principles of content analysis the data analysis was built, from which emerged two categories: theoretical and methodological procedures aligned to the major axes of literacy and Procedures of the specific theoretical and methodological fundamentals of literacy. As subsets of the transverse procedures others were seized: didactic-pedagogic procedures; social affective procedures. Regarding these ones, the research shows the importance of the teacher to build a relationship of listening to the students and their families in order to organize the pedagogical work, looking at multiple dimensions of the subject: the intellect, the creative, the affective, moral, noting that between the methodology and didactics or as part of it, the links built represent great opportunities to promote literacy. Regarding the specific procedures, others were built: procedures that emphasize oral communication, procedures that favor writing and procedures that privilege reading. Under these procedures, the results of research show that you can only promote literacy if the teacher provides the students effective conditions of understanding the principles of alphabetical notation from the use of various kinds of texts, leading them to comprehend and use them in different contexts. Therefore, instructors must meet the learners' prior knowledge, their language, and the learning real needs that will bring new challenges consistent with their possibilities. The research confirms the importance of the Educational Support extra school. However, it is essential to emphasize that it is a function of the school to promote literacy for all students in the early years of schooling. It is recorded, however, that for the implementation of this desire, we must break the school model characterized by a rigid tradition, in which there is only room for those who learn the content taught in a minimum time. Unfortunately, despite the discourse of inclusion and ensuring the right to education, the school remains exclusive and selective separating the school learning of interpersonal relations and social integration and performance. On the one hand, research showed the difficulties of conducting studies and/or strategies that address the particularities of children and young people believed not capable of learning. On the other hand, the political commitment and motivation have increased the perception that it is possible to mitigate the existing deficits in the educational context, beginning with the everyday teaching practice, in which new knowledge can be learned, methodologies can be improved and, despite everything, the educational success can be built

Ludopoiese e humanescência no educador infantil

This research has as study objective the development of humanescent experience in the process of self-formation of the teachers of the Infantile Educational Unit of the Education Center of the Federal University of Rio Grande do Norte. It has as general objective the description and analysis of how the humanscent experience of life contributes and is manifested in the children educator in his way of being, living and in his pedagogical practice. As specific objectives, the identification of the contributions of the humanescent experiences in the children educator in his way of being, living and in his pedagogical practice; the analysis of the contributions of the humanescent experiences to the children educator from the ludopoetic categories self-esteem, selfworth, self-realization, self-territory and self-connectivity. It is a descriptive study of qualitative nature understood as an existential action research that uses the principles and fundamentals of the etnomethodology and phenomenology. Sixteen teachers six that are effective teachers, six substitute teachers and 4 interns - took part in this investigation. Six humanescent experiences were carried out with them. As main tools we point out: the participative observation, the sand game, the photographic register and the semi-structured interview. The analyses were centered in the categories of the ludopoetic system, described above and referred to in the theoretical fundamentals selected for the study. From the analyses and to the answers to the objectives of the study, we make clear the following considerations: the reports of the teachers reveal that the humanescent experiences have contributed to make them more ludic, sensitive, emotional and lovely people, and this has reflected in their educational practice and has been making sense in their and their students lives. In this way, we make evident that the humanescent experiences have contributed to improve the ludopoesis of the teachers, revealing in the embodiment changes in their way of being, of living together and in their educational practice. In relation to the contributions of the humanescent experiences to the children educator from the ludopoetic categories self-esteem, selfworth, self-realization, self-territory and self-connectivity, we emphasize the following aspects: with the self-esteem, teachers have become more creative, rebuilding their possibilities of intensely experiencing the pleasure of living; in the context of selfterritory, the teachers have provided the realization of the wishes and expresson of oneself while lively interacting with the environment and with the other different territories of the educational process, in a continuous process of demarcation. Concerning the self-connectivity category, we emphasize that the teachers started to become more tuned with themselves, with the environment and with the other teachers because of the general well-being to the success of personal, pedagogical and institutional objectives, promoting a harmonic, lovely and ludic environment. Concerning the self-worth category, the teachers have valued the struggle for a school that is more committed with the search for happiness. From the self-realization, the teachers have shown self-recognition while ludic beings, playing with the beauty in their lives, allowing the flowing in its completeness, the other possibilities of analysis, the educational formation and development. We would like to emphasize that the considerations above are not over after what has been presented because of the richness of experiences revealed in the research

Avaliação de um programa de educação ambiental não formal: a Caravana Ecológica na visão dos participantes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Mechanism of infection and colonization of Rhipicephalus sanguineus eggs by Mertarhizium anisopliae as revealed by scanning eletron microscopy and histopathology

O presente trabalho teve como objetivo verificar a forma de penetração do fungo Metarhizium anisopliae em ovos do carrapato Rhipicephalus sanguineus, assim como as lesões infringidas no interior do ovo. A aderência e penetração do fungo foram estudadas por meio da microscopia eletrônica de varredura e a ação do fungo nos tecidos internos avaliada em secções histológicas convencionais. Para observação destes eventos, realizaram-se infecções experimentais em 11 grupos de ovos do R. sanguineus contendo 25 mg cada. Os ovos foram banhados durante 3 minutos, sob agitação manual, em suspensão com concentração de 10(8) conídios/mL. Nos grupos controle o banho foi realizado apenas no veículo da suspensão. Os ovos foram processados para análise histopatológica e microscopia eletrônica de varredura nos seguintes tempos após a infecção: 1 e 18h, e um, dois, três, quatro, cinco, seis, sete, nove e onze dias. Observou-se grande germinação de conídios em 67% dos ovos 18h após a inoculação e o fungo penetrou em 92,6% dos ovos 5 dias após a infecção. A extrusão do patógeno ocorreu em 87% dos ovos 7 dias após a infecção, chegando a 100% no 9º dia. Nas análises histopatológicas não foram observadas lesões dignas de nota, porem deve-se ressaltar que houve significativa redução (53,9%) na eclosão a partir dos ovos infectados.

Colonização e lesão em fêmeas ingurgitadas do carrapato Rhipicephalus sanguineus causadas pelo fungo Metarhizium anisopliae

O presente trabalho teve como objetivo verificar a forma de penetração do fungo Metarhizium anisopliae [METSCH. (SOROKIN, 1883)] em carrapatos da espécie Rhipicephalus sanguineus (LATREILLE, 1806), assim como as lesões infringidas nos tecidos internos do ácaro. A forma de aderência e penetração do fungo foi estudada através da microscopia eletrônica de varredura e a ação do fungo nos tecidos internos avaliada em secções histológicas convencionais. Para observação destes eventos, realizaram-se infecções experimentais em 11 grupos de fêmeas ingurgitadas do carrapato R. sanguineus contendo 12 fêmeas ingurgitadas cada. Para tal, as fêmeas ingurgitadas foram banhadas durante 3 minutos, sob agitação manual, em suspensão com concentração 108 conídios/mL. No caso dos grupos controle o banho foi realizado apenas no veículo da suspensão. Os carrapatos foram processados para histopatologia e microscopia eletrônica em diversos tempos após a infecção, a saber: 1 e 18h, e um, dois, três, quatro, cinco, seis, sete, nove e onze dias. Observou-se que a maior parte dos conídios germinou em até 18h após a inoculação e que o fungo penetrou no ácaro através do tegumento 48h após a infecção. Após a penetração, o fungo invadiu o corpo do hospedeiro promovendo uma colonização difusa, sem preferência aparente por tecidos específicos. Dentre as lesões nos tecidos internos do ácaro, ressalta-se o rompimento da parede intestinal e vazamento do conteúdo para a hemocele. A morte do hospedeiro ocorreu entre 96 e 120h pós-infecção, e a esporulação do patógeno sobre o cadáver do ácaro iniciou-se em torno de 120 a 144h pós-infecção. Espera-se, com este trabalho, contribuir para o desenvolvimento e viabilização de técnicas de controle biológico dos carrapatos por fungos como alternativa ao uso de acaricidas.

Conhecimento do enfermeiro sobre as ações de vigilância epidemiológica no Hospital Universitário Onofre Lopes, Natal, RN

This is an exploratory descriptive study with quantitative approach, aiming to verify the nurses' knowledge concerning the epidemiological surveillance activities at the Onofre Lopes hospital (HUOL), in Natal, Rio Grande do Norte. The study was performed with 63 nurses from the hospital and the data were collected through a questionnaire. All data were analyzed using descriptive statistics. The results were discussed and organized into four sections: nurses' knowledge on hospital epidemiological surveillance; procedures of the professional nurse through compulsory notification diseases; difficulties found by nurses to register the compulsory notification diseases and suggestions of strategies to joint epidemiological surveillance service with the care practices of nurses. The results showed that 55.55% of nurses know the main action of epidemiological surveillance, compulsory notification of diseases, and that 42.86% reported to the Hospital Epidemiology Center , while 57.14% did not allocate the information for this service. Most nurses found it difficult to perform notification for not knowing its flow; for the surveillance service does not operate 24 hours and for vagueness on diagnostic of disorders. Suggestions of strategies to improve the quality of epidemiological information are focused on training of nurses in hospital epidemiological surveillance; working in partnership with the surveillance center; diffusion of information on surveillance and conducting a daily active search. It comes to conclusion that most nurses don't notify the Surveillance Center about Compulsory Notification Diseases and it wasn't observed the incorporation of integrality values between the hospital surveillance and all nurses, since this principle guides the actions of health services based on dialogue, listening, ethical commitment, sharing of knowledge among professionals of various services and respect towards other professionals. Therefore, the integrality gap in the actions of the nurses studied, as well as in the surveillance service does not mobilize the potential of such services to changes in the sense of achievement of practices aimed at a special attention model that combines preventive and corrective actions, proposed and desired by SUS. Through the difficulties presented, it becomes important to recommend educational processes with strategy to transform the conducts, besides proposing actions under the principle of integrality provide responses agile and effective, as the purpose of VE hospital emergency care by the current epidemic