Controle judicial da política de assistência farmacêutica: direito, ciência e técnica

Para identificar mecanismos de compatibilização entre a lei e as normas técnicas, foram considerados o conceito de saúde e as características do Estado Democrático de Direito. Tomando-se o exemplo brasileiro das normas da política de assistência farmacêutica, concluiu-se que racionalidade jurídica impõe verificar se sua elaboração obedeceu ao requisito constitucional que exige a "participação da comunidade", instaurando um controle democrático e judicial.

Sustentabilidade financeira e econômica do gasto público em saúde no nível municipal: reflexões a partir de dados de municípios mato-grossenses

O financiamento do SUS é regido pelo modelo de federalismo fiscal, pelas regras de partilha do Orçamento da Seguridade Social (OSS), por normas do Ministério da Saúde, e pela Emenda Constitucional nº. 29 (EC-29), que vincula à saúde recursos dos entes federados brasileiros. Discute-se aqui a sustentabilidade do gasto público com saúde no nível municipal. Foram estudados 21 municípios, utilizando-se dados dos balanços municipais. De 1996 a 2006 as receitas correntes gerais per capita subiram 280% acima da inflação acumulada e do Produto Interno Bruto (PIB) nacional, variando conforme o porte do município, o qual também definiu a composição dos orçamentos municipais. Já o orçamento que conforma a base da EC-29 elevou-se bem menos (178%), impondo limitações ao incremento da contrapartida municipal em saúde. Acredita-se que o observado nesses municípios se reproduza em milhares de municípios brasileiros e comprometa a capacidade de investimento municipal em saúde, principalmente a partir de 2008. A situação ainda pode se agravar tendo em vista a extinção da Contribuição Provisória sobre a Movimentação ou Transmissão de Valores e de Créditos e Direitos de Natureza Financeira (CPMF), a tramitação dos Projetos de Lei nº. 306/08 e nº. 233/08, e a recessão mundial, a partir da crise do sistema financeiro norte-americano.

A construção do direito à saúde no Brasil

O direito à saúde recebeu - pela primeira vez - tratamento constitucional no brasil em 1988, fruto de grande participação popular. Neste estudo, se busca compreender a extensão dessa afirmação e verificar sua implementação normativa e jurisprudencial. A partir do estudo da evolução dos conceitos de saúde e de direito, concluiu-se que o direito à saúde deve implicar a constante participação popular para que possa ser delimitado. Verificou-se, também, que o arcabouço normativo vem sendo construído em conformidade com as exigências constitucionais. Quanto à construção jurisprudencial, se percebeu que ela vem acontecendo de forma errática e que os tribunais superiores raramente enfrentam a discussão da política de saúde desenhada na Constituição da República Federativa do Brasil de 1988. Concluiu-se que a afirmação constitucional tem demonstrado vigor, haja vista o grande desenvolvimento normativo conforme `compreensão contemporânea; e que o controle judicial da realização da política sanitária é ainda incipiente

Removal of ammonium via simultaneous nitrification-denitrification nitrite-shortcut in a single packed-bed batch reactor

A polyurethane packed-bed-biofilm sequential batch reactor was fed with synthetic substrate simulating the composition of UASB reactor effluents. Two distinct ammonia nitrogen concentrations (125 and 250 mg l(-1)) were supplied during two sequential long-term experiments of 160 days each (320 total). Cycles of 24 h under intermittent aeration for periods of 1 h were applied, and ethanol was added as a carbon source at the beginning of each anoxic period. Nitrite was the main oxidized nitrogen compound which accumulated only during the aerated phases of the batch cycle. A consistent decrease of nitrite concentration started always immediately after the interruption of oxygen supply and addition of the electron donor. Removal to below detection limits of all nitrogen soluble forms was always observed at the end of the 24 h cycles for both initial concentrations. Polyurethane packed-bed matrices and ethanol amendments conferred high process stability. Microbial investigation by cloning suggested that nitrification was carried out by Nitrosomonas-like species whereas denitrification was mediated by unclassified species commonly observed in denitrifying environments. The packed-bed batch bioreactor favored the simultaneous colonization of distinct microbial groups within the immobilized microbial biomass. The biofilm was capable of actively oxidizing ammonium and denitrification at high ratios in intermittent intervals within 24 h cycles. (c) 2008 Elsevier Ltd. All rights reserved.

Macrosegregation of Impurities in Directionally Solidified Silicon

Directional solidification of molten metallurgical-grade Si was carried out in a vertical Bridgman furnace. The effects of changing the mold velocity from 5 to 110 mu m seconds(-1) on the macrosegregation of impurities during solidification were investigated. The macrostructures of the cylindrical Si ingots obtained in the experiments consist mostly of columnar grains parallel to the ingot axis. Because neither cells nor dendrites can be observed on ingot samples, the absence of precipitated particles and the fulfillment of the constitutional supercooling criterion suggest a planar solid-liquid interface for mold velocities a parts per thousand currency sign10 mu m seconds(-1). Concentration profiles of several impurities were measured along the ingots, showing that their bottom and middle are purer than the metallurgical Si from which they solidified. At the ingot top, however, impurities accumulated, indicating the typical normal macrosegregation. When the mold velocity decreases, the macrosegregation and ingot purity increase, changing abruptly for a velocity variation from 20 to 10 mu m seconds(-1). A mathematical model of solute transport during solidification shows that, for mold velocities a parts per thousand yen20 mu m seconds(-1), macrosegregation is caused mainly by diffusion in a stagnant liquid layer assumed at the solid-liquid interface, whereas for lower velocities, macrosegregation increases as a result of more intense convective solute transport.

Closing the gap in curriculum development leadership

“Closing the gap in curriculum development leadership” is a Carrick-funded University of Queensland project which is designed to address two related gaps in current knowledge and in existing professional development programs for academic staff. The first gap is in our knowledge of curriculum and pedagogical issues as they arise in relation to multi-year sequences of study, such as majors in generalist degrees, or core programs in more structured degrees. While there is considerable knowledge of curriculum and pedagogy at the course or individual unit of study level (e.g. Philosophy I), there is very little properly conceptualised, empirically informed knowledge about student learning (and teaching) over, say, a three-year major sequence in a traditional Arts or Sciences subject. The Carrick-funded project aims to (begin to) fill this gap through bottom-up curriculum development projects across the range of UQ’s offerings. The second gap is in our professional development programs and, indeed, in our recognition and support for the people who are in charge of such multi-year sequences of study. The major convener or program coordinator is not as well supported, in Australian and overseas professional development programs, as the lecturer in charge of a single course (or unit of study). Nor is her work likely to be taken account of in workload calculations or for the purposes of promotion and career advancement more generally. The Carrick-funded project aims to fill this gap by developing, in consultation with crucial stakeholders, amendments to existing university policies and practices. The attached documents provide a useful introduction to the project. For more information, please contact Fred D’Agostino at f.dagostino@uq.edu.au.

The effect of grain refinement and silicon content on grain formation in hypoeutectic Al-Si alloys

The effect of increasing the amount of added grain refiner on grain size and morphology has been investigated for a range of hypoeutectic Al-Si alloys. The results show a transition in grain size at a silicon concentration of about 3 wt% in unrefined alloys; the grain size decreasing with silicon content before the transition, and increasing beyond the transition point. A change in morphology also occurs with increased silicon content. The addition of grain refiner leads to greater refinement for silicon contents below the transition point than for those contents above the transition point, while the transition point seems to remain unchanged. The slope of the grain size versus silicon content curve after the transition seems to be unaffected by the degree of grain refinement. The results are related to the competitive processes of nucleation and constitutional effects during growth and their impact on nucleation kinetics. (C) 1999 Elsevier Science S.A. All rights reserved.

Equiaxed solidification of Al-Si alloys

An experimental programme has been undertaken to determine which of the grain formation mechanisms of equiaxed crystals are dominant in the solidification of Al-Si foundry alloys. Small ingots were cast from alloys of varying silicon concentration with and without gauze barriers, using different types of mould materials and different mould preheats. The results show that two mechanisms of grain nucleation are operating. The first is a wall mechanism where crystals are nucleated either on or near the mould wall owing to thermal undercooling. The second is a constitutional supercooling mechanism where nucleants are activated in the constitutionally undercooled zone ahead of the advancing interface. As a consequence, the grain size decreases with increasing silicon content. However a transition in the growth mode occurs once a critical degree of constitutional undercooling is exceeded. This change in growth is accompanied by an increase in grain size. The transition point can be shifted with respect to solute content by changing the casting conditions, and a mechanism is proposed to explain this effect. MST/4109

Effect of smoke-free policies on the behaviour of social smokers

Objective-To test the hypothesis that proposed amendments to the Occupational Safety and Health Act making all enclosed workplaces in Western Australia smoke free would result in a decrease in cigarette consumption by patrons at nightclubs, pubs, and restaurants without adversely affecting attendance. Design-Cross sectional structured interview survey. Participants and setting-Patrons of several inner city pubs and nightclubs in Perth were interviewed while queuing for admission to these venues. Outcome measures-Current social habits, smoking habits, and how these might be affected by the proposed regulations. Persons who did not smoke daily were classified as social smokers. Results-Half (50%) of the 374 patrons interviewed were male, 51% currently did not smoke at all, 34.3% smoked every day, and the remaining 15.7% smoked, brat not every day. A clear majority (62.5%) of all 374 respondents anticipated no change to the frequency of their patronage of hospitality venues if smoke-free policies became mandatory One in five (19.3%) indicated that they would,ao out more often, and 18.2% said they would go out less often. Half (52%) of daily smokers anticipated no change to their cigarette consumption, while 44.5% of daily smokers anticipated a reduction in consumption. A majority of social smokers (54%) predicted a reduction in their cigarette consumption, with 42% of these anticipating quitting. Conclusions-One in nine (11.5%) of smokers say that adoption of smoke-Pi ee policies would prompt them to quit smoking entirely without a significant decrease in attendance at pubs and nightclubs. There can be few other initiatives as simple, cheap, and popular that would achieve so much for public health.

The case for a new system for oversight of research on human subjects

The increasing emphasis on evidence-based clinical practice has thrown into sharp focus multiple deficiencies in current systems of ethical review. This paper argues that a complete overhaul of systems for ethical oversight of studies involving human subjects is now required as developments in medical, epidemiological and genetic research have outstripped existing structures for ethical supervision. It shows that many problems are now evident and concludes that sequential and piecemeal amendments to present arrangements an inadequate to address these. Ar their core present systems of ethical review still rely on the integrity and judgement of individual investigators. One possible alternative is to train and license research investigators, make explicit their responsibilities and have ethics committees devote much more of their time to monitoring research activity in order to detect those infringing the rules.

Halo formation in directional solidification

A new model of halo formation in directional solidification is presented. The model describes halo formation in terms of competitive growth between the halo phase and coupled eutectic in liquid with a nominal composition that follows the primary phase liquidus extension with decreasing temperature. The model distinguishes between the effects of constitutional, capillarity and (where applicable) kinetic undercooling and avoids a number of theoretical inconsistencies associated with previous models. The critical growth rate for halo formation in directionally solidified hypereutectic Al-Si alloys is calculated using the model in conjunction with models of primary phase and coupled eutectic growth from the literature. The calculated result agrees reasonably well with the experimental result of Yilmaz and Elliott (Met. Sci. 18 (1984) 362), given the use of a relatively simple isolated dendrite tip model to calculate the growth undercooling of the halo tip. (C) 2002 Acta Materialia Inc. Published by Elsevier Science Ltd. All rights reserved.