As novas demandas de segurança e defesa nacional e seus impactos na transformação organizacional dos ambientes militares, em especial, do exército brasileiro

O presente trabalho teve por propósito principal, descrever as novas demandas de segurança e defesa nacional e seus impactos na transformação organizacional dos ambientes militares. O focus do trabalho foi a transformação organizacional e o locus o Exército Brasileiro (EB), tendo por principal base teórica a gestão de mudanças, a gestão estratégica e a transformação das organizações, assim como a dinâmica do processo decisório e as relações entre as estratégias militar e empresarial. A problemática do tema foi baseada na descrição de como essas demandas impactam a transformação das estruturas organizacionais dos ambientes militares e, nesse sentido, decorreu outro questionamento sobre a possível existência de um espaço que possa emergir desse ambiente onde se pretende implementar a transformação, o qual represente o que está ocorrendo naquele momento, permitindo uma análise mais aprofundada das mudanças pelas quais as organizações passam. A pesquisa teve caráter qualitativo, com marco temporal a partir de 2008, com a publicação da Estratégia Nacional de Defesa, abrangendo pesquisa de campo que contemplou os três níveis organizacionais. O método utilizado foi o estudo de caso que buscou, através da análise do processo de transformação ora em curso no Exército Brasileiro, identificar seus elementos integrantes, explicar a ambiência militar, identificar as demandas que geraram esse processo e descrever os impactos que essas demandas têm produzido nos ambientes militares. Os principais resultados foram a identificação dessas demandas e de seus respectivos impactos sobre o locus do estudo em três áreas principais: as decorrentes do marco legal (Estado Brasileiro e Ministério da Defesa, por exemplo), do ambiente externo (sociedade, as novas ameaças e os conflitos armados contemporâneos) e do ambiente interno (principalmente das necessidades da força de trabalho das Forças Armadas). Com base nos impactos gerados por essas áreas, da análise do processo de transformação do EB, da percepção dos entrevistados e com base no referencial teórico, foi possível identificar um espaço onde a transformação ocorre e, com isso, determinar em que momento a organização se encontra em seu processo rumo à transformação ou, se ela apenas, tem se adequado à nova conjuntura e realizado somente mudanças incrementais.

Prevalence of the metabolic syndrome and its components in Brazilian women with polycystic ovary syndrome

SOARES, Elvira Maria Mafaldo et al. Prevalence of the metabolic syndrome and its components in Brazilian women with polycystic ovary syndrome. Fertility and Sterility, v.89, n.3, p.649-655, mar. 2008

A humanização no parto e no nascimento: os saberes e as práticas no contexto de uma maternidade pública brasileira

The practice of medicine related to the gestational processes tend to be organized according to the context and the place of work, being thus dependent of the conditions both social and economical, and of the physical structure and the functionality of the services. The high mortality rate in this process has diminished, since 1986, the study made by the World Health Organization (WHO) as to the technical aspects and the social inequalities that influence this situation in different geographical contexts. This culminated recommendations that proposed the reorientation of the dynamical practice of medicine, with a focus on the safety of maternities. Brazil adopted, in the year 2000, the suggestions of the OMS, emphasizing the humanization as the main reason for these actions. However, this discussion tends to not consider the problems caused by the social inequalities and the epidemiological and social conditionings that define the actions of the Unified Health System (Sistema Único de Saúde SUS). In this area, this research seeks to analyze the practices, cares taken, and the universal symbol that promotes and rewards the assistance to the birth of children by the SUS. Besides the analysis of the public documents that deal with this subject, an ethnographic study was developed in a maternity in Natal/RN, considered a model of humanization after receiving the Galba de Araújo prize in 2002. In this stage, the methodological strategies were observed, and the focus of the individual interviews with workers and users of this service. In the analysis of the data, it became evident that the different professional workers and women who gave birth, tend to show concern of the standards the delimit production and reproduction of the practice of medicine, as they favor the absence of a critical posture of the actions destined to the population. Besides this, if became evident that the institutional difficulties associated to the economical, cultural, and political problems also difficult the involvement and the reflection of the workers in favor of assisting changes of the process. There is also a utilization of a perspective prescriptive of humanization in the everyday life of the social workers, without reflection of its meaning. Some workers present, in their statements, a preoccupation with the social and economical aspects that affect the practice of medicine, and with the limitations of the humanization discourse that disarticulates the necessities of those involved in the process of formation, and soon tend to return to the discussion of humanization while a kind practice characterized by the minimization of the interventionist actions. Now the users of the system show themselves before the dynamic of the services, submitting themselves to what is offered while assistance, without questioning and/or reflecting about their usual shortages. Therefore, to think of changes in the know and do of the practice of medicine destined to the birth of children implies reflection on the quotidian production of these practices and of the social contexts that influence the process of assistance in the practice of medicine. Herein it would be possible to predict the appropriation, by different workers concerning their exasperations and necessities, making them active in the pursuit of their rights as citizens

Mulher não vale nem um real : patriarcado nas letras das músicas de forró

Patriarchy is a dominating system that establishes male power in social relations as the social-ideological system and the structuring element of several ways of men‟s domination on gender social relations, on organization of social life, on private relations, and on political decision spaces. In this study we enlarge our reflection about patriarchy from the analysis of Forró lyrics, more specifically the variation known as stylized. Of late decades, it is a kind of music that has been receiving a large acceptance all over the national territory, making use of everyday expressions that propagate and make apology to many forms of discrimination, oppression and violence against women. We emphasize that over this study 14 Forró lyrics were analyzed of different styles besides stylized, like the traditional and the double meaning ones. However, we dwelled on the content analysis, particularly in three Stylized Forró lyrics, they are: Tapa na Cara (2008) by Saia Rodada Band; Mulher Roleira (2004), Aviões do Forró Band; and Bomba no Cabaré (2007), Matruz com Leite Band. In order to make a critical analysis of the elements in the lyrics content, we support ourselves on the theoretic-methodological references of the dialectical materialism, a method that allowed us to get closer to the totality of the reality that includes the popular involvement of the analyzed lyrics in a qualitative way. In that sense, we hold onto the theoretic-methodological categories: gender social relations, patriarchy, violence against women, ideology and cultural industry. As from the lyrics compilation, they were arranged by theme, we classified and analyzed the content, which allowed us to comprehend the messages in the lyrics, beyond the text shows at first sight. Today, there are many mechanisms of propagation and perpetuation of patriarchal ideology. A very relevant mechanism of this phenomenon is the sexual violence. The violence against women is a form to propagate and keep sexism, which may occur in different ways, like physical, psychological, sexual, patrimonial and social. Through our study we established that the propagation of the violence against women as being something natural and banal, giving reinforcement to the asymmetric construction of gender relations that priorizes male to the detriment of female. This banalization is perhaps, one of the strongest allies of this phenomenon‟s perpetuation, that affects women all over the world from different social classes

Violência e luta por direitos no capitalismo contemporâneo: crítica à configuração do atendimento às mulheres no Rio Grande do Norte

This research analyzes the Rio Grande do Norte care services to women who face violence in the context of contemporary capitalism. To do so, we situate the patriarchy in the set of current social relations and its relationship with the corporate determinations in everyday life. The new functions of the Patriarchy in the capital sociability permeates the lives of individuals and particularizes the relationships of violence which affects women, requiring, in the immediate level, policy-making to face them. The research found an arsenal of contradictory possibilities and limitations in dealing with violence. In this process, forms of struggle and resistance predominate, which appear as possibilities and limits were identified relate to the socio-historical context of regression of the rights, historical moment in which increase the objective difficulties in everyday life to ensure the legal achievements. It is worth to emphasize the achievements and contradictions that characterize the struggle process for rights, linking services to women to the social policies and to the limits they face in opposition to the aims of the State to meet the mandatory requirements of capital, reducing its role as the main guarantor of policies and rights. In this sense, the trajectory of the achievements that have referred to the proclamation of a specific law to deal with combat violence against women, the Maria da Penha Law - 11.340/06, which provides an integrated set of measures that, if implemented, would allow the women protection from relations of violence they experience. We identified in Rio Grande do Norte precarious services that are essential to achieve the Maria da Penha Law. This situation requires a feminist organization to claim the rights that enable women to see themselves as people with rights in the process of collective struggle. This is the historical need for continuity of struggles that accumulate policies for the existence of a new model of social relations of gender. One of the possibilities that are presented in the current context is the impact on the public budget in order to ensure compliance with the budget for public policies for women - woman budget. In this perspective, feminist segments in national and state level have been organized to understand the functioning and monitoring of social policies. This is a condition and prerequisite for ensuring policies to ensure basic rights and the violence combat , which still requires an integrated set of services. The survey results allow us to consider that the struggle for rights is necessary at this historical moment, however it is not sufficient in human emancipation, which requires new forms of social relations that determine substantive equality between men and women. Thus, the feminist movement faces the challenge to organize and strengthen itself in daily life, in order to execute a project that changes the meaning of women's rights, articulated to a corporate project which wants other command in the set of social relations . This study emphasizes the need for a more and more organic connection between feminism and social struggles, to ensure the inclusion of women in anti-capitalist struggle

Care cost for pregnant and parturient women with diabetes and mild hyperglycemia

OBJETIVO: Comparar custos de hospitalização e de atenção ambulatorial em gestantes/parturientes diabéticas e com hiperglicemia leve. MÉTODOS: Estudo observacional, prospectivo, quantitativo descritivo realizado em centro de diabete perinatal em Botucatu, SP, entre 2007 e 2008. Foram estimados os custos por absorção diretos e indiretos disponíveis na instituição e os custos específicos para a doença (medicamentos e exames). As 30 gestantes diabéticas tratadas com dieta foram acompanhadas em ambulatório e 20 tratadas com dieta mais insulina foram hospitalizadas. RESULTADOS: O custo da doença diabete (para a assistência pré-natal e parto) foi de US$ 3,311.84 para as gestantes hospitalizadas e de US$ 1,366.04 para as acompanhadas em ambulatório. CONCLUSÕES: Os custos diretos e indiretos e o custo total da assistência pré-natal foram mais elevados nas gestantes diabéticas hospitalizadas enquanto os custos da assistência ao parto e hospitalização para parto e puerpério foram semelhantes. Os custos da assistência pré-natal como no parto/puerpério foram superiores aos valores pagos pelo Sistema Único de Saúde.

Metabolic syndrome and its associated risk factors in Brazilian postmenopausal women

Objective To evaluate the prevalence of metabolic syndrome (MetS) and its associated risk factors in Brazilian postmenopausal women.Methods In this cross-sectional study, a total of 368 postmenopausal women, aged 40-75 years, seeking health care at a public outpatient center in Southeastern Brazil, were included. According to the US National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines, MetS was diagnosed in subjects with three or more of the following: waist circumference >= 88 cm, blood pressure >= 130/85 mHg, triglycerides >= 150 mg/dl, high density lipoprotein cholesterol <50 mg/dl and glucose >= 110 mg/dl. Data on past medical history, tobacco use, anthropometric indicators, and values of C-reactive protein (CRP) were collected. Multivariate analysis, using a logistic regression model (odds ratio, OR) was used to evaluate the influence of various simultaneous MetS risk factors.Results The prevalence of having at least three, four and five MetS diagnostic criteria were met in 39.6%, 16.8% and 3.8% of the cases, respectively. The most prevalent risk factor was abdominal obesity, affecting 62.5% of women. The risk of MetS increased with a personal history of diabetes (OR 5.95, 95% confidence interval (CI) 2.82-12.54), hypertension (OR 4.52, 95% CI 2.89-7.08), cardiovascular disease (OR 2.16, 95% CI 1.18-3.94) and high CRP (>1 mg/dl) (OR 3.35, 95% CI 1.65-6.79). Plasma CRP levels increased with the number of MetS components present. Age, time since menopause and smoking had no influence, while hormone therapy reduced MetS risk (OR 0.64, 95% CI 0.42-0.97).Conclusion Metabolic syndrome was highly prevalent among Brazilian postmenopausal women seeking gynecologic health care. Abdominal obesity, diabetes, hypertension and high CRP were strong MetS predictors and hormone therapy appeared to play a protective role for this condition.

Obsessive-compulsive disorder: Prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric Morbidity Survey of 2000

Objective: There is little information about obsessive-compulsive disorder in large representative community samples. The authors aimed to establish obsessive-compulsive disorder prevalence and its clinical typology among adults in private households in Great Britain and to obtain generalizable estimates of impairment and help-seeking.Method: Data from the British National Psychiatric Morbidity Survey of 2000, comprising 8,580 individuals, were analyzed using appropriate measurements. The study compared individuals with obsessive-compulsive disorder, individuals with other neurotic disorders, and a nonneurotic comparison group. ICD-10 diagnoses were derived from the Clinical Interview Schedule-Revised.Results: the authors identified 114 individuals (74 women, 40 men) with obsessive-compulsive disorder, with a weighted 1-month prevalence of 1.1%. Most individuals (55%) in the obsessive-compulsive group had obsessions only. Comorbidity occurred in 62% of these individuals, which was significantly greater than the group with other neuroses (10%). Co-occurring neuroses were depressive episode (37%), generalized anxiety disorder (31%), agoraphobia or panic disorder (22%), social phobia (17%), and specific phobia (15%). Alcohol dependence was present in 20% of participants, mainly men, and drug dependence was present in 13%. Obsessive-compulsive disorder, compared with other neurotic disorders, was associated with more marked social and occupational impairment. One-quarter of obsessive-compulsive disorder participants had previously attempted suicide. Individuals with pure and comorbid obsessive-compulsive disorder did not differ according to most indices of impairment, including suicidal behavior, but pure individuals were significantly less likely to have sought help (14% versus 56%).Conclusions: A rare yet severe mental disorder, obsessive-compulsive disorder is an atypical neurosis, of which the public health significance has been underestimated. Unmet need among individuals with pure obsessive-compulsive disorder is a cause for concern, requiring further investigation of barriers to care and interventions to encourage help-seeking.

The Pediatric Rheumatology International Trials Organization American-College-of-Rheumatology provisional criteria for the evaluation of response to therapy in juvenile systemic lupus erythematosus: Prospective validation of the definition of improvement

Objective. To use the Pediatric Rheumatology International Trials Organization (PRINTO) core set of outcome measures to develop a validated definition of improvement for the evaluation of response to therapy in juvenile systemic lupus erythematosus (SLE).Methods. Thirty-seven experienced pediatric rheumatologists from 27 countries, each of whom had specific experience in the assessment of juvenile SLE patients, achieved consensus on 128 patient profiles as being clinically improved or not improved. Using the physicians' consensus ratings as the gold standard measure, the chi-square, sensitivity, specificity, false-positive and false-negative rates, area under the receiver operating characteristic curve, and kappa level of agreement for 597 candidate definitions of improvement were calculated. Only definitions with a kappa value greater than 0.7 were retained. The top definitions were selected based on the product of the content validity score multiplied by its kappa statistic.Results. The definition of improvement with the highest final score was at least 50% improvement from baseline in any 2 of the 5 core set measures, with no more than 1 of the remaining worsening by more than 30%.Conclusion. PRINTO proposes a valid and reproducible definition of improvement that reflects well the consensus rating of experienced clinicians and that incorporates clinically meaningful change in core set measures in a composite end point for the evaluation of global response to therapy in patients with juvenile SLE. The definition is now proposed for use in juvenile SLE clinical trials and may help physicians to decide whether a child with SLE responded adequately to therapy.

Committees for ethics in research involving human subjects

In Brazil since October 1996 there have been guidelines for research involving human subjects. Now human subjects know when their treatment is part of research. Deceit is no longer tolerated. But is not enough to say we offer an explanation to the potential subject and we offer a choice before he or she is confronted with an informed consent form. As in all professional activity, scientific investigation needs social controls. In Brazil, the ultimate responsibility of an investigation lies on the investigator, but in every institution where research is carried out there is a Committee for Ethics in Research. All Committees are subordinated to the National Commission of Ethics in Research, which is submitted to the Brazilian Institute of Health. During 2005 around 17,000 protocols involving 700,000 human subjects were revised by 475 Committees distributed all over the country. Approximately 7,000 people are now working in these Committees.

Social Panorama of Latin America 2006

Includes bibliography

Sustainable development 20 years on from the earth summit: progress, gaps and strategic guidelines for Latin America and the Caribbean

Includes bibliography

Sustainable development: changing production patterns, social equity and the environment

Includes bibliography

Millennium development goals. 2006 report: a look at gender equality and empowerment of women in Latin America and the Caribbean

Includes bibliography

The United Nations Regional Commissions: Enhancing Capacities To Eradicate Violence Against Women

This study captures the significant regional and national knowledge that has been accumulated on measuring violence against women through the interregional project "Enhancing capacities to eradicate violence against women through networking of local knowledge communities". Supported by the United Nations Development Account, this two-year project was coordinated by the Economic Commission for Latin America and the Caribbean (ECLAC), through its Division for Gender Affairs, and implemented by the five regional commissions of the United Nations, in cooperation with the United Nations Statistical Division and UN-Women. Through the project, more than 30 countries worldwide have been engaged in the development, dissemination and testing of core indicators endorsed by the United Nations Statistical Commission. This process has made a decisive contribution to designing and building consensus around a common methodology to measure and document violence against women. Furthermore, the inclusion of all five regions in piloting the newly-developed tools to measure violence has also ensured that these tools capture a more comprehensive and complex vision of violence as experienced by women across cultures and regions. This report presents an overview of the activities that have taken place in the five regions, and outlines the key outcomes and lessons learned. Through its activities, the interregional project has made the cumulative body of existing knowledge in terms of policies, findings, innovative practices, processes and statistical data available to policymakers, activists and women's organizations. New knowledge was also produced through national studies that examined underexplored sources of data on violence against women. National capacities to collect information on violence against women through official statistics were strengthened through targeted training activities as well as through participation in expert meetings which provided the space for an effective exchange of best practices.