A participação dos conselhos de saúde na fiscalização da política de saúde: uma análise da sua ineficiência na RMB

Historicamente, o controle social das políticas públicas como direito Constitucional foi uma conquista da sociedade civil, por meio de inúmeras reivindicações e lutas pela defesa do SUS, como garantia de direito à saúde para todos os cidadãos. A participação social surge também como resultado desse processo de luta popular, e a inserção de novos atores sociais na gestão das políticas públicas é reconhecido e legitimado com a promulgação da Constituição federal de 1988. Neste sentido, os Conselhos de Saúde têm apresentado um quadro favorável à inserção de diversos segmentos nas decisões da agenda governamental. Os Conselhos de Saúde da Região Metropolitana de Belém (RMB), especificamente os municípios Belém, Marituba e Benevides, foram objeto de pesquisa neste trabalho, que tem como objetivo central identificar a atuação dos Conselhos de Saúde da Região Metropolitana de Belém na fiscalização das ações do SUS. Os procedimentos metodológicos utilizados nesta pesquisa foram: a entrevista; a observação; o questionário de entrevista aplicado aos conselheiros; e a pesquisa documental e bibliográfica. Utilizamos também a análise de discurso e de conteúdo, considerando principalmente a análise de anunciação e a análise temática, configurando em uma pesquisa quali e quantitativa. Os resultados da pesquisa constataram que, por meio de dados empíricos e conceituais de organização, na perspectiva de Olson (1999) e Michels (1982), de participação social, controle social e fiscalização utilizada neste trabalho, os entraves de cunho ideológico, social e econômico interferem de forma direta ou indireta na ineficiência das ações dos Conselhos. Sobretudo, são as questões políticas que influenciam de forma expressiva na fiscalização dos CS, muitas vezes de maneira “silenciosa” nas decisões e, consequentemente, na ineficiência da participação da sociedade nos Conselhos em sua função que, apesar de ser inerente, não funciona – a função fiscalizadora. Portanto, contribuir conceitual e metodologicamente para a análise dos níveis de fiscalização existentes nos CS foi o grande desafio deste trabalho, realizado por meio da construção da matriz da fiscalização, a fim de alterar o quadro situacional da ineficiência dos Conselhos na atualidade, considerando as diversidades, divergências e convergências existentes entre os atores envolvidos no processo de construção da Política de Saúde Municipal. Os resultados da pesquisa refletem um panorama desfavorável à efetiva fiscalização dos Conselhos, quando nos remetemos aos resultados centrais da referida pesquisa: os CS não cumprem seu papel fiscalizador; não há relação direta entre o que é decidido nas plenárias pelos conselheiros e os serviços implementados nos municípios; e não existem prioridades estabelecidas no processo decisório das ações a serem implementadas pelo CS. Sendo assim, o nível de fiscalização dos CS da RMB é predominantemente o nível 1, isto é, sem fiscalização. Neste sentido, afirmamos que os Conselhos de Saúde, apesar de ser uma conquista de lutas populares pela ampliação da participação na gestão pública, ainda predomina um baixo nível de fiscalização ou até mesmo nenhuma fiscalização da política municipal de saúde, o que pode ser considerado um dos entraves à consolidação do SUS, como estratégia à concretização do Estado democrático no país.

State of the art on animal embryonic chimeras

Embryonic chimerism is generally used in basic research and in vivo diagnosis of undifferentiated embryonic stem cells (ESC), mostly using mice embryos, although there have been reports in the literature on using rat, rabbit, sheep, chicken, primate, bovine, goat and pig embryos. Several techniques can currently be used to produce chimeric embryos, including microinjection, co-culture with ESC, fusion and aggregation. Although microinjection is the most commonly used method in mice, the mere aggregation of embryos with ESC may result in viable chimeras and be as efficient as microinjection. In mice, this chimerism technique has been shown to have the advantage of aggregating embryos in different stages of development with different ploidy, in addition to using ESC in the tetraploid complementation assay. Compared to other techniques for producing chimeras, the aggregation technique is a cheaper, faster and easier methodology to be performed. Moreover, aggregation can be simplified by chemically removing the zona pellucida with pronase or acidic Tyrode’s solution and be enhanced by using the Well of the Well culture system in combination with adhesion molecules, such as phytohemagglutinin. The most commonly used stages for chimerism by aggregation are those that precede the full compaction of the morula. In these stages, embryos have low-tension adherent junctions at the tangential point between two blastomeres. During the embryonic development of mice, the inner cell mass differentiates into epiblast and hypoblast. These layers will originate the fetal tissues and a portion of the extraembryonic tissues (yolk sac, allantois and amnion), whereas the trophectoderm (TE) gives rise to the chorion. A functional TE is essential for the complex molecular communications that occur between the embryo and the uterus. Embryos produced by somatic cell nuclear transfer, such as commercial cattle clones or endangered species, are subject to large fetal and neonatal losses. Hence embryo complementation with heterologous TE could be of assistance to decrease these losses and might as well assist development of high-value embryos in other approaches.

The role of the state in health public policies: an overview of the debate on the concept of State and the Brazilian case

This article is the result of a narrative literature review. The objective is to show the development of an overview on the ideological debate on the design of state health policies. We argue that the role of the state in the development of health policy, even under the pressure of the global market, may create alternatives to promote and drive economic and social development, meaning they are not subject to economic constraints imposed by the liberal ideal of market. Here is a part of a theoretical discussion about the construction and presence of the State in Latin America, particularly in Brazil. We take the approaches of the Marxist tradition and liberal to the issue as reference. This discussion allows us to understand the historical role of the state in the maintenance of social policies, specifically health, is an alternative to public control eases the intense capital mobility promoted by economic globalization. In this sense, the theme makes the Brazilian health an important issue of social sciences, why is the historicity of the construction of the Brazilian health system, as a public policy that can mirror the actual reconstruction of the institutional framework of the Brazilian state with the establishment instances of negotiation between the various spheres of power that strengthen the state in this process of democratization of Brazilian society.

Estimation of chlorophyll-a concentration and the trophic state of the Barra Bonita hydroelectric reservoir using oli/landsat-8 images

Reservoirs are artificial environments built by humans, and the impacts of these environments are not completely known. Retention time and high nutrient availability in the water increases the eutrophic level. Eutrophication is directly correlated to primary productivity by phytoplankton. These organisms have an important role in the environment. However, high concentrations of determined species can lead to public health problems. Species of cyanobacteria produce toxins that in determined concentrations can cause serious diseases in the liver and nervous system, which could lead to death. Phytoplankton has photoactive pigments that can be used to identify these toxins. Thus, remote sensing data is a viable alternative for mapping these pigments, and consequently, the trophic. Chlorophyll-a (Chl-a) is present in all phytoplankton species. Therefore, the aim of this work was to evaluate the performance of images of the sensor Operational Land Imager (OLI) onboard the Landsat-8 satellite in determining Chl-a concentrations and estimating the trophic level in a tropical reservoir. Empirical models were fitted using data from two field surveys conducted in May and October 2014 (Austral Autumn and Austral Spring, respectively). Models were applied in a temporal series of OLI images from May 2013 to October 2014. The estimated Chl-a concentration was used to classify the trophic level from a trophic state index that adopted the concentration of this pigment-like parameter. The models of Chl-a concentration showed reasonable results, but their performance was likely impaired by the atmospheric correction. Consequently, the trophic level classification also did not obtain better results.

State of the Arctic October 2006

This State of the Arctic Report presents a review of recent data by an international group of scientists who developed a consensus on the information content and reliability. The report highlights data primarily from 2000 to 2005 with a first look at winter 2006, providing an update to some of the records of physical processes discussed in the Arctic Climate Impact Assessment (ACIA, 2004, 2005). Of particular note: • Atmospheric climate patterns are shifting (Fig. 1). The late winter/spring pattern for 2000–2005 had new hot spots in northeast Canada and the East Siberian Sea relative to 1980–1999. Late winter 2006, however, shows a return to earlier climate patterns, with warm temperatures in the extended region near Svalbard. • Ocean salinity and temperature profiles at the North Pole and in the Beaufort Sea, which changed abruptly in the 1990s, show that conditions since 2000 have relaxed toward the pre-1990 climatology, although 2001–2004 has seen an increase in northward ocean heat transport through Bering Strait (Fig. 2), which is thought to impact sea ice loss. • Sea ice extent continues to decrease. The sea ice extent in September 2005 was the minimum observed in summer during the satellite era (beginning in 1979), marking an unprecedented series of extreme ice extent minima beginning in 2002 (Fig. 3). The sea ice extent in March 2006 was also the minimum observed in winter during the satellite era. • Tundra vegetation greenness increased, primarily due to an increase in the abundance of shrubs. Boreal forest vegetation greenness decreased, possibly due to drought conditions (Fig. 4). • There is increasing interest in the stability of the Greenland ice sheet. The velocity of outlet glaciers increased in 2005 relative to 2000 and 1995, but uncertainty remains with regard to the total mass balance. • Permafrost temperatures continue to increase. However, data on changes in the active layer thickness (the relatively thin layer of ground between the surface and permafrost that undergoes seasonal freezing and thawing) are less conclusive. While some of the sites show a barely noticeable increasing trend in the thickness of the active layer, most of them do not. • Globally, 2005 was the warmest year in the instrumental record (beginning in 1880), with the Arctic providing a large contribution toward this increase. Many of the trends documented in the ACIA are continuing, but some are not. Taken collectively, the observations presented in this report indicate that during 2000–2005 the Arctic system showed signs of continued warming. However, there are a few indications that certain elements may be recovering and returning to recent climatological norms (for example, the central Arctic Ocean and some wind patterns). These mixed tendencies further illustrate the sensitivity and complexity of the Arctic physical system. They underline the importance of maintaining and expanding efforts to observe and better understand this important component of the climate system to provide accurate predictions of its future state.

The chemiluminescent peroxyoxalate system: state of the art almost 50 years from its discovery

Almost fifty years after the discovery of the peroxyoxalate reaction by E. A. Chandross in the early nineteen sixties, this review article intends to give a general overview on mechanistic aspects of this system and to describe the principles of its analytical application. After a short general introduction on the principles of chemiluminescence and the history of peroxyoxalate discovery, mechanistic aspects of high-energy intermediate formation, its structure and its reaction with an activator in the peroxyoxalate system are discussed. Finally, analytical applications of peroxyoxalate chemiluminescence are exemplified using representative recent examples, including oxalic acid detection in biological samples.

Complex mixed state of the Pauli-limited superconductor CeCoIn5

Magnetization measurements were performed on CeCoIn5 at temperatures down to 20 mK and magnetic fields up to 17 T applied along different crystallographic orientations. For field configurations nearly parallel to the ab plane (theta less than or similar to 40 degrees and T <= 50 mK), we have found an intriguing vortex dynamics regime revealed by a hysteretic and metastable anomalous peak effect (APE), which gives evidence of surface barrier effects enhanced by antiferromagnetic fluctuations in the mixed state of CeCoIn5. Furthermore, we have observed crossover features in the torque and magnetization traces at fields below H-c2, which are consistent with vortices lattice phase transitions and with the anomalies speculated to be the Fulde-Ferrel-Larkin-Ovchinnikov (FFLO) superconducting state in CeCoIn5. All of the above features were found to be dramatically perturbed in Ce0.98Gd0.02CoIn5.

Service Innovation: the state of the art and a proposal of a research agenda

The service sector has acquired a growing importance in every country economy, which has stimulated research in the field of service innovation, a new field in management studies. This text aimed to state a research agenda upon service innovation, based on an articulated discussion of the results of several articles that compose the state of the art of this concept. 73 empirical articles were analyzed, 33% of them exploring the innovation strategies and technology; 18% of the articles describe research on economic performance and enterprise productivity; 16% are related to antecedents and determinants of innovation; another 16% about network capacity development, alliances and collaboration among organizations; 9% of the articles explore service quality, innovation taxonomy, flexible systems and regional systems of innovation; and another 8% are related to themes such as intensive knowledge, research and development. The researches were concentrated in the Engineering & Technology and Hospitality Industries, which accounted for 31% and 24% of the texts, respectively. The remaining 45% of the articles referred to sectors such as Telecommunications, Health, Retail, Financial & Insurance and Public Services. The main gaps identified in these texts refer to the difficulties on measuring service innovation, besides the small number of researches on the public sector. At the end, a research agenda in the subject is presented, including the development of a scale for orientating the innovation and identifying the determining factors of the innovation in the public environment.

Effect of the interaction between food state and the action of estrogen on oxytocinergic system activity

Increased plasma osmolality by food intake evokes augmentation of plasma oxytocin (OT). Ovarian steroids may also influence the balance of body fluids by acting on OT neurones. Our aim was to determine if estrogen influences the activity of OT neurones in paraventricular nucleus (PVN) and supraoptic nucleus (SON) under different osmotic situations. Ovariectomized rats (OVX) were treated with either estradiol (E-2) or vehicle and were divided into three groups: group I was fed ad libitum, group II underwent 48 h of fasting, and group III was refed after 48 h of fasting. On the day of the experiment, blood samples were collected to determine the plasma osmolality and OT. The animals were subsequently perfused, and OT/FOS immunofluorescence analysis was conducted on neurones in the PVN and the SON. When compared to animals which were fasted or fed ad libitum, the plasma osmolality of refed animals was higher, regardless of whether they were treated with vehicle or E-2. We observed neural activation of OT cells in vehicle-or E-2-treated OVX rats refed after 48 h of fasting, but not in animals fed ad libitum or in animals that only underwent 48 h of fasting. Finally, the percentage of neurones that co-expressed OT and FOS was lower in both the PVN and the SON of animals treated with E-2 and refed, when compared to vehicle-treated animals. These results suggest that E-2 may have an inhibitory effect on OT neurones and may modulate the secretion of OT in response to the increase of osmolality induced by refeeding. Journal of Endocrinology (2012) 212, 129-138

Low-Resolution Molecular Models Reveal the Oligomeric State of the PPAR and the Conformational Organization of Its Domains in Solution

The peroxisome proliferator-activated receptors (PPARs) regulate genes involved in lipid and carbohydrate metabolism, and are targets of drugs approved for human use. Whereas the crystallographic structure of the complex of full length PPAR gamma and RXR alpha is known, structural alterations induced by heterodimer formation and DNA contacts are not well understood. Herein, we report a small-angle X-ray scattering analysis of the oligomeric state of hPPAR gamma alone and in the presence of retinoid X receptor (RXR). The results reveal that, in contrast with other studied nuclear receptors, which predominantly form dimers in solution, hPPAR gamma remains in the monomeric form by itself but forms heterodimers with hRXR alpha. The low-resolution models of hPPAR gamma/RXR alpha complexes predict significant changes in opening angle between heterodimerization partners (LBD) and extended and asymmetric shape of the dimer (LBD-DBD) as compared with X-ray structure of the full-length receptor bound to DNA. These differences between our SAXS models and the high-resolution crystallographic structure might suggest that there are different conformations of functional heterodimer complex in solution. Accordingly, hydrogen/deuterium exchange experiments reveal that the heterodimer binding to DNA promotes more compact and less solvent-accessible conformation of the receptor complex.

Tracking the impact of translational research in psychiatry: state of the art and perspectives

Personalized treatments have become a primary goal in translational psychiatric research. They include the identification of neural circuits associated with psychiatric disorders and definition of treatment according to individual characteristics. Many new tools and technologies have been developed but further efforts are required to provide clues on how these scientific advances in psychiatry may be translated into more effective therapeutic approaches. Obstacles to the progress of translational psychiatry also involve numerous scientific, financial, ethical, logistics and regulatory aspects. Also, the goal of DSM-5 to expand “signs and symptoms” classification to incorporate biological measures may help the development of new multifactorial and dimensional models able to better understand the pathophysiology of psychiatric disorders and develop improved treatments. Finally, a better understanding on the significant response variability, cognitive functioning, role of comorbidities and treatment-resistant cases are critical for the development of prevention and intervention strategies that are more effective.

Direitos fundamentais na Constituição de 1988 e incorporação, ao Direito brasileiro, de tratados internacionais a eles relativos

Este artigo tem por objetivo apresentar uma visão geral e evolutiva sobre a disciplina constitucional dos direitos fundamentais no Brasil, com foco especial nos direitos originários de tratados internacionais e as mudanças recentes do entendimento do Supremo Tribunal Federal quanto à sua hierarquia