Novas perspectivas na gestão do sistema de saúde da Espanha

Ao longo dos últimos vinte e cinco anos, a organização do sistema de saúde na Espanha vem adotando diversas medidas que reorientaram seu gerenciamento, melhoraram sua eficiência e aprimoraram seu sistema de financiamento, resultado de profundas reformas e da introdução de novos instrumentos de gestão. Este artigo é resultado de uma análise documental que objetivou descrever a trajetória de conformação do sistema de saúde espanhol e sua organização na contemporaneidade. Apresenta alguns determinantes históricos que tornaram possíveis as reformas no setor sanitário, como a descentralização para o nível das Comunidades Autônomas, a incorporação de mecanismos de coordenação e a integração e o financiamento dos novos e distintos formatos organizativos coexistentes no país. Além disso, identifica desafios que emergem no cenário atual do Sistema Nacional de Saúde, como o fenômeno da imigração, o avançado processo de transição demográfica, a crescente demanda por melhorias na qualidade da atenção e de incorporação tecnológica. Todos esses fatores influem na sustentabilidade do sistema, o que motivou a criação de mais um espaço para estabelecimentos de consensos sobre o papel fundamental do sistema sanitário para o Estado de Bem-Estar espanhol.

Entre a frieza, o cálculo e a "vida loka": violência e sofrimento no trajeto de um adolescente em cumprimento de medida socioeducativa

O conceito de sofrimento social caracteriza-se pela compreensão das situações de aflição e dor como experiências sociais e não como problemas individuais. Este trabalho analisa a natureza social e política do sofrimento de um adolescente em cumprimento de medida socioeducativa. Inspirado na abordagem de Veena Das, o artigo se apóia em "carne" e discurso para problematizar a relação entre cidadania e segmentos juvenis discriminados, que se manifesta nas ambiguidades das práticas institucionais presentes no fluxo de execução de medidas socioeducativas. O artigo analisa as contradições entre o objetivo institucional de evitar a reincidência de atos infracionais, auxiliando o adolescente a tornar-se um cidadão autônomo, e as narrativas e expressões corporais dos adolescentes durante o cumprimento das medidas. A trajetória aqui descrita leva ao reconhecimento de que o trânsito da medida de internação para as medidas em meio aberto se dá sob a tensão entre o discurso institucional de reorganizar a vida escolar, familiar e comunitária e a experiência cotidiana dos adolescentes, que segue marcada pela constante ameaça policial e pela privação de acessos a bens públicos. O cumprimento de medidas socioeducativas acaba por reforçar entre os adolescentes a aflição de serem socialmente tidos como suspeitos e fugitivos e, consequentemente, a incorporação de um lugar social particular, o de membro do "mundo do crime". O desempenho na vida cotidiana de um "estilo bandido" revela formas de resposta ao discurso dominante no sistema socioeducativo, contexto que indica o paradoxo do Estado brasileiro, que garante uma democracia formal enquanto viola direitos civis.

The P450 oxidoreductase, RedA, controls development beyond the mound stage in Dictyostelium discoideum

Background: NADPH-cytochrome- P450 oxidoreductase (CPR) is a ubiquitous enzyme that belongs to a family of diflavin oxidoreductases and is required for activity of the microsomal cytochrome-P450 monooxygenase system. CPR gene-disruption experiments have demonstrated that absence of this enzyme causes developmental defects both in mouse and insect. Results: Annotation of the sequenced genome of D. discoideum revealed the presence of three genes (redA, redB and redC) that encode putative members of the diflavin oxidoreductase protein family. redA transcripts are present during growth and early development but then decline, reaching undetectable levels after the mound stage. redB transcripts are present in the same levels during growth and development while redC expression was detected only in vegetative growing cells. We isolated a mutant strain of Dictyostelium discoideum following restriction enzyme-mediated integration (REMI) mutagenesis in which redA was disrupted. This mutant develops only to the mound stage and accumulates a bright yellow pigment. The mound-arrest phenotype is cell-autonomous suggesting that the defect occurs within the cells rather than in intercellular signaling. Conclusion: The developmental arrest due to disruption of redA implicates CPR in the metabolism of compounds that control cell differentiation.

Self-organized distribution of periodicity and chaos in an electrochemical oscillator

We report a detailed numerical investigation of a prototype electrochemical oscillator, in terms of high-resolution phase diagrams for an experimentally relevant section of the control (parameter) space. The prototype model consists of a set of three autonomous ordinary differential equations which captures the general features of electrochemical oscillators characterized by a partially hidden negative differential resistance in an N-shaped current-voltage stationary curve. By computing Lyapunov exponents, we provide a detailed discrimination between chaotic and periodic phases of the electrochemical oscillator. Such phases reveal the existence of an intricate structure of domains of periodicity self-organized into a chaotic background. Shrimp-like periodic regions previously observed in other discrete and continuous systems were also observed here, which corroborate the universal nature of the occurrence of such structures. In addition, we have also found a structured period distribution within the order region. Finally we discuss the possible experimental realization of comparable phase diagrams.

Intercellular transport of epidermis-expressed MADS domain transcription factors and their effect on plant morphology and floral transition

P>During the lifetime of an angiosperm plant various important processes such as floral transition, specification of floral organ identity and floral determinacy, are controlled by members of the MADS domain transcription factor family. To investigate the possible non-cell-autonomous function of MADS domain proteins, we expressed GFP-tagged clones of AGAMOUS (AG), APETALA3 (AP3), PISTILLATA (PI) and SEPALLATA3 (SEP3) under the control of the MERISTEMLAYER1 promoter in Arabidopsis thaliana plants. Morphological analyses revealed that epidermal overexpression was sufficient for homeotic changes in floral organs, but that it did not result in early flowering or terminal flower phenotypes that are associated with constitutive overexpression of these proteins. Localisations of the tagged proteins in these plants were analysed with confocal laser scanning microscopy in leaf tissue, inflorescence meristems and floral meristems. We demonstrated that only AG is able to move via secondary plasmodesmata from the epidermal cell layer to the subepidermal cell layer in the floral meristem and to a lesser extent in the inflorescence meristem. To study the homeotic effects in more detail, the capacity of trafficking AG to complement the ag mutant phenotype was compared with the capacity of the non-inwards-moving AP3 protein to complement the ap3 mutant phenotype. While epidermal expression of AG gave full complementation, AP3 appeared not to be able to drive all homeotic functions from the epidermis, perhaps reflecting the difference in mobility of these proteins.

The importance of scientific literacy in fostering education for sustainability: Theoretical considerations and preliminary findings from a Brazilian experience

Scientific literacy can be considered as a new demand of post-industrial society. It seems necessary in order to foster education for sustainability throughout students` academic careers. Universities striving to teach sustainability are being challenged to integrate a holistic perspective into a traditional undergraduate curriculum, which aims at specialization. This new integrative, inter- and transdisciplinary epistemological approach is necessary to cultivate autonomous citizenship, i.e., that each citizen be prepared to understand and participate in discussions about the complex contemporary issues posed by post-industrial society. This paper presents an epistemological framework to show the role of scientific literacy in fostering education for sustainability. We present a set of 26 collaborative concept maps (CCmaps) in order to illustrate an instance of theory becoming practice. During a required course for first-year undergraduate students (ACH 0011, Natural Sciences), climate change was presented and discussed in broad perspective by using CCmaps. We present students` CCmaps to show how they use concepts from quantitative and literacy disciplines to deal with the challenges posed by the need of achieving a sustainable development. (C) 2009 Elsevier Ltd. All rights reserved.

A Fault-Tolerant Manipulator Robot Based on H(2), H(infinity), and Mixed H(2)/H(infinity) Markovian Controls

This paper develops a Markovian jump model to describe the fault occurrence in a manipulator robot of three joints. This model includes the changes of operation points and the probability that a fault occurs in an actuator. After a fault, the robot works as a manipulator with free joints. Based on the developed model, a comparative study among three Markovian controllers, H(2), H(infinity), and mixed H(2)/H(infinity) is presented, applied in an actual manipulator robot subject to one and two consecutive faults.

Coloured Petri nets and graphical simulation for the validation of a robotic cell in aircraft industry

This paper proposes a mixed validation approach based on coloured Petri nets and 3D graphic simulation for the design of supervisory systems in manufacturing cells with multiple robots. The coloured Petri net is used to model the cell behaviour at a high level of abstraction. It models the activities of each cell component and its coordination by a supervisory system. The graphical simulation is used to analyse and validate the cell behaviour in a 3D environment, allowing the detection of collisions and the calculation of process times. The motivation for this work comes from the aeronautic industry. The automation of a fuselage assembly process requires the integration of robots with other cell components such as metrological or vision systems. In this cell, the robot trajectories are defined by the supervisory system and results from the coordination of the cell components. The paper presents the application of the approach for an aircraft assembly cell under integration in Brazil. This case study shows the feasibility of the approach and supports the discussion of its main advantages and limits. (C) 2011 Elsevier Ltd. All rights reserved.

Topology optimization for designing strain-gauge load cells

Load cells are used extensively in engineering fields. This paper describes a novel structural optimization method for single- and multi-axis load cell structures. First, we briefly explain the topology optimization method that uses the solid isotropic material with penalization (SIMP) method. Next, we clarify the mechanical requirements and design specifications of the single- and multi-axis load cell structures, which are formulated as an objective function. In the case of multi-axis load cell structures, a methodology based on singular value decomposition is used. The sensitivities of the objective function with respect to the design variables are then formulated. On the basis of these formulations, an optimization algorithm is constructed using finite element methods and the method of moving asymptotes (MMA). Finally, we examine the characteristics of the optimization formulations and the resultant optimal configurations. We confirm the usefulness of our proposed methodology for the optimization of single- and multi-axis load cell structures.

Investigation of a method for predicting AUV derivatives

The paper addresses the problem of autonomous underwater vehicle (AUV) modelling and parameter estimation as a means to predict the dynamic performance of underwater vehicles and thus provide solid guidelines during their design phase. The use of analytical and semi-empirical (ASE) methods to estimate the hydrodynamic derivatives of a popular class of AUVs is discussed. A comparison is done with the results obtained by using computational fluid dynamics to evaluate the bare hull lift force distribution around a fully submerged body. An application is made to the estimation of the hydrodynamic derivatives of the MAYA AUV, an autonomous underwater vehicle developed under a joint Indian-Portuguese project. The estimates obtained were used to predict the turning diameter of the vehicle during sea trials. (C) 2008 Elsevier Ltd. All rights reserved.

Investigation of Normal Force and Moment Coefficients for an AUV at Nonlinear Angle of Attack and Sideslip Range

This paper presents a comparative study of computational fluid dynamics (CFD) and analytical and semiempirical (ASE) methods applied to the prediction of the normal force and moment coefficients of an autonomous underwater vehicle (AUV). Both methods are applied to the. bare hull of the vehicle and to the body-hydroplane combination. The results are validated through experiments in a towing tank. It is shown that the CFD approach allows for a good prediction of the coefficients over the range of angles of attack considered. In contrast with the traditional ASE formulations used in naval and aircraft fields, an improved methodology is introduced that takes advantage of the qualitative information obtained from CFD flow visualizations.

Hardware/firmware implementation of a soft sensor using an improved version of a fuzzy identification algorithm

This paper presents the design and implementation of an embedded soft sensor, i. e., a generic and autonomous hardware module, which can be applied to many complex plants, wherein a certain variable cannot be directly measured. It is implemented based on a fuzzy identification algorithm called ""Limited Rules"", employed to model continuous nonlinear processes. The fuzzy model has a Takagi-Sugeno-Kang structure and the premise parameters are defined based on the Fuzzy C-Means (FCM) clustering algorithm. The firmware contains the soft sensor and it runs online, estimating the target variable from other available variables. Tests have been performed using a simulated pH neutralization plant. The results of the embedded soft sensor have been considered satisfactory. A complete embedded inferential control system is also presented, including a soft sensor and a PID controller. (c) 2007, ISA. Published by Elsevier Ltd. All rights reserved.

The Conditional Autonomy of Tafuri's Historian / De Provisorische Autonomie van de Historicus bij Tafuri

This article considers the conditions placed on the autonomous architectural history discipline often understood at stake in Manfredo Tafuri's 1968 book Teorie e storia dell'architettura.

Familial hyperaldosteronism type II: Description of a large kindred and exclusion of the aldosterone synthase (CYP11B2) gene

Familial hyperaldosteronism type II (FH-II) is characterized by autosomal dominant inheritance and hypersecretion of aldosterone due to adrenocortical hyperplasia or an aldosterone-producing adenoma; unlike FH type I (FH-I), hyperaldosteronism in FH-II is not suppressible by dexamethasone. Of a total of 17 FH-II families with 44 affected members, we studied a large kindred with 7 affected members that was informative for linkage analysis. Family members were screened with the aldosterone/PRA ratio test; patients with aldosterone/PRA ratio greater than 25 underwent fludrocortisone/salt suppression testing for confirmation of autonomous aldosterone secretion. Postural testing, adrenal gland imaging, and adrenal venous sampling were also performed. Individuals affected by FH-II demonstrated lack of suppression of plasma A levels after 4 days of dexamethasone treatment (0.5 mg every 6 h). All patients had neg ative genetic testing for the defect associated with FH-I, the CYP11B1/CYP11B2 hybrid gene. Genetic linkage was then examined between FH-II and aldosterone synthase (the CYP11B2 gene) on chromosome 8q. A polyadenylase repeat within the 5'-region of the CYP11B2 gene and 9 other markers covering an approximately 80-centimorgan area on chromosome 8q21-8qtel were genotyped and analyzed for linkage. Two-point logarithm of odds scores were negative and ranged from -12.6 for the CYP11B2 polymorphic marker to -0.98 for the D8S527 marker at a recombination distance (theta) of 0. Multipoint logarithm of odds score analysis confirmed the exclusion of the chromosome 8q21-8qtel area as a region harboring the candidate gene for FH-II in this family. We conclude that FH-II shares autosomal dominant inheritance and hyperaldosteronism with FH-I, but, as demonstrated by the large kindred investigated in this report, it is clinically and genetically distinct. Linkage analysis demonstrated that the CYP11B2 gene is not responsible for FH-II in this family; furthermore, chromosome 8q21-8qtel most likely does not harbor the genetic defect in this kindred.

An agent-based approach to modelling driver route choice behaviour under the influence of real-time information

This paper presents an agent-based approach to modelling individual driver behaviour under the influence of real-time traffic information. The driver behaviour models developed in this study are based on a behavioural survey of drivers which was conducted on a congested commuting corridor in Brisbane, Australia. Commuters' responses to travel information were analysed and a number of discrete choice models were developed to determine the factors influencing drivers' behaviour and their propensity to change route and adjust travel patterns. Based on the results obtained from the behavioural survey, the agent behaviour parameters which define driver characteristics, knowledge and preferences were identified and their values determined. A case study implementing a simple agent-based route choice decision model within a microscopic traffic simulation tool is also presented. Driver-vehicle units (DVUs) were modelled as autonomous software components that can each be assigned a set of goals to achieve and a database of knowledge comprising certain beliefs, intentions and preferences concerning the driving task. Each DVU provided route choice decision-making capabilities, based on perception of its environment, that were similar to the described intentions of the driver it represented. The case study clearly demonstrated the feasibility of the approach and the potential to develop more complex driver behavioural dynamics based on the belief-desire-intention agent architecture. (C) 2002 Elsevier Science Ltd. All rights reserved.