984 resultados para CPV-2a


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To update and extend a 2006 report on the clinical effectiveness and cost-effectiveness of adefovir dipivoxil (ADV) and pegylated interferon alpha (PEG-alpha) for the treatment of chronic hepatitis B (CHB). Thirteen bibliographic databases were searched including MEDLINE, EMBASE and the Cochrane Library. Searches were run from the beginning of 2005 to September 2007. For the clinical effectiveness review, randomised controlled trials (RCTs) comparing ADV, PEG-alpha-2a and PEG-alpha-2b with currently licensed treatments for CHB, including non-pegylated interferon alpha (IFN-alpha) and lamivudine (LAM), were included. Outcomes included biochemical, histological and virological response to treatment, drug resistance and adverse effects. A systematic review of economic evaluations of antiviral treatments for CHB was conducted. The economic Markov model used in the 2006 report was updated in terms of utility values, discount rates and costs. `

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This paper presents a summary of the evidence review group (ERG) report into the clinical and cost-effectiveness of entecavir for the treatment of chronic hepatitis B (CHB) in adults based upon a review of the manufacturer's submission to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal (STA) process. The submission's evidence came from five randomised controlled trials (RCTs), of good methodological quality and measuring a range of clinically relevant outcomes, comparing entecavir with lamivudine. After 1 year of treatment entecavir was statistically superior to lamivudine in terms of the proportion of patients achieving hepatitis B virus (HBV) DNA suppression, alanine aminotransferase (ALT) normalisation and histological improvement, but not in terms of the proportion of patients achieving hepatitis B e antigen (HBeAg) seroconversion. The incidence of adverse or serious adverse events was similar for both treatments. The results of the manufacturer's mixed treatment comparison (MTC) model to compare entecavir with the comparator drugs in nucleoside-naive patients were considered to be uncertain because of concerns over its conduct and reporting. For the economic evaluation the manufacturer constructed two Markov state transition models, one in HBeAg-positive and one in HBeAg-negative patients. The modelling approach was considered reasonable subject to some uncertainties and concerns over some of the structural assumptions. In HBeAg-positive patients the base-case incremental cost-effectiveness ratios (ICER) for entecavir compared with lamivudine and pegylated interferon alpha-2a were 14,329 pounds and 8403 pounds per quality-adjusted life-year (QALY) respectively. Entecavir was dominated by telbivudine. In HBeAg-negative patients the base-case ICERs for entecavir compared with lamivudine, pegylated interferon alpha-2a and telbivudine were 13,208 pounds, 7511 pounds and 6907 pounds per QALY respectively. In HBeAg-positive lamivudine-refractory patients entecavir dominated adefovir added to lamivudine. In one-way deterministic sensitivity analysis on all key input parameters for entecavir compared with lamivudine in nucleoside-naive patients, ICERs generally remained under 30,000 pounds per QALY. In probabilistic sensitivity analysis in nucleoside-naive HBeAg-positive patients the probability of the ICER for entecavir being below 20,000 pounds per QALY was 57%, 82% and 45% compared with lamivudine, pegylated interferon alpha-2a and telbivudine respectively. In nucleoside-naive HBeAg-negative patients the probabilities were 90%, 100% and 96% respectively. The manufacturer's lifetime treatment scenario for HBeAg-negative patients and the ERG's 20-year treatment scenario for HBeAg-positive patients increased the ICERs, particularly in the latter case. Amending the HBeAg-negative model so that patients with compensated cirrhosis would also receive lifetime treatment gave probabilities of entecavir being cost-effective at a willingness to pay of 20,000 pounds and 30,000 pounds of 4% and 40% respectively. The NICE guidance issued in August 2008 as a result of the STA states that entecavir is recommended as an option for the treatment of people with chronic HBeAg-positive or HBeAg-negative hepatitis B in whom antiviral treatment is indicated.

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Statistical copolymers of indigo (1a) and N-acetylindigo (1b) building blocks with defined structures were studied. They belong to the class of polymeric colorants. The polymers consist of 5,5′-connected indigo units with keto structure and N-acetylindigo units with uncommon tautomeric indoxyl/indolone (=1H-indol-3-ol/3H-indol-3-one) structure (see 2a and 2b in Fig. 1). They formed amorphous salts of elongated monomer lengths as compared to monomeric indigo. The polymers were studied by various spectroscopic and physico-chemical methods in solid state and in solution. As shown by small-angle-neutron scattering (SANS) and transmission-electron microscopy (TEM), disk-like polymeric aggregates were present in concentrated solutions (DMSO and aq. NaOH soln.). Their thickness and radii were determined to be ca. 0.4 and ca. 80 nm, respectively. From the disk volumes and by a Guinier analysis, the molecular masses of the aggregates were calculated, which were in good agreement with each other. Defined structural changes of the polymer chains were observed during several-weeks storage in concentrated DMSO solutions. The original keto structure of the unsubstituted indigo building blocks reverted to the more flexible indoxyl/indolone structure. The new polymers were simultaneously stabilized by intermolecular H-bonds to give aggregates, preferentially dimers. Both aggregation and tautomerization were reversible upon dissolution. The polymers were synthesized by repeated oxidative coupling of 1,1′-diacetyl-3,3′-dihydroxybis-indoles 5 (from 1,1′-diacetyl-3,3′-bis(acetyloxy)bis-indoles 6) followed by gradual hydrolysis of the primarily formed poly(N,N′-diacetylindigos) 7 (Scheme). N,N′-Diacetylbis-anthranilic acids 9 were isolated as by-products.

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Background: Published clinical trials of the treatment of HCV are largely multicentre prospective pharmaceutical trials. Patients in clinical trials tend to have more favorable outcomes than patients in the 'real-world', due to strict patient selection and differences in treatment conditions and available resources. Objectives: To assess the outcomes of Hepatitis C infected patients treated at the Barwon Health Liver Clinic with combination Pegylated interferon (PEG-IFN) and Ribavirin (RBV) therapy and to determine factors associated with a treatment response. Methods: Retrospective review of patients who received treatment for Hepatitis C at our institution's Liver Clinic from January 2001-September 2011. Patient demographics, comorbidities, treatment-related parameters and side effects were extracted from medical records and analyzed. Results: A total of 190 patients (120 male, 70 female) with a mean age of 42.8 years (range 20-68 years) commenced treatment. The most common genotype was genotype 3 (48.9%), followed by genotype 1 (42.6%). 150 of 190 patients (78.9%) completed treatment and had end of treatment data available. 107 of 182 patients, (58.8%) for whom sustained virologic response (SVR) rate data was available achieved an SVR. Overall response rates were; 46.9%, 68.8% and 62.4% in genotypes 1, 2 and 3 respectively. The response rate was significantly lower in 29 patients with documented cirrhosis (20.7%). Age, diabetes and alcohol abuse did not predict treatment response in our cohort. Side effects reported in 81.6% of patients included general malaise, hematological disturbance and psychiatric issues, and necessitated cessation of therapy in 16 patients (8.4%) and dose reduction in 26 patients (13.7%). Conclusions: Response rates to combination PEG-IFN and RBV therapy at our institution are comparable to other 'real-world' and pharmaceutical registration trials. Side effects of combination therapy were prominent but resulted in fewer discontinuations of therapy compared to pharmaceutical trials.

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Platelet serotonin type 2A receptor (5-HT2A) sensitivity changes have previously been documented in depression, although it is unclear if this represents a stable trait marker of the illness, or whether it represents an acute state marker of depression that would change with treatment. Electroconvulsive therapy (ECT) may be a useful intervention to separate out trait and state marker status avoiding the potential confounding effects of pharmacotherapy on receptor function. Using spectrofluorometry, the platelet 5HT2A, receptor sensitivity as reflected by the intracellular calcium response to serotonin stimulation, was measured every week in patients suffering from major depression and undergoing ECT. There was a significant drop in the platelet response to serotonin stimulation over a course of ECT, with an associated progressive decrease in Hamilton Rating Scale of Depression (HAM-D) scores. This may suggest either decreased sensitivity of platelet 5HT2A receptors as a mechanism of action of ECT, or changes in second messengers such as the inositide phospholipid system. This suggests that the enhanced sensitivity of platelet 5HT2A receptors may be a state marker of major depression.

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Synthesis and complete characterization of some ester functionalized vinylic tellurides bearing an aryl ligand with varying steric and electronic effects bound to tellurium is described. Hydrotelluration of methyl propiolate using Ar2Te2/NaBH4 in methanol results in a mixture of stereoisomers of methyl β-(aryltelluro)acrylates, ArTeCH[double bond, length as m-dash]CHCOOMe (Ar = 4-MeOC6H4, 1A; 1-C10H7, 2A; 2,4,6-Me3C6H2, 3A; C5H5FeC5H4, 4A; 4-Me2NC6H4, 5A; and 2-C4H3S, 6A). The same reaction in ethanol provides isomeric mixtures of the ethyl esters ArTeCH[double bond, length as m-dash]CHCOOEt (1B–6B). However, in the reactions between methyl propiolate and Ar2Te2 (Ar = 2,4,6-Me3C6H2, 4-Me2NC6H4) in isopropanol or t-butanol, no exchange of alkyl groups between the parent ester and the solvent is observed, instead detelluration of the Ar2Te2 to Ar2Te is a competing reaction along with almost exclusive formation of the (Z)-isomers (3Aa, 5Aa). The geometry of the separated stereoisomers is established in solution, with the help of 1H, 13C and 125Te NMR spectrometry. Of particular interest is the observation that 125Te chemical shifts {deshielded in (Z) compared to (E); Δδ = 106–136 ppm} and the geminal heteronuclear coupling constants {2J(1H–125Te) values for (E) are more than seven times that of the corresponding (Z) isomer} can be used to distinguish between liquid isomers. Structural characterization in the solid state by single-crystal X-ray diffraction for the 2Ba, 3Aa, 3Ba, 5Aa, 8 (Z)-isomers as well as for both stereoisomers of 4-Me2NC6H4TeCH[double bond, length as m-dash]CHCOOEt (5Ba and 5Bb) is also presented. The carbonyl O atom of the ester group is invariably involved, at least in the solid state, in a secondary bonding interaction with the Te(II) atom. While an intermolecular Te⋯O interaction gives rise to one-dimensional supramolecular arrays in the crystal lattice of 5Bb with (E) configuration, it is realized intramolecularly in the case of the (Z)-isomers due to the cis position of the chalcogen atoms.

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In recent years metabotropic glutamate receptors have emerged as key targets for the design of new antipsychotic medications for schizophrenia, in particular mGluR5 and mGluR2/3. These receptors exhibit diverse interactions with other neurotransmitter receptors and critical elements of intracellular signalling cascades known to be important to the pharmacotherapy of schizophrenia. In addition, mGluR5 and mGluR2/3 are intimately involved in behavioural domains related to the symptoms of this disorder. Both animal and clinical studies using novel drugs targeting these receptors have provided encouraging results. The number of patents registered for drugs targeting metabotropic glutamate receptors has grown dramatically, and positive allosteric modulators for both receptors show particular promise.

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BACKGROUND: Iron binding, naturally occurring protein bovine lactoferrin (bLf) has attracted attention as a safe anti-cancer agent capable of inducing apoptosis. Naturally, bLf exists partially saturated (15-20%) with Fe(3+) however, it has been demonstrated that manipulating the saturation state can enhance bLf's anti-cancer activities. METHODS: Apo-bLf (Fe(3+) free) and Fe-bLf (>90% Fe(3+) Saturated) were therefore, tested in MDA-MB-231 and MCF-7 human breast cancer cells in terms of cytotoxicity, proliferation, migration and invasion. Annexin-V Fluos staining was also employed in addition to apoptotic protein arrays and Western blotting to determine the specific mechanism of bLf-induced apoptosis with a key focus on p53 and inhibitor of apoptosis proteins (IAP), specifically survivin. RESULTS: Apo-bLf induced significantly greater cytotoxicity and reduction in cell proliferation in both cancer cells showing a time and dose dependent effect. Importantly, no cytotoxicity was detected in normal MCF-10-2A cells. Both forms of bLf significantly reduced cell invasion in cancer cells. Key apoptotic molecules including p53, Bcl-2 family proteins, IAP members and their inhibitors were significantly modulated by both forms of bLf, though differentially in each cell line. Most interestingly, both Apo-bLf and Fe-bLf completely inhibited the expression of survivin protein (key IAP), after 48 h at 30 and 40 nM in cancer cells. CONCLUSIONS: The capacity of these forms of bLf to target survivin expression and modulation of apoptosis demonstrates an exciting potential for bLf as an anti-cancer therapeutic in the existing void of survivin inhibitors, with a lack of successful inhibitors in the clinical management of cancer.

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BACKGROUND: Few studies have evaluated the effects of infrastructural improvements to promote walking and cycling. Even fewer have explored how the context and mechanisms of such interventions may interact to produce their outcomes. METHODS: This mixed-method analysis forms part of the UK iConnect study, which aims to evaluate new walking and cycling routes at three sites - Cardiff, Kenilworth and Southampton. Applying a complementary follow-up approach, we first identified differences in awareness and patterns of use of the infrastructure in survey data from a cohort of adult residents at baseline in spring 2010 (n = 3516) and again one (n = 1849) and two (n = 1510) years later following completion of the infrastructural projects (Analysis 1). We subsequently analysed data from 17 semi-structured interviews with key informants to understand how the new schemes might influence walking and cycling (Analysis 2a). In parallel, we analysed cohort survey data on environmental perceptions (Analysis 2b). We integrated these two datasets to interpret differences across the sites consistent with a theoretical framework that hypothesised that the schemes would improve connectivity and the social environment. RESULTS: After two years, 52% of Cardiff respondents reported using the infrastructure compared with 37% in Kenilworth and 22% in Southampton. Patterns of use did not vary substantially between sites. 17% reported using the new infrastructure for transport, compared with 39% for recreation. Environmental perceptions at baseline were generally unfavourable, with the greatest improvements in Cardiff. Qualitative data revealed that all schemes had a recreational focus to varying extents, that the visibility of schemes to local people might be an important mechanism driving use and that the scale and design of the schemes and the contrast they presented with existing infrastructure may have influenced their use. CONCLUSIONS: The dominance of recreational uses may have reflected the specific local goals of some of the projects and the discontinuity of the new infrastructure from a satisfactory network of feeder routes. Greater use in Cardiff may have been driven by the mechanisms of greater visibility and superior design features within the context of an existing environment that was conducive neither to walking or cycling nor to car travel.

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The reaction of lanthanoid chlorides or nitrates with sodium 3-(4′-hydroxyphenyl)propionate (Na4hpp) in methanol or water has yielded complexes [La4(4hpp)12(H2O)6]·4H2O·MeOH (1), [Ce2(4hpp)6(H2O)3]·(H2O)·2.5(EtOH) (2a) (after crystallization from ethanol), [Ho(4hpp)3(H2O)2] (5), [Er(4hpp)3(H2O)2]·1.5(H2O) (6), and [Lu(4hpp)3]·H2O crystal composition (7), as well as heterobimetallics [NaCe2(4hpp)7(H2O)2]·3(H2O) (2b), [NaPr2(4hpp)7(H2O)2]·3(H2O) (3), and [NaNd2(4hpp)7(H2O)(MeOH)]·(H2O)·3(MeOH) (4). The structures of homometallic complexes 1, 2a, 6, and 7 reveal one-dimensional coordination polymers and vividly illustrate the effect of lanthanoid contraction with a decline in coordination numbers in the series from 9-11 (1), 9,10 (2a), 8 (6) to 7 (7) through variations in carboxylate coordination and ligation of water. Bimetallic complexes 2a and 4 each exhibit five different carboxylate binding modes as well as coordination of the 4-OH substituent of 4hpp to sodium thereby linking 1D polymer chains into a 2D network with both 9 and 10 coordinate Ln atoms and 6 coordinate sodium. Bulk products after drying lose solvent of crystallization in some cases (2a, 6), or exchange MeOH for water (4). X-ray powder diffraction indicates that bulk 2b and 3 are isotypic, as are bulk 5 and 6. In contrast to the excellent corrosion protection of lanthanum 4-hydroxycinnamate, compound 1 is ineffective in preventing the corrosion of mild steel, thereby establishing the importance of the -CHCH- structural unit of the former in its anti-corrosion properties. However the flexible -CH2-CH2- chain of the 4hpp ligand enables the crystal engineering of its lanthanoid complexes in a wide variety of structures as well as effective crystallization for structure determination, whereas the analogous 4-hydroxycinnamates have so far evaded structural characterization except for Ln = La, Ce owing to crystallization problems.

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Most studies on dietary vegetable oil in rainbow trout (Oncorhynchus mykiss) have been conducted on a background of dietary EPA (20 : 5n-3) and DHA (22 : 6n-3) contained in the fishmeal used as a protein source in aquaculture feed. If dietary EPA and DHA repress their endogenous synthesis from α-linolenic acid (ALA, 18 : 3n-3), then the potential of ALA-containing vegetable oils to maintain tissue EPA and DHA has been underestimated. We examined the effect of individual dietary n-3 PUFA on the expression of the biosynthetic genes required for metabolism of ALA to DHA in rainbow trout. A total of 720 juvenile rainbow trout were allocated to twenty-four experimental tanks and assigned one of eight diets. The effect of dietary ALA, EPA or DHA, in isolation or in combination, on hepatic expression of fatty acyl desaturase (FADS)2a(Δ6), FADS2b(Δ5), elongation of very long-chain fatty acid (ELOVL)5 and ELOVL2 was examined after 3 weeks of dietary intervention. The effect of these diets on liver and muscle phospholipid PUFA composition was also examined. The expression levels of FADS2a(Δ6), ELOVL5 and ELOVL2 were highest when diets were high in ALA, with no added EPA or DHA. Under these conditions ALA was readily converted to tissue DHA. Dietary DHA had the largest and most consistent effect in down-regulating the gene expression of all four genes. The ELOVL5 expression was the least responsive of the four genes to dietary n-3 PUFA changes. These findings should be considered when optimising aquaculture feeds containing vegetable oils and/or fish oil or fishmeal to achieve maximum DHA synthesis.

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A época de aplicação de N na cultura da cevada pode influenciar o rendimento de grãos pelo estímulo específico dado a seus componentes. Neste sentido, foi realizado o presente trabalho para determinar o período e os estádios fenológicos da cultura da cevada afetados pela aplicação de N. Foram conduzidos três experimentos a campo em Eldorado do Sul, Encruzilhada do Sul e e outro em Victor Graeff, no ano de 2000, e dois experimentos a campo, um em Eldorado do Sul e Victor Graeff, no ano de 2001. Os estádios de aplicação de N foram na emergência das plântulas; emissão da 2a ou 3ª folha; 4a ou 5ª folha; 6a ou 7ª folha; 8a ou 9ª folha e emborrachamento, e as doses de N foram 30 ou 40 e 60 ou 80 kg.ha-1. Foram analisados o rendimento de grãos e seus componentes (espigas área-1, grãos espiga-1 e massa de grão), a característica cervejeira dos grãos, o desenvolvimento de afilhos, a produção de massa seca e o acúmulo de N na parte aérea. As maiores respostas em rendimento de grãos foram observadas entre a emissão da 3a folha à emissão da 7a folha do colmo principal. A aplicação de N antecedendo o início do afilhamento beneficiou a formação de colmos área-1 e grãos espiga-1 e a aplicação no final do afilhamento consolidou o número de espigas área-1 e grãos espiga-1. A aplicação de N no final do afilhamento resultou na maior disponibilidade de N para dar aporte ao processo de acúmulo de massa seca e N, que é intensificado no período de alongamento dos entrenós O aporte de N a estes processos diminuiu a competição entre os colmos e as estruturas reprodutivas, reduzindo a mortalidade de colmos. Até o final do afilhamento, não houve incremento no teor de proteína dos grãos devido à maior produção de massa seca e ao aumento do número de grãos área-1, diluindo o N acumulado na parte aérea neste componente.

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A Icnologia, os Argilominerais e a Geoquímica foram integradas aos estudos de Associação Faciológica com objetivo de testá-las como ferramentas auxiliares na caracterização de Seqüências Deposicionais, segundo os conceitos da Estratigrafia de Seqüências (sentido Exxon). Para isso, foi selecionado o intervalo estratigráfico, compreendido do Sakmariano ao Kunguriano (Permiano), correspondente às formações Rio do Sul, Rio Bonito e base da Formação Palermo. A área de estudo está situada na borda leste da Bacia do Paraná, nos municípios de Orleans e Lauro Müller, região sul do estado de Santa Catarina. Como metodologia de trabalho, foi selecionado um arcabouço estratigráfico considerando uma hierarquia de eventos de 3a e 4a ordem, inseridos em um evento de 2a ordem, correspondente a uma superseqüência. Para isso, foram selecionados dez afloramentos, e os poços PB-18 e PB-20, com testemunhos, totalizando 500 m. Foram interpretadas seis associações faciológicas, representadas, da base para o topo, por rochas glácio-marinha, plataforma marinha dominada por ondas com estrutura “hummocky”, arenito de “shoreface” médio/superior, bioturbados, pelitos marinho/marinhos marginais, flúvio-estuarino e ilha de barreira/laguna. Admitiu-se ainda a formação de vales incisos para as região de Lauro Müller e para a área do poço RL-6, a partir da deposição das rochas flúvio-estuarinas. O uso da Icnologia limitou-se à interface entre o topo da formação Rio do Sul e a base do Membro Triunfo da Formação Rio Bonito, onde a identificação da Icnofábrica de Glossifungites auxiliou na delimitação de limites de seqüência de alta freqüência. Além disso, foram reconhecidas, o predomínio das Icnofábricas de Thalassinoides e Teichichnus e, secundariamente, Planolites, Ophiomorpha, Arenicolites, Cylindrichnus, Monocraterion, Diplocraterion e Rosselia, permitindo posicionar a interface entre estas formações na Icnofácies Skolithos/Cruziana. Helminthopsis, Condrites e Palaeophycus passam a predominar quando da presença de subambientes mais restritos tipo baías e lagunas. Os argilominerais identificados foram a caolinita, a clorita, a ilita e o interestratificado ilita-esmectita (I-S) do tipo ordenado. O predomínio da clorita e da ilita, na Formação Rio do Sul e o da caolinita no Membro Siderópolis, indicam variações paleoclimáticas, onde, inicialmente, existiram condições mais frias e secas, passando para condições de clima mais quente e úmido. Os pelitos transgressivos do Membro Paraguaçu da Formação Rio Bonito foram caracterizados pelos valores relativos mais elevados do interestratificado I-S, e do SiO2 e Na2O e, os menores valores relativos do Al2O3, K2O, Fe2O3, MgO e TiO2. Interpretou-se uma proveniência detrítica para estes argilominerais sendo associados a minerais micáceos e feldspáticos. As relações V/(V+Ni) e V/Cr indicam condições paleoambientais restritas, de caráter redutor, praticamente para todo o intervalo estudado. A relação Sr/Ba mostrou-se boa indicadora de eventos transgressivos no PB-18 e no poço 1-TV-4-SC, perfurado em posição mais distal na bacia. Embora o uso da Taphonomia não tenha sido contemplada no objetivo inicial, a utilização da razão pólens/esporos foi satisfatória. Pulsos transgressivos de alta freqüência puderam também ser balizados pelas razões mais elevadas desta relação, havendo uma correlação razoável com as indicações advindas da curva da razão Sr/Ba. Integrando-se os resultados destas várias ferramentas foi possível dividir o intervalo estratigráfico no PB-18, em sete seqüências deposicionais de 4a ordem e, em cinco seqüências deposicionais, no PB-20. As variações encontradas nos estilos de estaqueamento estratigráfico entre as áreas perfuradas por estes poços, deve-se às variações locais no estilo tectono-sedimentar, dentro do modelo de bacias tipo “foreland” – parte distal, modelo este adotado para a sedimentação destas seqüências e que tiveram, na subsidência e no controle glácio-eustático, os agentes moduladores deste padrão estratigráfico.

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Esta pesquisa objetiva a elaboração de um referencial teórico e uma proposta de roteiro para a elaboração do Plano Ambiental de Municípios com 15.000 a 30.000 habitantes, como forma de auxiliar os administradores municipais na atividade de planejamento ambiental. Foi desenvolvida utilizando-se uma abordagem metodológica de natureza qualitativa, com o emprego de questionário, entrevistas e consultas, aplicados aos Municípios, instituições governamentais e não governamentais, ligados à área ambiental. A investigação mostrou que a maior parte dos Municípios pesquisados não dispõe de estrutura administrativa adequada de meio ambiente. A maior parcela dos responsáveis pelas questões ambientais não possui formação compatível com as necessidades do cargo e as equipes técnicas, quando existem, são diminutas. Como conseqüência deste quadro, apenas um Município, dentre 33, informou possuir um plano ambiental de ampla abordagem em elaboração com base na Agenda 21. Ficou evidente que os recursos destinados ao meio ambiente são desconhecidos e escassos, levando a administração a descumprir com as suas responsabilidades legais. O estudo revelou que, em termos de política ambiental, 54,5 % dos Municípios não possui Conselho Municipal de Meio Ambiente, o que resulta na existência de legislação ambiental específica para as questões locais em apenas 15,5 % dos Municípios. Para atender aos objetivos do trabalho, primeiramente é apresentado um referencial básico, constituído por conceitos, metodologias administrativas e ambientais, acrescidos de recomendações sobre o recolhimento de informações necessárias ao adequado desenvolvimento do processo de planejamento. No passo seguinte, é apresentada uma proposta de montagem do plano de trabalho para a elaboração do Plano Ambiental, que precisa ser aprovado pelo Executivo e Câmara de Vereadores. Este importante e indispensável documento de planejamento deve ser preparado por uma comissão organizadora, preferencialmente constituída por técnicos da Prefeitura, ao longo do período médio de um mês. O plano de trabalho define o que deve ser feito, como deve ser feito, quem vai trabalhar, com quais recursos, durante quanto tempo e quanto vai custar. A última parte do trabalho descreve uma proposta de roteiro e conteúdo para a elaboração do Plano Ambiental, de acordo com o plano de trabalho aprovado. O roteiro é constituído por oito Etapas, distribuídas em quatro Fases, recomendando a utilização de metodologias de planejamento estratégico e participativo. A equipe técnica poderá realizar o trabalho num prazo de três a seis meses, dependendo da complexidade dos problemas ambientais do Município, da possibilidade de realização de convênios com instituições de apoio ao planejamento e dos recursos financeiros disponíveis. Na 1a Etapa do roteiro devem ser estabelecidas as bases políticas do Plano; na 2a Etapa é necessária a elaboração de um diagnóstico ambiental, referente aos fatores físicos e bióticos; a 3a Etapa refere-se ao diagnóstico social e econômico; a 4a Etapa é destinada à identificação e avaliação dos impactos ambientais; na 5a Etapa é realizado o zoneamento ambiental; na 6a Etapa são elaborados os programas; a 7a Etapa destina-se à apresentação das conclusões e na 8a Etapa é realizada a audiência pública. O produto final, denominado Plano Ambiental Municipal, é constituído por três documentos: 1. Fundamentação Político-administrativa; 2. Diagnósticos, Impactos e Zoneamento Ambiental; 3. Programas Ambientais. Dentre eles, apenas o último deve ser implementado pela administração municipal.