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

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

Serviço público de saúde: representações sociais dos profissionais

Este artigo foi redigido com parte dos resultados da pesquisa de dissertação de mestrado sobre o trabalho multiprofissional no Serviço Público de Saúde no município de Bandeirantes- Paraná. Foram entrevistados 44 profissionais de saúde de nível superior, com 4 questões abertas que abordaram aspectos de interesse para o tema. O presente estudo se propõe retratar uma das figuras metodológicas do Discurso do Sujeito Coletivo (DSC) que é a Ancoragem e analisar as representações sociais dos profissionais de saúde. A análise e a discussão as Ancoragens ressaltam a sua utilidade para o resgate das representações sociais. Quanto a seu conteúdo, estas representações revelam que os profissionais de saúde entrevistados consideram seu trabalho como um atendimento vocacionado. Destacam ainda que o serviço público é para pobre e que todo funcionário do setor público é sobrecarregado. Estes resultados, por refletirem a realidade da totalidade de profissionais de um município de pequeno porte, e por sua amostra ser composta de profissionais de saúde de nível superior, subsidiarão o gestor em futuras decisões sobre a conduta e abordagem dos profissionais de nível superior. E se profissionais puderem tomar suas próprias concepções como objeto de reflexão e distinguir os elementos que compõem seus " ideais" para consolidação do SUS, poderão compreender a função que cumprem na sociedade e trabalhar na construção de novos valores

Saúde bucal e cuidado odontológico: representações sociais de mães usuárias de um serviço público de saúde

Objetivo: identificar as representações sociais de mães de crianças da faixa etária de zero a cinco anos de idade do Núcleo de Saúde da Família IV, em Ribeirão Preto-SP, procurando saber o que pensam sobre saúde bucal e tratamento odontológico. Método: trata-se de pesquisa qualitativa, sendo utilizada a entrevista semi-estruturada para a coleta dos dados e a análise de conteúdo. Resultados: constatou-se grande dificuldade das mães em se expressar a respeito do que é, para elas, saúde. Para essas mães a saúde bucal está relacionada com normas de higiene e dietéticas e também com a ida ao dentista, restringindo-se na preocupação com a estética e pouco com a função. Já em relação ao tratamento odontológico, a grande maioria demonstrou apresentar medo, causado pela sua experiência anterior com o tratamento. A assistência particular está associada à pontualidade e ao atendimento da maneira desejada enquanto o tratamento oferecido pelo setor público à demora e à falta de equipamentos e materiais. A humanização no atendimento e competência do profissional emergiram como dois aspectos importantes, e podem estar determinando a decisão de ir ou não ao dentista. Conclusões: A expressão saúde bucal foi associada à assistência odontológica. O atendimento pelo setor privado foi referido como o que mais se aproxima do tipo ideal de assistência odontológica

Pernambuco, Rio da Prata e a crise do antigo regime na América ibérica: o “caso” de Félix José Tavares Lira

The aim of this article is to discuss conexions between Pernambuco and Rio de la Plata around the year 1817. In a more general sense, it offers a large pattern of comprehension of the indepdendences of Luso and Spanish America in terms of its mutual relationships.

Beyond the Fragmentation Threshold Hypothesis: Regime Shifts in Biodiversity Across Fragmented Landscapes

Ecological systems are vulnerable to irreversible change when key system properties are pushed over thresholds, resulting in the loss of resilience and the precipitation of a regime shift. Perhaps the most important of such properties in human-modified landscapes is the total amount of remnant native vegetation. In a seminal study Andren proposed the existence of a fragmentation threshold in the total amount of remnant vegetation, below which landscape-scale connectivity is eroded and local species richness and abundance become dependent on patch size. Despite the fact that species patch-area effects have been a mainstay of conservation science there has yet to be a robust empirical evaluation of this hypothesis. Here we present and test a new conceptual model describing the mechanisms and consequences of biodiversity change in fragmented landscapes, identifying the fragmentation threshold as a first step in a positive feedback mechanism that has the capacity to impair ecological resilience, and drive a regime shift in biodiversity. The model considers that local extinction risk is defined by patch size, and immigration rates by landscape vegetation cover, and that the recovery from local species losses depends upon the landscape species pool. Using a unique dataset on the distribution of non-volant small mammals across replicate landscapes in the Atlantic forest of Brazil, we found strong evidence for our model predictions - that patch-area effects are evident only at intermediate levels of total forest cover, where landscape diversity is still high and opportunities for enhancing biodiversity through local management are greatest. Furthermore, high levels of forest loss can push native biota through an extinction filter, and result in the abrupt, landscape-wide loss of forest-specialist taxa, ecological resilience and management effectiveness. The proposed model links hitherto distinct theoretical approaches within a single framework, providing a powerful tool for analysing the potential effectiveness of management interventions.

Antilocalization of hole carriers in Pb(1-x)Eu(x)Te alloys in the metallic regime

Magnetoresistance measurements in p-type Pb(1-x)Eu(x)Te alloys, for x varying from 0% up to 5%, have been used to investigate localization and antilocalization effects. These are attributed to both the spin-orbit scattering and to the large Zeeman splitting present in these alloys due to the large values of the effective Lande g factor. The magnetoresistance curves are analyzed using the model of Fukuyama and Hoshino, which takes into account the spin-orbit and Zeeman scattering mechanisms. The spin-orbit scattering time is found to be independent of the temperature, while the inelastic-scattering time increases with decreasing temperature suggesting the electron-phonon interaction as the main scattering mechanism.

Multifractal regime transition in a modified minority game model

The search for more realistic modeling of financial time series reveals several stylized facts of real markets. In this work we focus on the multifractal properties found in price and index signals. Although the usual minority game (MG) models do not exhibit multifractality, we study here one of its variants that does. We show that the nonsynchronous MG models in the nonergodic phase is multifractal and in this sense, together with other stylized facts, constitute a better modeling tool. Using the structure function (SF) approach we detected the stationary and the scaling range of the time series generated by the MG model and, from the linear (non-linear) behavior of the SF we identified the fractal (multifractal) regimes. Finally, using the wavelet transform modulus maxima (WTMM) technique we obtained its multifractal spectrum width for different dynamical regimes. (C) 2009 Elsevier Ltd. All rights reserved.

Political Systems and the Perspective on Nursing Education during the Spanish Transition (from the Franco Regime to Democracy). A Contribution based on Nursing History

The aim of this study is to describe the changes in nursing education during the process prior to and after the establishment of democracy in Spain. It begins with the hypothesis that differences in social and political organization influenced the way the system of nursing education evolved, keeping it in line with neopositivistic schemes and exclusively technical approaches up until the advent of democracy. The evolution of a specific profile for nursing within the educational system has been shaped by the relationship between the systems of social and political organization in Spain. To examine the insertion of subjects such as the anthropology of healthcare into education programs for Spanish nursing, one must consider the cultural, intercultural and transcultural factors that are key to understanding the changes in nursing education that allowed for the adoption of a holistic approach in the curricula. Until the arrival of democracy in 1977, Spanish nursing education was solely technical in nature and the role of nurses was limited to the tasks and procedures defined by the bureaucratic thinking characteristic of the rational-technological paradigm. Consequently, during the long period prior to democracy, nursing in Spain was under the influence of neopositivistic and technical thinking, which had its effect on educational curricula. The addition of humanities and anthropology to the curricula, which facilitated a holistic approach, occurred once nursing became a field of study at the university level in 1977, a period that coincided with the beginnings of democracy in Spain.

Influence of hardness of the harder body on wear regime transition in a sliding pair of steels

In the unlubricated sliding wear of steels the mild-severe and severe-mild wear transitions have long been investigated. The effect of system inputs such as normal load, sliding speed, environment humidity and temperature, material properties, among others, on those transitions have also been studied. Although transitions seem to be caused by microstructural changes, surfaces oxidation and work-hardening, some questions remain regarding the way each aspect is involved. Since the early studies in sliding wear, it has usually been assumed that only the material properties of the softer body influence the wear behavior of contacting surfaces. For example, the Archard equation involves only the hardness of the softer body, without considering the hardness of the harder body. This work aims to discuss the importance of the harder body hardness in determining the wear regime operation. For this, pin-on-disk wear tests were carried out, in which the disk material was always harder than the pin material. Variations of the friction force and vertical displacement of the pin were registered during the tests. A material characterization before and after tests was conducted using stereoscopy and scanning electron microscopy (SEM) methods, in addition to mass loss, surface roughness and microhardness measurements. The wear results confirmed the occurrence of a mild-severe wear transition when the disk hardness was decreased. The disk hardness to pin hardness ratio (H(d)/H(p)) was used as a criterion to establish the nature of surface contact deformation and to determine the wear regime transition. A predominantly elastic or plastic contact, characterized by H(d)/H(p) values higher or lower than one, results in a mild or severe wear regime operation, respectively. (c) 2009 Elsevier B.V. All rights reserved.

Repeated disturbances and canopy disturbance regime in a tropical semi-deciduous forest

The canopy disturbance regime and the influence of gap methods on the interpretation of forest structure and dynamics were evaluated in a tropical semi-deciduous forest in south-eastern Brazil. We encountered a gap density of 11.2 gaps ha(-1) and an average size which varied from 121 to 333 m(2) depending on the gap delimitation method considered (minimum gap size was 10 m(2)). Although average size was slightly higher, the median value obtained (78 m(2)) was comparable to other tropical forest sites and the gap size-class distribution found supported the pattern described for such forest sites. Among 297 gap makers, snapping and uprooting were the most common modes of disturbance. The number and basal area of gap makers were good predictors of gap size. Almost 25% of all gaps suffered from repeated disturbance events that brought about larger gap sizes. Such processes, along with delimitation methods, strongly influenced the estimation of turnover rate and therefore the interpretation of forest dynamics. These results demonstrated the importance of further studies on repeated disturbances, which is often neglected in forest studies.

A novel nucleation apparatus for regime separated granulation

A novel nucleation apparatus is presented for the production of narrow sized nuclei from various powder and binder liquid combinations. Mono-sized binder liquid droplets are produced by a specially designed mono-disperse droplet generator. The droplet generator is positioned above a conveyor belt, transporting a powder bed through the spray zone of the droplet generator. By nucleating powder on a conveyer belt, the nucleation mechanism is completely separated from all other granulation mechanisms due to the lack of relative motion between primary particles and/or formed nuclei. Nucleation tests were performed using chalcopyrite and limestone powders with water as the binder liquid. At all operating conditions, the formed nuclei were found to originate from multiplicities of drops that merged on the powder bed surface. Investigation of the dynamics of nuclei formation showed that powder-binder liquid combinations with fast penetration dynamics result in less variation in the number of droplets from which nuclei originate. Smaller and more narrowly distributed nuclei were also achieved by increasing powder speed through the spray zone.

Extended integrability regime for the supersymmetric U model

An extension of the supersymmetric U model for correlated electrons is given and integrability is established by demonstrating that the model can he constructed through the quantum inverse scattering method using an R-matrix without the difference property. Some general symmetry properties of the model are discussed and from the Bethe ansatz solution an expression for the energies is presented.

Gas-surface interactions in the thermal and sub-thermal regime: A molecular dynamics study

Molecular dynamics simulations are used to study the interaction of low-energy Ar atoms with the Ni(001) surface, Angular scattering distributions, in and out of the plane of incidence, are investigated as a function of incident energy, angles of incidence, crystallographic orientation of the incident beam and surface temperature. The results show a clear transition to the structure scattering regime at around 2 eV. However, at lower energies, two sub-regimes are revealed by the simulations, Far energies up to 250 meV, scattering is mainly diffuse, and significant trapping on the surface is observed, At energies above this level, lobular patterns start to form and trapping decreases with the increase in energy, Generally, there is a weak temperature dependence, but variations in the angle of incidence and/or changes in the crystallographic direction, generate significant changes in the scattering patterns.