A judicialização da saúde na perspectiva da gestão local : um estudo da experiência de Saquarema - RJ

A Constituição Federal de 1988 garante o direito à saúde no Brasil a todos os brasileiros. Para assegurar esse direito constitucional foi instituído através das Leis ns 8080/90 e 8142/90, o Sistema Único de Saúde (SUS), organização de direito público que normatiza toda a prestação de assistência à saúde da população. O SUS, constituído a partir de diretrizes filosóficas, garante assistência universal e gratuita em todas as áreas do setor saúde. Incorporado ao SUS através da Política Nacional de Medicamentos e depois pela Política Nacional de Assistência Farmacêutica, o acesso a medicamentos é um setor estratégico da política pública de saúde. A judicialização do acesso à saúde e à assistência farmacêutica, que se converteu em recurso necessário para garantir o direito à saúde no Brasil, é hoje um importante componente da gestão municipal de saúde. Trata-se de um processo que se inicia com a aquisição de medicamentos para tratar o HIV/Aids na década de 1990. Este trabalho realizou uma pesquisa, de caráter exploratório, no município de Saquarema, que permitiu construir uma análise (qualitativa e quantitativa) das ordens judiciais, procedentes da Defensoria Pública da Comarca de Saquarema para aquisição de medicamentos, entre 01/01/2011 e 31/12/2012, totalizando 106 demandas, a partir de prescrições médicas individuais feitas por profissionais do SUS. A pesquisa constatou que a hipossuficiência de recursos e a urgência dos autores das ações são os principais respaldos das decisões judiciais. Ela também observou que a maioria dos requerentes é do gênero feminino, com idade acima de 61 anos, com patologias crônicas e fazendo uso contínuo de medicamentos. Esses medicamentos foram prescritos por quatro profissionais médicos oriundos de quatro especialidades (oftalmologia, cardiologia, endocrinologia e pediatria) e representam 60% das demandas judiciais. A situação de conflito pesquisada mostra que o direito à saúde está sendo exercido através do Poder Judiciário, com uma Defensoria Pública relativamente eficiente, atendendo a uma população com poucos recursos econômicos, que faz uso de medicamentos para tratamento de doenças crônicas e degenerativas. A prescrição médica individual é o documento necessário para requisitar os medicamentos de uso contínuo. A pesquisa, após analisar os principais resultados, aponta algumas alternativas, chamadas de ações defensivas, que as gestões municipais de saúde em Saquarema e outras municipalidades podem adotar.

Survey- and fishery-derived estimates of Pacific cod (Gadus macrocephalus) biomass: implications for strategies to reduce interactions between groundfish fisheries and Steller sea lions (Eumetopias jubatus)

Survey- and fishery-derived biomass estimates have indicated that the harvest indices for Pacific cod (Gadus macrocephalus) within a portion of Steller sea lion (Eumetopias jubatus) critical habitat in February and March 2001 were five to 16 times greater than the annual rate for the entire Bering Sea-Aleutian Islands stock. A bottom trawl survey yielded a cod biomass estimate of 49,032 metric tons (t) for the entire area surveyed, of which less than half (23,329 t) was located within the area used primarily by the commercial fishery, which caught 11,631 t of Pacific cod. Leslie depletion analyses of fishery data yielded biomass estimates of approximately 14,500 t (95% confidence intervals of approximately 9,000–25,000 t), which are within the 95% confidence interval on the fished area survey estimate (12,846–33,812 t). These data indicate that Leslie analyses may be useful in estimating local fish biomass and harvest indices for certain marine fisheries that are well constrained spatially and relatively short in duration (weeks). In addition, fishery effects on prey availability within the time and space scales relevant to foraging sea lions may be much greater than the effects indicated by annual harvest rates estimated from stock assessments averaged across the range of the target spec

Deputados e Prefeitos: o nacional e o local na estrutura de oportunidades políticas no Brasil

A elaboração dessa tese tem por finalidade contribuir para a discussão sobre o modelo de carreira política que vem se desenvolvendo no Brasil. O objetivo do trabalho é compreender a sua construção a partir da apreensão da lógica da tomada de decisão do legislador brasileiro na definição de sua trajetória profissional. Para isso, o estudo procurou estabelecer as motivações dos membros da Câmara dos Deputados diante das opções de carreira que se apresentam, no sentido de permanecer ou não na arena legislativa. A questão analisada é se a instituição está oferecendo atrativos aos seus membros para sua permanência, ou se estes estão alocados em outras instâncias. A hipótese-teste é a de que o Poder Executivo tem atraído os membros do Legislativo, desenhando um padrão de carreira política no qual as arenas se intercalariam Executivo e Legislativo assim como as esferas federal, estadual e municipal. A tese está estruturada em uma revisão das literaturas estrangeira e brasileira sobre carreira política, apresentando também um exame dos modelos de recrutamento e permanência na carreira parlamentar. São consideradas as influências de dois elementos estruturais da lógica política no Brasil. O primeiro é a estrutura federativa adotada no país a partir da Constituição de 1988 e o segundo é o seu sistema eleitoral e partidário, sobretudo o papel dos partidos políticos e do tipo de recrutamento de candidatos na adoção das estratégias de carreira de seus representantes. Procura-se entender o modo pelo qual o quadro criado pela conjunção dessas características gera, viabiliza ou impede a construção das carreiras políticas no Brasil e das ambições que as determinam. Os dados coletados na pesquisa compreendem as eleições para a Câmara dos Deputados e para a Prefeitura em todos os municípios do Brasil ocorridas nos últimos 20 anos. São analisadas as trajetórias prévias e futuras dos deputados federais que, durante o mandato, se candidataram ao cargo de Prefeito. A premissa aqui utilizada vem da visão de que sair do Parlamento pode ser a melhor estratégia − do ponto de vista eleitoral − para a ele poder retornar e a melhor estratégia para aqueles que desejam prosseguir em suas carreiras com maior segurança. E obter cargos junto ao Executivo pode dar acesso a recursos que não estão disponíveis aos parlamentares.

Report of Catch Assessment Survey of Lake Albert – Albert Nile conducted in July 2012

A Catch Assessment Surveys (CAS) with the overall objective of generating information on the fish production and commercial value of the fisheries of Lake Albert and Albert Nile system was implemented by the National Fisheries Resources Research Institute (NAFIRRI) in collaboration with the Department of Fisheries Resources (DFR), Local Government staff (FOs) and BMU members at selected landing sites on Lake Albert (12 landing sites) and Albert Nile (26 landing sites) in July 2012. A total 622 and 313 boat days on Lake Albert and Albert Nile respectively were sampled for a period of 9 days. Results indicate an annual landing of 151,600 and 5,900 tonnes (t) of fish with an estimated beach value of 122.5 and 14 Billion (UShs) from Lake Albert and Albert Nile respectively. Over 80% of the catch from Lake Albert comprised the small pelagic species; Neobola bredoi (Muziri) and Brycinus nurse (Ragoogi) followed by Nile perch (6%). However, due to low market value of the small fishes and the high prices attached to Nile perch for industrial processing and export market, the contribution of the latter to beach value rose to 34% of the total. The contribution of the light fishery based on small pelagic species (B. nurse and N. bredoi) are insignificant on Albert Nile. Even if the small pelagic species may be present in the river system, a light fishery based on these two is yet to be developed. Proportionally, Albert Nile still remain a multispecies fishery with over 20 fish species harvested commercially. Interestingly, the Albert Nile fishery still remains primitive with simple crafts and gears (mainly dugout canoes, traps, and gillnets). This could suggest that the more developed the system becomes the higher the level of transformation in its fisheries leading to simplification, characterized by reduction in multispecies nature and dominance of few species. Illegal gears especially undersized gillnet of mesh size less than 4 inches were the most dominant in the Lake Albert and Albert Nile fisheries. They captured large quantities of immature fish particularly when used to target Nile perch, Bagrus, Nile tilapia, and large Barbus spp. Their impact when used to target the smaller species (Ragoogi, Angara & Ngasia) is yet to be evaluated. A specific study to analyze selectivity and impacts of these nets is a recommended. However, the dominance of 1.5” mesh sizes especially on Albert Nile to target Angara, Ngassia and Barbus, is definitely destructive to their fisheries and should be checked forthwith. In addition, there is an emerging fishing method locally referred to as “Salsio or Luzira” whereby fishers stay on the lake from 3 days up to 2 weeks without returning to the landing site. They carry with them food and salt for processing the catches on the lake, and in the case of Albert Nile on make shift shelters on islands and in the game park. They normally use gillnets of 3-3½ inch mesh size and caught mainly Nile perch & Bagrus (Pethi & Munama). On return they land several tons of fish. Most of these Catches are not captured in the estimates presented in our analyses since we target daily fishing boats. The possible impacts of this fishing method should be studied and appropriate action recommended.

A Preliminary survey of 21 Ceylon lakes. 3. Parasites and predators, food of fish, and marginal fauna

Three nematodes, two acanthocephalans and three cestodes were collected by dissecting 15 species of fish. Of these parasites only Hedruris sp. a larval nematode is responsible directly for the death of fish, since it is found in predatory species a reduction of these might prove of considerable consequence to fish, production. Bothriocephalus gowleonensis, a cestode probably introduced from China with Chinese carp, was recorded in an indigenous carp Puntius sarana. This parasite causes heavy mortality in grass carp in China and is a potential danger to local species. A single crustacean parasite was recorded. It is likely that they are widespread. No protozoa were recorded but there can be little doubt that they occur in local freshwater species and may be of considerable importance in fisheries. Several predators (insects, fish and other vertebrates) were recorded and are doubtless of considerable importance. However, the role of parasites and of predators (especially fishes) in relation to the productivity of fisheries can hardly be assessed at present and needs further study. A study of the fauna found at the shallow edges of 21 irrigation reservoirs showed an abundance of fauna in the low-country reservoirs whilst the up-country reservoirs had a poor fauna. The fauna showed insects, crustacea and mollusca in this order of abundance. The presence of insect and molluscs feeding fish in our fauna shows that these rich sources of food are being utilised.

Survey of the regional fish trade

Fish export trade,both regional and international, has significantly contributed to uganda's economic growth and to the livehoods of many Ugandans in terms of revenue and employment. while there is substantive information on local and international fish trade on which decsions could be based to appropriately develop the trade,informatrion on regional fish export trade is lacking and where avaliable,it has not been adequately documented. This report contains the findings of the survey on regional fish trade at the border district of West Nile,South/Western and Eastern regions key markets and selected fish supply beaches on Lake Victoria.

Lake Nabigaga: a field survey undertaken by the National Fisheries Resources Research Institute (NaFIRRI)

The field survey was undertaken by NaFIRRI technical staff. The terms of reference for the survey were to make an assessment of the lake for possible cage fish farming. The survey was undertaken on the 26 August 2010 by a team composed of the several. The lake supports small subsistence fishing activities by the local communities living around it. Information from the local community indicates that the fish species/types occurring in the lake include the Ngege, Nile perch, the African catfish and the lung fish. The fishing crafts in operation are largely Dug-out and Bao Tatu canoes and the main fishing gears are nylon and monofilament gillnets, hooks and beach seines.

Beel fishery and livelihood of the local community in Rajdhala, Netrakona, Bangladesh

Baseline survey and Participatory Rural Appraisal (PRA) during January 2003 to December 2004 on the fishing community revealed that unregulated fishing, use of destructive fishing gears, poaching of fishes, difficulties encountered in enforcing fisheries regulation and the helplessness of fishers to find alternative sources of income during banned fishing period (June to October) were the major management problems. CBFM (Community Based Fisheries Management) system as an alternative management strategy has been introduced to ensure active participation of the target group-the poor fishers living around the beet who were previously deprived to get access to the beet. Establishing a leasing system for controlled access, ensuring greater user-group participation through equitable distribution of all resource benefits among members, attempting to enforce penalties for illegal fishing linked with surprise checks to enforce management regulations are some of the recent steps taken by the BMC (Beel Management Committee). Chapila fish intake by the community was 31.25 g/head/day before stocking the beel by carp fingerlings. After stocking, they consumed chapila as fish protein from 8.33 g to 20.8 g/head/day during the fishing season (November to May) indicating that due to introduction of carp fingerlings, chapila production has been decreased in 2003-2004. About 77.5% families around the beel were found to be dependent directly and/or indirectly on chapila and other indigenous fishes of the beel for their livelihood, through fishing, marketing and other activities like net and boat preparation and nets mending etc. Particularly fishers' families were found to face serious problem during non-fishing period like June to October for their livelihood. Analyzing the present research result it was also observed that other than declination in biodiversity, the fishing pressure on promising chapila of the beel was found high and that is why the production of chapila has also been decreased. To get sustainable chapila production from the heel, it is suggested to ensure successful spawning and recruitment as juveniles, and hence the chapila should be undisturbed during its breeding period from March to July, and fishing pressure on the same species needs to be reduced for obtaining sustainable fish production.

Community Councils online: a survey.

A survey of Scottish Community Councils found that only 22% have up-to-date online public presences. Only 4% of Community Councils have easily accessible online planning content. Most Community Councils websites communicate from Community Councils to citizen – only 10% use social media to host online discussion and opinion-gathering. Local Authority-hosted presences guarantee that Community Councils have presence but not that they are up to date. Such presences are also not content-rich. Community Councils’ own volition makes the difference between having no presence at all, mediocre presences and informative, content-rich presences that may serve citizens well. Suggestions to improve matters include broadening the scope of Local Authority-hosted presences and CCs mentoring each other.

Scottish Community Councils online: the 2014 survey.

This document reports the results of a survey, carried out in late spring 2014, of the public web presences of potentially over 1300 Scottish Community Councils (CCs). It follows on from similar survey in summer 2012. The report reviews content-types associated with up-to-date presences and examines Community Councils’ social media use, using three archetypes which may be used to derive models and examples of good practice, and create recommendations for Community Councils and their Local Authorities (LAs). The research found that there has little change overall since 2012, which combined with a high level of churn implies an increasing number of digitally disengaged Community Councils. A good way forward would be for to CCs emulate and adapt the examples of good practice identified, by publishing minutes, news, planning and local area information, limiting publication of other types of content, and using social media to engage with citizens. A number of broader recommendations are made to LAs, including that that they publish CC schemes on their websites, provide training in online methods and work together via their CCLOs and IT teams to support CCs

Crossing the cultural divide: assessing the needs of a local immigrant community

Gemstone Team CARE (Community Assessment of Resident Experiences)

Survey of the potential environmental and health impacts in the immediate aftermath of the coal ash spill in Kingston, Tennessee.

An investigation of the potential environmental and health impacts in the immediate aftermath of one of the largest coal ash spills in U.S. history at the Tennessee Valley Authority (TVA) Kingston coal-burning power plant has revealed three major findings. First the surface release of coal ash with high levels of toxic elements (As = 75 mg/kg; Hg = 150 microg/kg) and radioactivity (226Ra + 228Ra = 8 pCi/g) to the environment has the potential to generate resuspended ambient fine particles (< 10 microm) containing these toxics into the atmosphere that may pose a health risk to local communities. Second, leaching of contaminants from the coal ash caused contamination of surface waters in areas of restricted water exchange, but only trace levels were found in the downstream Emory and Clinch Rivers due to river dilution. Third, the accumulation of Hg- and As-rich coal ash in river sediments has the potential to have an impact on the ecological system in the downstream rivers by fish poisoning and methylmercury formation in anaerobic river sediments.

New insights into Hoogsteen base pairs in DNA duplexes from a structure-based survey.

Hoogsteen (HG) base pairs (bps) provide an alternative pairing geometry to Watson-Crick (WC) bps and can play unique functional roles in duplex DNA. Here, we use structural features unique to HG bps (syn purine base, HG hydrogen bonds and constricted C1'-C1' distance across the bp) to search for HG bps in X-ray structures of DNA duplexes in the Protein Data Bank. The survey identifies 106 A•T and 34 G•C HG bps in DNA duplexes, many of which are undocumented in the literature. It also uncovers HG-like bps with syn purines lacking HG hydrogen bonds or constricted C1'-C1' distances that are analogous to conformations that have been proposed to populate the WC-to-HG transition pathway. The survey reveals HG preferences similar to those observed for transient HG bps in solution by nuclear magnetic resonance, including stronger preferences for A•T versus G•C bps, TA versus GG steps, and also suggests enrichment at terminal ends with a preference for 5'-purine. HG bps induce small local perturbations in neighboring bps and, surprisingly, a small but significant degree of DNA bending (∼14°) directed toward the major groove. The survey provides insights into the preferences and structural consequences of HG bps in duplex DNA.

High-resolution spectroscopic observations of post-asymptotic giant branch candidates from the Edinburgh-Cape Survey

High spectral resolution ( R similar to 40 000) and signal-to-noise optical spectra, obtained at the Very Large Telescope ( VLT), are presented for three post-asymptotic giant branch ( AGB) candidates selected from the Edinburgh-Cape ( EC) Faint Blue Object Survey. The stellar atmospheric parameters and chemical compositions, derived using sophisticated non-local thermodynamic equilibrium calculations, reveal that EC 14102-1337 and EC 20068-7324 are both in an evolved post-horizontal branch ( HB) evolutionary state. However, EC 11507-2253 is most likely a post-AGB star.