La instrumentalización del derecho fundamental a la salud a través de la prestación del servicio público

La salud además de ser un derecho fundamental también es un servicio público, el cual debe brindarse adecuadamente en términos de oportunidad, cobertura y calidad. Al entender la salud como un derecho fundamental autónomo, significa, que requiere por parte del Estado la garantía de su goce efectivo para todos los habitantes del territorio nacional, el cual es susceptible de limitaciones, con sujeción a los principios de eficiencia, universalidad y solidaridad, dentro del marco de la dignidad humana. Por otro lado, el análisis de la salud como un servicio público puede abordarse desde la prestación del mismo por parte de los particulares, lo que significa analizar la figura de la descentralización por colaboración en un Estado Unitario, lo que implica: 1. La actuación de particulares en la prestación del servicio público, previa autorización legal 2. La implementación de sistemas de control, inspección y vigilancia, por parte del Estado sobre dicha prestación. 3. La expedición de instrumentos de regulación y reglamentación normativa que regulen la prestación del servicio público de salud. A través de la interpretación integradora podemos afirmar que la salud es un derecho de la persona que se materializa mediante la prestación de un servicio público de carácter obligatorio. Es decir, los servicios públicos se constituyen como instrumentos para garantizar el logro de la plena vigencia y eficacia de los derechos constitucionales y por ende de la realización de los fines del Estado Social de Derecho.

Effects of GeneXpert MTB/RIF Testing and GxAlert eHealth Platforms on MDR-TB Diagnosis and Linkage to Care in Sofala Province, Mozambique

Thesis (Master's)--University of Washington, 2016-06

Definição de "pequeno empresário", aplicável ao § 2º do art. 1.179 do Código civil, em relação aos conceitos de "microempresa" e de "empresa de pequeno porte" definidos pela Lei nº 9.841/99

Consultoria Legislativa - Área VII - Sistema Financeiro, Direito Comercial, Direito Econômico, Defesa do Consumidor.

Paleomagnetic reconstructions of sediments at ODP Sites 135-840 and 135-841

The geometry of the Tonga Arc implies that it has rotated approximately 17° clockwise away from the Lau Ridge as the Lau Basin formed in between. Questions have arisen about the timing of the opening, whether the arc behaved rigidly, and whether the opening occurred instead from motion of the Lau Ridge, the remanent arc. We undertook to address these questions by taking paleomagnetic samples from sediment cores drilled on the Tonga Arc at Sites 840 and 841, orienting the samples in azimuth, and comparing the paleodeclinations to expected directions. Advanced hydraulic piston corer (APC) cores from Holes 840C and 841A were oriented during drilling with a tool based on a magnetic compass and attached to the core barrel. Samples from Hole 841B were drilled with a rotary core barrel (RCB) and therefore are azimuthally unoriented. They were oriented by identifying faults and dipping beds in the core and aligning them with the same features in the Formation MicroScanner (FMS) wireline logs, which were themselves oriented with a three-axis magnetometer in the FMS tool. The best results came from the APC cores, which yielded a mean pole at -69.0°S, 112.2°E for an age of 4 Ma. This pole implies a declination anomaly of 20.8° ± 12.6° (95% confidence limit), which appears to have occurred by tectonic rotation of the Tonga Arc. This value is almost exactly that expected from the geometry of the arc and implies that it did indeed rotate clockwise as a rigid body. The large uncertainty in azimuth results from core orientation errors, which have an average standard deviation of 18.6°. The youngest cores used to calculate the APC pole contain sediments deposited during Subchron 2A (2.48-3.40 Ma), and their declinations are indistinguishable from the others. This observation suggests that most of the rotation occurred after their deposition; this conclusion must be treated with caution, however, because of the large azimuthal orientation errors. Poles from late and early Miocene sediments of Hole 841B are more difficult to interpret. Samples from this hole are mostly normal in polarity, fail a reversal test, and yield poles that suggest that the normal-polarity directions may be a recent overprint. Late Miocene reversed-polarity samples may be unaffected by this overprint; if so, they imply a declination anomaly of 51.1° ± 11.5°. This observation may indicate that, for older sediments, Tonga forearc rotations are larger than expected.

(Table 1) Sedimentary thicknesses, lithologies, ages, and interpreted paleowater depths for ODP Sites 135-840 and 135-841

The sedimentary succession drilled at Sites 840 and 841 on the Tonga forearc allows the sedimentary evolution of the active margin to be reconstructed since shortly after the initiation of subduction during the mid Eocene. Sedimentation has been dominated by submarine fan deposits, principally volcaniclastic turbidites and mass-flows derived from the volcanic arc. Volcaniclastic sedimentation occurred against a background of pelagic nannofossil sedimentation. A number of upward-fining cycles are recognized and are correlated to regional tectonic events, such as the rifting of the Lau Basin at 5.6 Ma. Episodes of sedimentation dating from 16.0 and 10.0 Ma also correlate well with major falls in eustatic sea level and may be at least partially caused by the resulting enhanced erosion of the arc edifice. The early stages of rifting of the Lau Basin are marked by the formation of a brief hiatus at Site 840 (Horizon A), probably a result of the uplift of the Tonga Platform. Controversy exists as to the degree and timing of the uplift of Site 840 before Lau Basin rifting, with estimates ranging from 2500 to 300 m. Structural information favors a lower value. Breakup of the Tonga Arc during rifting resulted in deposition of dacite-dominated, volcaniclastic mass flows, probably reflecting a maximum in arc volcanism at this time. A pelagic interval at Site 840 suggests that no volcanic arc was present adjacent to the Tonga Platform from 5.0 to 3.0 Ma. This represents the time between separation of the Lau Ridge from the Tonga Platform and the start of activity on the Tofua Arc at 3.0 Ma. The sedimentary successions at both sites provide a record of the arc volcanism despite the reworked nature of the deposits. Probe analyses of volcanic glass grains from Site 840 indicate a consistent low-K tholeiite chemistry from 7.0 Ma to the present, possibly reflecting sediment sourcing from a single volcanic center over long periods of time. Trace and rare-earth-element (REE) analyses of basaltic glass grains indicate that thinning of the arc lithosphere had begun by 7.0 Ma and was the principle cause of a progressive depletion of the high-field-strength (HFSE), REE, and large-ion-lithophile (LILE) elements within the arc magmas before rifting. Magmatic underplating of the Tofua Arc has reversed this trend since that time. Increasing fluid flux from the subducting slab since basin rifting has caused a progressive enrichment in LILEs. Subduction erosion of the underside of the forearc lithosphere has caused continuous subsidence and tilting toward the trench since 37.0 Ma. Enhanced subsidence occurred during rifting of the South Fiji and Lau basins. Collision of the Louisville Ridge with the trench has caused no change in the nature of the sedimentation, but it may have been responsible for up to 300 m of uplift at Site 840.

Postpartum fatigue and driving : relating experiences, thoughts and opinions 12 weeks post-birth

Fatigue in the postnatal period is such a common experience for most mothers that the term ‘postpartum fatigue’ (PPF) has been coined to describe it. When new mothers experience extreme fatigue, it follows that their physical health, mental health, and social-wellbeing is negatively affected. It is interesting to note that there is a distinct lack of empirical investigations focusing on the link between PPF and increased risk of injury; particularly when the links between fatigue and increased risk of road crashes are well documented. The purpose of this investigation was to undertake pilot research to develop an understanding of the duration of PPF and the performance impairments experienced by new mothers when involved in safety-sensitive activities, such as driving a motor vehicle. Semi-structured interviews were undertaken with women (N = 24) at 12 weeks postpartum living in South-east Queensland, Australia. Key themes were identified; with a particular emphasis towards understanding the link between the participant’s experience of postpartum fatigue and the impact this has on their overall cognitive and physiological functioning, as well as their experience of the driving task. Further, sleep/wake data was collected and using the Karolinska Sleepiness Scale (KSS) the potential crash risk for this group of mothers is discussed. It is proposed that the findings of this investigation could be used to improve current knowledge among new mothers and practitioners regarding the mechanisms and consequences of fatigue and to inform interventions that lead to a decreased risk of injury associated with postpartum fatigue.

Raman spectroscopic study of the antimonate mineral brandholzite Mg[Sb(OH)12].6H2O

Raman spectra of brandholzite Mg[Sb(OH)6].6H2O were studied, complemented with infrared spectra, and related to the structure of the mineral. An intense Raman sharp band at 618 cm-1 is attributed to the SbO symmetric stretching mode. The low intensity band at 730 cm-1 is ascribed to the SbO antisymmetric stretching vibration. Low intensity Raman bands were found at 503, 526 and 578 cm-1. Corresponding infrared bands were observed at 527, 600, 637, 693, 741 and 788 cm-1. Four Raman bands observed at 1043, 1092, 1160 and 1189 cm-1 and eight infrared bands at 963, 1027, 1055, 1075, 1108, 1128, 1156 and 1196 cm-1 are assigned to δ SbOH deformation modes. A complex pattern resulting from the overlapping band of the water and hydroxyl units is observed. Raman bands are observed at 3240, 3383, 3466, 3483 and 3552 cm-1, infrared bands at 3248, 3434 and 3565 cm-1. The first two Raman bands and the first infrared band are assigned to water stretching vibrations. The two higher wavenumber Raman bands observed at 3466 and 3552 cm-1 and two infrared bands at 3434 and 3565 cm-1 are assigned to the stretching vibrations of the hydroxyl units. Observed Raman and infrared bands are connected with O-H…O hydrogen bonds and their lengths 2.72, 2.79, 2.86, 2.88 and 3.0 Å (Raman) and 2.73, 2.83 and 3.07 Å (infrared).

Raman spectroscopic study of the arsenite minerals leiteite ZnAs2O4 , reinerite Zn3(AsO3)2 and cafarsite Ca5(Ti,Fe,Mn)7(AsO3)12.4H2O

The selected arsenite minerals leiteite, reinerite and cafarsite have been studied by Raman spectroscopy. DFT calculations enabled the position of AsO22- symmetric stretching mode at 839 cm-1, the antisymmetric stretching mode at 813 cm-1, and the deformation mode at 449 cm-1 to be calculated. The Raman spectrum of leiteite shows bands at 804 and 763 cm-1 assigned to the As2O42- symmetric and antisymmetric stretching modes. The most intense Raman band of leiteite is the band at 457 cm-1 and is assigned to the ν2 As2O42- bending mode. A comparison of the Raman spectrum of leiteite is made with the arsenite minerals reinerite and cafarsite.

Maternal feeding practices and feeding behaviors of Australian children aged 12 to 36 months

Objectives To explore parents' perceptions of the eating behaviors and related feeding practices of their young children. Methods Mothers (N=740) of children aged 12 to 36 months and born in South Australia were randomly selected by birth date in four 6-month age bands from a centralized statewide database and invited to complete a postal questionnaire. Results Valid completed questionnaires were returned for 374 children (51% response rate; 54% female). Although mothers generally reported being confident and happy in feeding their children, 23% often worried that they gave their child the right amount of food. Based on a checklist of 36 specified items, 15% of children consumed no vegetables in the previous 24 hours, 11% no fruit and for a further 8% juice was the only fruit. Of 12 specified high fat/sugar foods and drinks, 11% of children consumed none, 20% one, 26% two, and 43% three or more. Six of eight child-feeding practices that promote healthy eating behaviors were undertaken by 75% parents 'often' or 'all of the time'. However, 8 of 11 practices that do not promote healthy eating were undertaken by a third of mothers at least ‘sometimes’. Conclusions In this representative sample, dietary quality issues emerge early and inappropriate feeding practices are prevalent thus identifying the need for very early interventions that promote healthy food preferences and positive feeding practices. Such programs should focus not just on the 'what', but also the 'how' of early feeding, including the feeding relationship and processes appropriate to developmental stage. Key words: Maternal feeding practices, infants, obesity