Disentangling Processing and Storage Accounts of Working Memory Development in Childhood.

Researchers have been asking the question of what drives the development of working memory (WM) during childhood for decades. This question is particularly challenging because so many aspects of cognition develop with age that it is difficult to disentangle them and find out which factors are causal or fundamental. In this review, we first prepare to discuss this issue by inquiring whether increases in storage, processing, or both are the fundamental driving factor(s) of the age-related increase in WM capability in childhood. We contend that by experimentally manipulating either factor and observing changes in the other, it is possible to learn about causal roles in WM development. We discuss research on school-aged children that seems to suggest, by means of such an approach, that the growth of storage is causal for some phases or steps in WM tasks, but that the growth of processing is causal for other steps. In our theoretical proposal, storage capacity of the focus of attention determines earlier steps of information processing by constraining the selective encoding of information into WM, whereas processing dependent on the focus of attention determines later steps, like the detection of patterns that can simplify the effective memory load and adoption of a proactive stance of maintenance in dual-task settings. Future directions for research are discussed.

Volatility of the COVID-19 vaccine hesitancy: sentiment analysis conducted in Brazil.

Background: Vaccine hesitancy is a phenomenon that can interfere with the expansion of vaccination coverage and is positioned as one of the top 10 global health threats. Previous studies have explored factors that affect vaccine hesitancy, how it behaves in different locations, and the profile of individuals in which it is most present. However, few studies have analyzed the volatility of vaccine hesitancy. Objective: Identify the volatility of vaccine hesitancy manifested in social media. Methods: Twitter's academic application programming interface was used to retrieve all tweets in Brazilian Portuguese mentioning the COVID-19 vaccine in 3 months (October 2020, June 2021, and October 2021), retrieving 1,048,576 tweets. A sentiment analysis was performed using the Orange software with the lexicon Multilingual sentiment in Portuguese. Results: The feelings associated with vaccine hesitancy were volatile within 1 month, as well as throughout the vaccination process, being positioned as a resilient phenomenon. The themes that nurture vaccine hesitancy change dynamically and swiftly and are often associated with other topics that are also affecting society. Conclusion: People that manifest the vaccine hesitancy present arguments that vary in a short period of time, what demand that government strategies to mitigate vaccine hesitancy effects be agile and counteract the expressed fear, by presenting scientific arguments.

The effect of volunteer-led activities on the quality of life of volunteers, residents, and employees of a long-term care institution: a cohort study.

BACKGROUND: The COVID-19 pandemic primarily impacted long-term care facilities by restricting visiting and circulation of visitors, affecting the quality of life (QoL) of older adults living in these institutions. Volunteer activities, essential for older adults' daily life, were also interrupted and potentially negatively impacted the QoL of older adults, volunteers themselves, and also employees in these institutions. In this context, this study aims to evaluate the impact of the return of volunteer-led activities in a long-term care institution on the QoL of older adult residents, employees, and volunteers. METHODS: This study used a pre-test and post-test design within the same group. The first round of data collection was conducted before volunteer-led activities returned and the second round after 1 month of return. The instrument used to assess QoL was the EUROHIS-QoL-8 scale. This study was conducted within a nursing home in São Paulo, Brazil, created in 1937 by members of the Israeli community living in Brazil. Volunteer-led activities were part of residents' daily life before the COVID-19 pandemic, when these activities were interrupted for about 20 months. A total of 79 individuals participated in both rounds (pre and post), of which: 29 residents, 27 volunteers, and 23 employees of the long-term care institution. RESULTS: Using a Wilcoxon signed-rank test, the analyses indicated improvements after the 1 month return in different QoL aspects for the three groups. Volunteers improved their personal relationships (Z - 2.332, p < .05), residents their overall health (Z - 2.409, p < .05) and employees in their overall QoL perception (Z - 2.714, p < .05). Influencing factors for residents were the number of activities (3 or more), gender (male), and education (undergraduate/graduate). For employees, those who assumed additional activities due to the volunteer-led activities interruption had a significant impact on their overall QoL. CONCLUSIONS: Evidence from this study suggests that volunteers' return positively impacted different QoL aspects for volunteers, residents, and employees.

Can children and adolescents with ADHD use attention to maintain verbal information in working memory?

Children and adolescents with attentional-deficit/hyperactivity disorder (ADHD) present deficits in working memory (WM), but accounts for this phenomenon are still lacking. In this study, we used two variations of a complex-span task to test whether a specific WM mechanism, attentional refreshing, causes these deficits. Attentional refreshing is a maintenance strategy based on the sequential switch of attention between maintaining and processing information in WM. Its use is evidenced by a decrease in recall performance proportional to the distraction of attention away from the memoranda. In this study, we designed two experiments requiring children and adolescents with ADHD symptoms to maintain sequences of letters for subsequent recall, while performing a distracting task. In Experiment 1, the distracting task consisted of reading digits aloud. In Experiment 2, it consisted in making spatial judgements. The pace of the distracting tasks was varied to manipulate the level of attentional distraction. We observed that recall in ADHD participants was higher in the distracting conditions that give attention more opportunity to refresh letters. Moreover, ADHD participants had a similar recall performance to their age-matched typically developing peers. This study shows first evidence that individuals with ADHD can use attention to maintain verbal information in WM and calls for more research to understand their WM development.

Attentional Orienting in Working Memory in Children with ADHD.

Children with attentional-deficit/hyperactivity disorder (ADHD) have impairments in working memory (WM) functioning. Impaired orienting of visual attention during encoding and/or maintenance is hypothesized as the cause of poor performance in visuospatial WM in 10-to-16-year-olds. We used a color-recognition task with valid location cues before encoding (pre-cues) and during maintenance (retro-cues). If ADHD children have an orienting deficit during these processing stages, they should not benefit from the cues. We observed strong pre- and retro-cueing benefits both for ADHD and typically developing controls, with no differences between the groups. This strengthens findings showing that ADHD is not characterized by deficits in orienting attention and provides evidence of retro-cue benefits in this population.

Organizational Justice - An Overview of the Brazilian Scientific Production / Justiça Organizacional - Um Panorama da Produção Científica Brasileira

Abstract The relevance of organizational justice for the improvement of the relationship between workers and organizations has given the theme a prominent role on the international stage in recent decades. In Brazil, discrepancies between national and foreign contributions were pointed out by the last review on the subject, in 2005. Thus, this study analyzed the Brazilian scientific production on organizational justice, focusing on the dimensions of the organizational justice, the theoretical background, and the relationships investigated. A semi-systematic literature review was carried out in 19 journals (1996-2018). The results showed significant differences between national and international production. A national research agenda is presented, highlighting the need for studies exploring the antecedents and the effects of the process of mediation and interaction of justice and a better theoretical foundation.

Resumo A relevância da justiça organizacional para melhoria da relação entre trabalhadores e organizações conferiu ao tema destaque em cenário internacional nas últimas décadas. No Brasil, discrepâncias entre as contribuições nacionais e estrangeiras foram apontadas pela última revisão do tema, em 2005. Assim, buscando responder como as dimensões de justiça foram pesquisadas, baseadas em que teorias e quais as principais relações investigadas, este estudo analisou o desenvolvimento da produção científica brasileira sobre justiça organizacional. Realizou-se uma revisão semi-sistemática da literatura, em 19 periódicos (1996-2018). Os resultados evidenciaram diferenças significativas entre a produção nacional e internacional. Apresenta-se uma agenda de pesquisa nacional, explicitando as necessidades de investigação dos antecedentes e dos efeitos mediacionais e interacionais do construto e de melhor fundamentação teórica.

Prenatal and pubertal exposure to 17α-ethinylestradiol cause morphological changes in the prostate of old gerbils.

This study evaluated such as exposure to ethinylestradiol during the prenatal (18th-22nd day) and pubertal (42nd-49th day) periods acts on the male ventral prostate and female prostate of 12-month old gerbils. We performed the analysis to serum hormone levels for estradiol and testosterone. The prostates were submitted to morphometric and immunohistochemical analyses. Exposure to ethinylestradiol during these developmental periods decreased the testosterone serum levels in males and increased the estradiol serum levels in females. Morphologically, prostate intraepithelial neoplasia and disorders in the arrangement of the fibrous components were observed in the prostate glands of both sexes of gerbil exposed to ethinylestradiol during development periods. In the male prostate, the ethinylestradiol promoted decreased in the frequency of positive epithelial cell for androgen receptor (AR) and increased the frequency of positive stromal cell for estrogen receptor α. However, in the female prostate, this synthetic estrogen caused AR upregulation and increased cell proliferation. This study shows that the exposure to ethinylestradiol during development phases alters the morphology and the hormonal signaling in the male and female prostates of old gerbils, confirming the action of ethinylestradiol as endocrine disruptor.

The sex of body images modulates size estimations and lateralized responses in body perception.

Previous findings suggest a right hemispheric contribution to body image distortions only in women. Here we set out to replicate this finding and investigate whether the sex of the body image would play a role in this lateralization. We report here two experiments of body size estimation using the divided visual field methodology. In Experiment 1 we found no effect of visual field, participant sex, and body image sex. We discuss the results in terms of the androgynous-like stimuli appearance. In Experiment 2 we increased the dimorphism of body image stimuli. Surprisingly, we observed a different pattern. Both men and women overestimated the size of female models presented in both visual fields, but the size of male models was underestimated for presentations in the left visual field compared to presentations in the right visual field. We found no differences between men and women. Our results suggest that the differences in lateralization of body image distortions between men and women observed in previous studies can be attributed to the sex of the body image. To the best of our knowledge, this is the first study to show that the sex of the body image modulates lateralization and body image distortion.

Como delimitar e descrever um sistema de Memória Humana? / How to delimit and describe a Human Memory system? / ¿Cómo delimitar y describir un sistema de Memoria Humana?

O estudante ou pesquisador que inicia seus estudos em Psicologia Cognitiva geralmente aprende sobre o funcionamento de diversos sistemas de memória (e.g. memória declarativa/explícita e não-declarativa/implícita, memória episódica, memória semântica, memória operacional/de trabalho, memória procedural), mas não tem acesso aos detalhes do processo científico de descrição desses sistemas. De maneira semelhante, o profissional clínico pode enfrentar dificuldades para compreender os detalhes metodológicos dos estudos que originaram ferramentas de avaliação e intervenção neuropsicológica ao consultar a literatura científica da área. O objetivo deste artigo é apresentar uma visão global dos desafios teóricos e metodológicos no estudo da memória humana, com ênfase na delimitação dos sistemas de memória. A autora apresenta o método experimental geralmente usado nas pesquisas, alguns dos critérios usados no campo para delimitar os sistemas de memória, e uma proposta para a formulação de um modelo integrado dos sistemas. Ao final, são feitas considerações sobre os desafios do estudante/pesquisador que quer contribuir com o campo.

The student or researcher beginning his/her studies in Cognitive Psychology usually learns about the functioning of various memory systems (e.g. declarative/explicit memory and non-declarative/implicit memory, episodic memory, semantic memory, working memory, procedural memory), but does not have access to the detailed scientific process of describing these systems. Similarly, clinical psychologists may face difficulties to comprehend methodological details that originated neuropsychological evaluation and rehabilitation instruments while consulting the scientific literature of the field. The aim of this paper is to present an overview of the theoretical and methodological challenges in the study of human memory, with emphasis on the delimitation of memory systems. The author presents the experimental method commonly used in research, some criteria used in the field to delimit memory systems, and a proposal for the formulation of an integrated memory model. The author concludes with considerations about the challenges of the student/researcher willing to contribute to the field.

El estudiante o investigador que comienza sus estudios en Psicología Cognitiva generalmente aprende sobre el funcionamiento de varios sistemas de memoria (por ejemplo, memoria declarativa/explícita y memoria no-declarativa/implícita, memoria episódica, memoria semántica, memoria operativa/ de trabajo, memoria de procedimiento), pero no tiene acceso a los detalles del proceso científico de descripción de esos sistemas. Del mismo modo, los psicólogos clínicos pueden enfrentar dificultades para comprender los detalles metodológicos de los estudios que originaron los instrumentos de evaluación e intervención neuropsicológica mientras consultan la literatura científica del campo. El objetivo de este trabajo es presentar una visión general de los desafíos teóricos y metodológicos en el estudio de la memoria humana, con énfasis en la delimitación de los sistemas de memoria. La autora presenta el método experimental comúnmente utilizado en las investigaciones, algunos de los criterios utilizados en el campo para delimitar los sistemas de memoria y una propuesta para la formulación de un modelo integrado de sistemas. La autora concluye con consideraciones sobre los desafíos del estudiante/investigador que quiere contribuir al campo.

A recuperação da informação visual baseada na localização e nas características visuais dos objetos / The retrieval of visual information based on the location and visual features of objects / La recuperación de la información visual basada en la localización y en las características visuales de los objetos

Resumo Nós investigamos a recuperação de características visuais (cor, forma) de um objeto armazenado na memória de trabalho visual. Dicas retroativas, espaciais ou baseadas nas características visuais do objeto memorizado, foram apresentadas em uma tarefa de reconhecimento visual. Dicas retroativas espaciais sinalizavam o local ora da cor, ora da forma a ser reconhecida; a dica de forma sinalizava a cor a ser reconhecida; a dica de cor sinalizava a forma. Os resultados mostram que a dica espacial proporciona um ganho no reconhecimento da cor, mas não da forma. Nem a cor nem a forma proporcionam ganhos no reconhecimento, respectivamente, da forma ou da cor. Nossos resultados sugerem que a informação espacial é mais relevante para a recuperação da informação memorizada do que a informação visual. Discutimos o papel da atenção no processo de recuperação e a importância do buffer visual como sistema da memória de trabalho visual.

Abstract We investigate the retrieval of visual characteristics (color, form) of an object stored in visual working memory. Retro-cues based on location or on memorized characteristics were presented in a visual recognition task. Location retro-cues pointed out the place where the to be recognized feature (color or form) was at the memorized scene; color retro-cues cued the to be recognized form; form retro-cues cued color. Results show that spatial retro-cue allows a gain in color recognition but not in form recognition. Neither the color nor the form retro-cues provide significant improvement in recognition of form or color, respectively. Our results suggest that spatial information is more relevant to the recovery of the memorized information than the visual characteristics. We discuss the role of attention in the recovery process and the importance of the visual buffer as a visual working memory system.

Resumen Nosotros investigamos la recuperación de características visuales (color, forma) de un objeto almacenado en la memoria de trabajo visual. Pistas retroactivas, espaciales o embazadas en características del objeto memorizado, fueron presentadas en una tarea de reconocimiento visual. Pistas espaciales señalaron el sitio del color, o de la forma a ser reconocida; la pista de forma señaló el color y la pista de color señaló la forma a ser reconocida. Los resultados muestran que las pistas espaciales proporcionan un gaño en lo reconocimiento del color, pero no de forma. Ni el color ni la forma proporcionan beneficios en el reconocimiento, respectivamente, de la forma o del color. Nuestros resultados sugieren que la información espacial es más relevante para la recuperación que la información visual. Discutimos el rol de la atención en la recuperación y la importancia del visual buffer como un sistema de la memoria de trabajo visual.

Assessment of carcinogenic potential of soft drinks of cola, diet cola, orange and lemon, produced in the city of Uberlândia, Minas Gerais state, Brazil / Avaliação do potencial carcinogênico de refrigerantes à base de cola, diet cola, laranja e limão, produzidos no município de Uberlândia, estado de Minas Gerais, Brasil

Soft drinks are industrialized unfermented beverages, free of alcohol, carbonated, rich in artificial flavors and sugar. The intense consumption of such beverages can be related to not inheritable diseases such as caries, allergy, cellulite and stretch marks, gastrointestinal disorders, diabetes and cancer. The aim of this study was to evaluate the carcinogenic potential of different concentrations of soft drinks produced in the Uberlândia city, Minas Gerais State, Brazil, by means of Epithelial Tumor Detection Test using Drosophila melanogaster as a model. Third stage larvae descendants of crosses between D. melanogaster virgin females wts/TM3, sb¹ and males mwh/mwh were treated with different concentrations (0.83, 1.66 or 3.33 mL/g) of cola, diet cola, orange or lemon soft drinks. The total epithelial tumor rate observed in flies treated with 3.33 mL/g of cola and orange soft drinks was higher than the negative control. The diet cola and lemon caused no significant increase in the overall frequency of epithelial tumors in D. melanogaster. In conclusion, in these experimental conditions, the cola and orange base soft drinks demonstrated carcinogenic potential in somatic cells of D. melanogaster in the concentration of 3.33 mL/g.

Refrigerantes são bebidas industrializadas não fermentadas, livre de álcool, carbonatadas, ricas em aromas artificiais e açúcar. O consumo intenso dessas bebidas pode estar relacionada à doenças não herdáveis como, cáries, quadros alérgicos, formação de celulite e estrias cutâneas, alterações gastrointestinais, diabetes e câncer. O objetivo desse trabalho foi avaliar o potencial carcinogênico de diferentes concentrações de refrigerantes produzidos no município de Uberlândia, Estado de Minas Gerais, Brasil. Foi realizado o Teste de Detecção de Tumor Epitelial em Drosophila melanogaster. Larvas de terceiro estágio descendentes do cruzamento entre fêmeas virgens wts/TM3, sb¹ e machos mwh/mwh de D. melanogaster foram tratadas com diferentes concentrações (0,83; 1,66 ou 3,33 mL/g) de refrigerantes à base de cola, diet cola, laranja e limão. Os resultados mostraram aumento na frequência de tumor epitelial em moscas tratadas 3,33 mL/g de refrigerantes à base de cola e de laranja, quando comparados ao controle negativo. Os refrigerantes diet cola e limão não provocaram aumento na frequência de tumor epitelial em D. melanogaster. Em conclusão, nessas condições experimentais, os refrigerantes à base de cola e laranja mostraram potencial carcinogênico em células somáticas de D. melanogaster na concentração de 3,33 mL/g.

Vaccines, adjuvants and autoimmunity.

Vaccines and autoimmunity are linked fields. Vaccine efficacy is based on whether host immune response against an antigen can elicit a memory T-cell response over time. Although the described side effects thus far have been mostly transient and acute, vaccines are able to elicit the immune system towards an autoimmune reaction. The diagnosis of a definite autoimmune disease and the occurrence of fatal outcome post-vaccination have been less frequently reported. Since vaccines are given to previously healthy hosts, who may have never developed the disease had they not been immunized, adverse events should be carefully accessed and evaluated even if they represent a limited number of occurrences. In this review of the literature, there is evidence of vaccine-induced autoimmunity and adjuvant-induced autoimmunity in both experimental models as well as human patients. Adjuvants and infectious agents may exert their immune-enhancing effects through various functional activities, encompassed by the adjuvant effect. These mechanisms are shared by different conditions triggered by adjuvants leading to the autoimmune/inflammatory syndrome induced by adjuvants (ASIA syndrome). In conclusion, there are several case reports of autoimmune diseases following vaccines, however, due to the limited number of cases, the different classifications of symptoms and the long latency period of the diseases, every attempt for an epidemiological study has so far failed to deliver a connection. Despite this, efforts to unveil the connection between the triggering of the immune system by adjuvants and the development of autoimmune conditions should be undertaken. Vaccinomics is a field that may bring to light novel customized, personalized treatment approaches in the future.

The safety of human papilloma virus-blockers and the risk of triggering autoimmune diseases.

INTRODUCTION: With the safety of human papilloma virus vaccine (HPVv) being questioned, this article aims to assess the risks and benefits of the commercially available HPVv. Within the last decade, two vaccines (Gardasil and Cervarix) have been put on the market to prevent infection with the most oncogenic HPV subtypes. Both vaccines contain aluminum adjuvants that are meant to cause a hyper stimulated immune response to prevent HPV infection. AREAS COVERED: The purpose of this paper is to consider the safety of these two vaccines based on the data from the U.S. Vaccine Adverse Event Reporting System (VAERS) and case reports. EXPERT OPINION: The current HPVv are both effective and generally safe. However, it should be noted that autoimmune side effects have been reported in several studies. Further research should be done to understand the relationship between HPVv and autoimmunity.

Amizade na adolescência e a entrada na universidade / Friendship in adolescence and college admission

O presente estudo investigou o relacionamento de amizade em jovens que recém-ingressaram na universidade. Os aspectos estudados da amizade foram: freqüência de amizades, presença de melhor amizade, origem, duração, influências de outros contextos de interação (família, romance, escola), freqüência de contato e presença de melhores amizades extras. Integraram a amostra 24 estudantes com idade entre 16 e 17 anos, regularmente matriculados em cursos de graduação na Universidade Federal do Rio Grande do Sul, em Porto Alegre, envolvendo diversas áreas do conhecimento. O estudo procura contribuir para uma melhor compreensão desta fase peculiar da vida de alguns adolescentes - o ingresso na universidade. Além disso, abre possibilidades para futuras investigações que promovam um melhor entendimento sobre este tema de pesquisa e de intervenção. (AU)

This study investigated friendship in youngsters that had just been admitted into college. The friendship aspects under study were: frequency of friends, presence of a best friend, origin, duration, influence from other contexts of interaction (family, romance, school), frequency of contact and presence of extra-best friends. The sample was composed of 24 adolescents, from 16 to 17 years-old, registered in major courses at Universidade Federal do Rio Grande do Sul, in Porto Alegre, south of Brazil, comprising diverse areas of knowledge. The study aims at contributing to a better understanding of this peculiar life-phase for some adolescents - admission into college. In addition to that, this study brings about possibilities concerning future investigations that evince a better understanding about this research and intervention topic. (AU)

[Health policy in the European Union: impact on the Spanish health system]. / Los temas de salud en la Unión Europea: su impacto en la sanidad española.

This text reviews the impact of European integration on the health sector (public health and health services) by studying European Union (EU) institutions, functioning, and responsibilities through the literature, documents, and authors' observations. The EU does not have direct health responsibilities, but Community legislation has important repercussions on all member states' health policies. This influence affects health protection issues, consumer safety, regulation of medicines and medical devices, mutual recognition of professional qualifications, freedom of movement for health professionals and patients, public contracts and bidding, research, etc. The evolution of EU health policy shows a progressive reinforcement of responsibilities consistent with the objective of reaching a high level of health protection, which in turn affects other European policies. The impact of European integration on the Spanish health system is analyzed as a case study, and key aspects and present and future challenges are highlighted. Lessons are also drawn for regional integration processes to foster equity and efficiency in health.

[Health on the borders: access to and demands on the Brazilian National Health System by foreigners and non-resident Brazilians in cities along the border with MERCOSUR countries from the perspective of municipal health secretaries]. / Saúde nas fronteiras: acesso e demandas de estrangeiros e brasileiros não residentes ao SUS nas cidades de fronteira com países do MERCOSUL na perspectiva dos secretários municipais de saúde.

In the context of forming common markets, border areas require special attention, since they anticipate the effects of integration processes. Along borders, different political, monetary, security, and social systems coexist; the intensification of flows resulting from integration raises challenges for the health systems, requiring specific policies focused on guaranteeing the right to health. This article presents the results of a study on the conditions for access to (and demands for) health services in the MERCOSUR border cities. A survey was performed with municipal health secretaries in the 69 Brazilian cities in the States of Rio Grande do Sul, Santa Catarina, Paraná, and Mato Grosso do Sul that border on the other MERCOSUR countries. The study attempted to identify the services demanded by the border population, mechanisms used for access, flows between services and systems, response strategies, and local agreements. Initiatives for cooperation between Brazilian and foreign local administrators were identified in nearly half of the municipalities and can orient the formulation of guidelines for border situations, allowing improvement in comprehensive access to health care.

Los temas de salud en la Unión Europea: su impacto en la sanidad española / Health policy in the European Union: impact on the Spanish health system

El texto revisa el impacto de la integración europea en el sector salud (salud pública y servicios sanitarios), estudiando instituciones, funcionamiento y competencias de la Unión Europea (UE), a partir de literatura, documentos y observaciones coyunturales. La UE no tiene competencias directas en salud, pero su legislación ejerce importante impacto en las políticas sanitarias de todos los Estados Miembros. Esta influencia se manifiesta en la protección de la salud y seguridad de los consumidores, regulación de medicamentos y aparatos médicos, homologación de títulos profesionales, libertad de movimiento de profesionales y pacientes, compras y contratación, e investigación biomédica. Estudiando la evolución de la política de salud en la UE se constata un refuerzo progresivo de sus políticas sanitarias y que el objetivo de alcanzar un alto nivel de protección de la salud, tiene importantes implicaciones en todas las políticas europeas. Tomando como caso de estudio las repercusiones de la integración europea en el sistema sanitario español, se destacan sus aspectos más influyentes, retos actuales y perspectivas, así como lecciones para que procesos de integración regional sean factores de equidad y eficiencia en salud.

This text reviews the impact of European integration on the health sector (public health and health services) by studying European Union (EU) institutions, functioning, and responsibilities through the literature, documents, and authors' observations. The EU does not have direct health responsibilities, but Community legislation has important repercussions on all member states' health policies. This influence affects health protection issues, consumer safety, regulation of medicines and medical devices, mutual recognition of professional qualifications, freedom of movement for health professionals and patients, public contracts and bidding, research, etc. The evolution of EU health policy shows a progressive reinforcement of responsibilities consistent with the objective of reaching a high level of health protection, which in turn affects other European policies. The impact of European integration on the Spanish health system is analyzed as a case study, and key aspects and present and future challenges are highlighted. Lessons are also drawn for regional integration processes to foster equity and efficiency in health.

Saúde nas fronteiras: acesso e demandas de estrangeiros e brasileiros não residentes ao SUS nas cidades de fronteira com países do MERCOSUL na perspectiva dos secretários municipais de saúde / Health on the borders: access to and demands on the Brazilian National Health System by foreigners and non-resident Brazilians in cities along the border with MERCOSUR countries from the perspective of municipal health secretaries

No contexto de formação de mercados comuns, as regiões de fronteira adquirem especial atenção, pois antecipam efeitos dos processos de integração. Nas fronteiras convivem diferentes sistemas políticos, monetários, de segurança e proteção social, e a intensificação de fluxos decorrentes da integração gera novos desafios para os sistemas de saúde, exigindo políticas específicas direcionadas à garantia do direito à saúde nas regiões fronteiriças. Este trabalho apresenta resultados de pesquisa com o objetivo de analisar condições de acesso e demandas por serviços de saúde em cidades fronteiriças do MERCOSUL. Foi realizado inquérito com secretários municipais de saúde das 69 localidades brasileiras da linha de fronteira com países do MERCOSUL referentes aos Estados do Rio Grande do Sul, Santa Catarina, Paraná e Mato Grosso do Sul. Buscou-se identificar ações demandadas pela população fronteiriça, mecanismos utilizados para acesso, fluxos entre serviços e sistemas, estratégias de resposta e acordos locais. Iniciativas de cooperação entre gestores locais brasileiros e estrangeiros, identificadas em quase metade dos municípios, podem orientar a formulação de diretrizes para situações de fronteira que possibilitem a melhoria do acesso integral à atenção à saúde.

In the context of forming common markets, border areas require special attention, since they anticipate the effects of integration processes. Along borders, different political, monetary, security, and social systems coexist; the intensification of flows resulting from integration raises challenges for the health systems, requiring specific policies focused on guaranteeing the right to health. This article presents the results of a study on the conditions for access to (and demands for) health services in the MERCOSUR border cities. A survey was performed with municipal health secretaries in the 69 Brazilian cities in the States of Rio Grande do Sul, Santa Catarina, Paraná, and Mato Grosso do Sul that border on the other MERCOSUR countries. The study attempted to identify the services demanded by the border population, mechanisms used for access, flows between services and systems, response strategies, and local agreements. Initiatives for cooperation between Brazilian and foreign local administrators were identified in nearly half of the municipalities and can orient the formulation of guidelines for border situations, allowing improvement in comprehensive access to health care.