Economic analysis through alternative data and big data techniques: what do they tell about Brazil?

Alternative data are now widely used in economic analyses worldwide but still infrequent in studies on the Brazilian economy. This research demonstrates how alternative data extracted from Google Trends and Google Mobility contribute to innovative economic analysis. First, it demonstrates that the search for the future on the internet is correlated (R = 0.62) with the average household income in Brazilian states. The three Brazilian states with the most people looking for the future on the internet have an average household income 1.6 times higher than people from states that do not have this behavior. The search for the future represents 10.9% of the economic development potential of the states, while the proportion of people with university degrees, scientific publications, and researchers represents another 60.4%. The reduction in mobility in retail/recreation locations averaged 34.28% in Brazil, Ecuador, Paraguay, and Uruguay. This group of countries had COVID-19 infection and death rates 1.25 and 1.74 times higher than in countries that reduced their mobility in retail/recreation locations by 45.03%. The impact of reduced mobility in retail/recreation locations on the unemployment rate, gross domestic product degrowth, and inflation in countries such as Brazil was 1.1, 2.2, and 2.6 times lower than in countries that reduced mobility more of people. The research contributions are associated with identifying new indicators extracted from alternative data and their application to carry out innovative economic analyses.

The benefits, costs and feasibility of a low incidence COVID-19 strategy.

In the summer of 2021, European governments removed most NPIs after experiencing prolonged second and third waves of the COVID-19 pandemic. Most countries failed to achieve immunization rates high enough to avoid resurgence of the virus. Public health strategies for autumn and winter 2021 have ranged from countries aiming at low incidence by re-introducing NPIs to accepting high incidence levels. However, such high incidence strategies almost certainly lead to the very consequences that they seek to avoid: restrictions that harm people and economies. At high incidence, the important pandemic containment measure 'test-trace-isolate-support' becomes inefficient. At that point, the spread of SARS-CoV-2 and its numerous harmful consequences can likely only be controlled through restrictions. We argue that all European countries need to pursue a low incidence strategy in a coordinated manner. Such an endeavour can only be successful if it is built on open communication and trust.

Physicochemical and microbiological assessment of a dental adhesive doped with cashew nut shell liquid.

To evaluate i) the inhibitory and bactericidal activity of cashew nut shell liquid (CNSL) and its isolated compounds (anacardic acid and cardol) against oral bacteria; ii) the biofilm formation inhibition, resin-dentin bond strength and physicochemical properties of a dental adhesive incorporated with these substances. The antibacterial effect of CNSL, anacardic acid, and cardol were assessed by determining the minimum inhibitory (MIC) and minimum bactericidal (MBC) concentrations. Effect in inhibiting biofilm formation of the adhesive incorporated with the substances (15 µg/ml) against a mixed-species biofilm of Streptococcus mutans and Candida Albicans and was determined by direct contact test. Additional Analysis included microtensile bond strength (µTBS) test, elastic modulus (EM), flexural strength (FS), degree of conversion (DC), water sorption (WS) and solubility (SL). The data were submitted to statistical analysis by one-way ANOVA and Tukey's test (p < 0.05). CNSL, anacardic acid and cardol showed antibacterial activity for all strains tested, with MIC and MBC values ranging from 3.12 to 25 µg/ml. There was no growth of colonies forming units in the adhesives incorporated with the substances. EM increased in the adhesive incorporated with anacardic acid, decreased after incorporation of cardol and it was not affected by incorporation of CNSL. The substances tested showed no effect in FS, DC, WS, SL and µTBS. In conclusion, the CNSL, anacardic acid and cardol showed antibacterial effects against oral bacteria and, the incorporation of substances did not reduce the performance of the adhesive.

Assessment of the antibacterial, antivirulence, and action mechanism of Copaifera pubiflora oleoresin and isolated compounds against oral bacteria.

The microorganisms that constitute the oral microbiome can cause oral diseases, including dental caries and endodontic infections. The use of natural products could help to overcome bacterial resistance to the antimicrobials that are currently employed in clinical therapy. This study assessed the antimicrobial activity of the Copaifera pubiflora oleoresin and of the compounds isolated from this resin against oral bacteria. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assays provided values ranging from 6.25 to > 400 µg/mL for the C. pubiflora oleoresin and its isolated compounds. The fractional inhibitory concentration index (FICI) assay showed that the oleoresin and chlorhexidine did not act synergistically. All the tested bacterial strains formed biofilms. MICB50 determination revealed inhibitory action: values varied from 3.12-25 µg/mL for the oleoresin, and from 0.78 to 25 µg/mL for the ent-hardwickiic acid. Concerning biofilm eradication, the C. pubiflora oleoresin and hardwickiic acid eradicated 99.9 % of some bacterial biofilms. Acid resistance determination showed that S. mutans was resistant to acid in the presence of the oleoresin and ent-hardwickiic acid at pH 4.0, 4.5, and 5.0 at all the tested concentrations. Analysis of DNA/RNA and protein release by the cell membrane demonstrated that the oleoresin and hardwiickic acid damaged the bacterial membrane irreversibly, which affected membrane integrity. Therefore, the C. pubiflora oleoresin and ent-hardwickiic acid have potential antibacterial effect and can be used as new therapeutic alternatives to treat oral diseases such as dental caries and endodontic infections.

Decision Support System for Inventory Management in Healthcare Organizations: A Case Study at the Brazilian National Cancer Institute.

Nowadays, the great majority of the healthcare organizations has been criticized due to the high costs and low efficiency and are facing a critical situation aggravated by unmet demand and aging population. Availability of medicines is one of the clearest indicators that a healthcare organization is working efficiently. Medicines represent a large portion of the costs in the health services due to the significant value of these products and their storage and control requirements. Shortages of inventory have become a severe problem at the Brazilian healthcare organizations. The purpose of this work is to present the deployment of a Decision Support System which supports real-time inventory control and medicine tracking providing transparency and accessibility of this critical information at the Brazilian National Cancer Institute.

Insecticide activity of Curcuma longa (leaves) essential oil and its major compound α-phellandrene against Lucilia cuprina larvae (Diptera: Calliphoridae): Histological and ultrastructural biomarkers assessment.

Lucilia cuprina, known as the Australian blowfly, is of high medico-sanitary and veterinary importance due to its ability to induce myiasis. Synthetic products are the most frequent form of fly control, but their indiscriminate use has selected for resistant populations and accounted for high levels of residues in animal products. This study aimed to assess the effect of essential oil from leaves of Curcuma longa (CLLEO), and its major compound α-phellandrene against L. cuprina L3. An additional goal was to determine the morphological alterations in target organs/tissues through ultrastructural assessment (SEM) and light microscopy, as well as macroscopic damage to cuticle induced by CLLEO. Groups of 20 L3 were placed on filter paper impregnated with increasing concentrations of CLLEO (0.15 to 2.86 µL/cm2) and α-phellandrene (0.29 to 1.47 µL/cm2). Efficacy was determined by quantifying L3 mortality 6, 24 and 48 h after contact with CLLEO and by measuring the structural damage to L3. CLLEO and α-phellandrene inhibited adult emergence by 96.22 and 100%, respectively. Macroscopic cuticle damage, appeared as diffuse pigment and darkening of larval body, was caused by both extracts. The SEM revealed dryness on the cuticle surface, distortion of the sensorial structures and general degeneration in treated L3. Furthermore, alterations in target organs (digestive tract, fat body and brain) were noticed and shall be used as biomarkers in future attempts to elucidate the mechanism of action of these compounds. The vacuolar degeneration and pyknotic profiles observed in the brain tissue of treated larvae with both extracts and the decreased motility within <6 h after treatment leads us to suggest a neurotoxic activity of the products. This work demonstrates the potential use of CLLEO and α-phellandrene as bioinsecticides to be used against L. cuprina, representing an ecofriendly alternative for myiasis control in humans and animals.

Right to the city, right to health: what are the interconnections? / Direito à cidade, direito à saúde: quais interconexões?

Right to health intertwines with right to the city: guaranteed access to healthy urban spaces reduces inequities among the population, so that disadvantaged groups can also enjoy positive urbanization effects. In this sense, interconnection between right to the city and right to health promotes equity. This article seeks to explore the interconnection between right to the city and right to health on the basis of an integrative review guided by the question 'What knowledge about right to the city and right to health has been produced in the light of equity?' For this purpose, we analyzed evidence available in the literature indexed in PubMed/Medline, Lilacs, and SciELO between 1986 and 2016. Over this three-decade span, we identified the presence of different degrees of right to the city and right to health in the formulation of policies and in social movement agendas. Formulations regarding population growth moved away from the rights agenda, but in a later phase of democratic consolidation, the fight for rights to health re-emerged. In a third moment of the political visibility of excluded geographical spaces and multiple identity agendas, the struggle to ensure everyone's right to the city came on strong in the game.

O direito à saude se interconecta com o direito à cidade na medida em que, ao se garantir espaços urbanos saudáveis para a população, garante-se também a redução de iniquidades e a expansão do usufruto dos efeitos positivos da urbanização a grupos postergados e desfavorecidos. A interconexão entre o direito à cidade e o direito à saúde é hipotetizado como propulsor necessário à promoção da equidade. Este artigo busca explorar esta interconexão entre o direito à cidade e o direito à saúde, ancorado em uma revisão integrativa, norteada pela questão: Qual o conhecimento produzido sobre o direito à cidade e o direito à saúde à luz da equidade? Analisaram-se evidências disponíveis na literatura indexadas no PubMed/Medline, Lilacs e SciELO, entre 1986 e 2016. Foram identificados nas três décadas analisadas distintos níveis de presença do direito à cidade e do direito à saúde na formulação de políticas e na agenda de revindicações dos movimentos sociais. Formulações em torno do crescimento populacional afastam da agenda os direitos, enquanto numa fase posterior o adensamento democrático revitaliza a luta pelos direitos à saúde. Num terceiro momento de visibilização política dos espaços geográficos excluídos e das agendas identitárias, entra forte no jogo a luta pelo direito de todos e todas à cidade.

Photovoice as a listening mode: subsidies for the promotion of equity. / Photovoice como modo de escuta: subsídios para a promoção da equidade.

Health Promotion observations of patients from a Rehabilitation Center in rural São Paulo evidenced that these people faced difficulties in dealing with their physical limitations when these prevented them from working. This study aimed to broaden listening methods to facilitate dialogue with people in situations of physical frailty and removal from their work activities, using Photovoice, a participatory research-action method, as a tool and Health Promotion's theoretical framework. Images captured and reports that accompanied them consisted of the material of this study. Two thematic categories stood out: the expert decision; and physical condition: vanity, power and hope. Labor activity is perceived as a determinant of individuals' introduction in their environment and defines their role in the family and in the social field. Faced with disability, they feel deprived of their identity, vulnerable and without future prospects of social reintegration, an individual and familiar misfit process, but without social visibility and with negative consequences for global health is observed. Photovoice proved to be effective in apprehending perceptions and stimulating debate, providing essential inputs to promote equity in socially disadvantaged groups.

A partir de observações no campo da Promoção da Saúde, junto a pacientes de um Centro de Reabilitação no interior de São Paulo, notou-se que eles apresentam dificuldades em lidar com as limitações físicas adquiridas quando estas os incapacitavam para o trabalho. Objetivou-se ampliar os modos de escuta para facilitar o diálogo com pessoas em situações de debilidade física e afastadas de suas atividades laborais, utilizando o Photovoice, método de pesquisa-ação participativa, como ferramenta e o referencial teórico da Promoção da Saúde. As imagens captadas e os relatos que as acompanharam consistiram no material deste estudo. Duas categorias temáticas se sobressaíram: a decisão pericial e a condição física (vaidade, poder e esperança). A atividade laboral é percebida como determinante da inserção do indivíduo em seu meio, além de definir seu papel na família e no campo social. Diante da incapacidade, percebem-se sem identidade, vulneráveis e sem perspectivas futuras de reinserção social. Observase um processo de desajuste individual, familiar, mas sem visibilidade social e com consequências negativas para a saúde global. O Photovoice se mostrou efetivo na apreensão das percepções e no estímulo para o debate, fornecendo subsídios essenciais para a Promoção da Equidade em grupos em desvantagem social.

Direito à cidade, direito à saúde: quais interconexões? / Right to the city, right to health: what are the interconnections?

Resumo O direito à saude se interconecta com o direito à cidade na medida em que, ao se garantir espaços urbanos saudáveis para a população, garante-se também a redução de iniquidades e a expansão do usufruto dos efeitos positivos da urbanização a grupos postergados e desfavorecidos. A interconexão entre o direito à cidade e o direito à saúde é hipotetizado como propulsor necessário à promoção da equidade. Este artigo busca explorar esta interconexão entre o direito à cidade e o direito à saúde, ancorado em uma revisão integrativa, norteada pela questão: Qual o conhecimento produzido sobre o direito à cidade e o direito à saúde à luz da equidade? Analisaram-se evidências disponíveis na literatura indexadas no PubMed/Medline, Lilacs e SciELO, entre 1986 e 2016. Foram identificados nas três décadas analisadas distintos níveis de presença do direito à cidade e do direito à saúde na formulação de políticas e na agenda de revindicações dos movimentos sociais. Formulações em torno do crescimento populacional afastam da agenda os direitos, enquanto numa fase posterior o adensamento democrático revitaliza a luta pelos direitos à saúde. Num terceiro momento de visibilização política dos espaços geográficos excluídos e das agendas identitárias, entra forte no jogo a luta pelo direito de todos e todas à cidade.

Abstract Right to health intertwines with right to the city: guaranteed access to healthy urban spaces reduces inequities among the population, so that disadvantaged groups can also enjoy positive urbanization effects. In this sense, interconnection between right to the city and right to health promotes equity. This article seeks to explore the interconnection between right to the city and right to health on the basis of an integrative review guided by the question 'What knowledge about right to the city and right to health has been produced in the light of equity?' For this purpose, we analyzed evidence available in the literature indexed in PubMed/Medline, Lilacs, and SciELO between 1986 and 2016. Over this three-decade span, we identified the presence of different degrees of right to the city and right to health in the formulation of policies and in social movement agendas. Formulations regarding population growth moved away from the rights agenda, but in a later phase of democratic consolidation, the fight for rights to health re-emerged. In a third moment of the political visibility of excluded geographical spaces and multiple identity agendas, the struggle to ensure everyone's right to the city came on strong in the game.

Photovoice como modo de escuta: subsídios para a promoção da equidade / Photovoice as a listening mode: subsidies for the promotion of equity

Resumo A partir de observações no campo da Promoção da Saúde, junto a pacientes de um Centro de Reabilitação no interior de São Paulo, notou-se que eles apresentam dificuldades em lidar com as limitações físicas adquiridas quando estas os incapacitavam para o trabalho. Objetivou-se ampliar os modos de escuta para facilitar o diálogo com pessoas em situações de debilidade física e afastadas de suas atividades laborais, utilizando o Photovoice, método de pesquisa-ação participativa, como ferramenta e o referencial teórico da Promoção da Saúde. As imagens captadas e os relatos que as acompanharam consistiram no material deste estudo. Duas categorias temáticas se sobressaíram: a decisão pericial e a condição física (vaidade, poder e esperança). A atividade laboral é percebida como determinante da inserção do indivíduo em seu meio, além de definir seu papel na família e no campo social. Diante da incapacidade, percebem-se sem identidade, vulneráveis e sem perspectivas futuras de reinserção social. Observase um processo de desajuste individual, familiar, mas sem visibilidade social e com consequências negativas para a saúde global. O Photovoice se mostrou efetivo na apreensão das percepções e no estímulo para o debate, fornecendo subsídios essenciais para a Promoção da Equidade em grupos em desvantagem social.

Abstract Health Promotion observations of patients from a Rehabilitation Center in rural São Paulo evidenced that these people faced difficulties in dealing with their physical limitations when these prevented them from working. This study aimed to broaden listening methods to facilitate dialogue with people in situations of physical frailty and removal from their work activities, using Photovoice, a participatory research-action method, as a tool and Health Promotion's theoretical framework. Images captured and reports that accompanied them consisted of the material of this study. Two thematic categories stood out: the expert decision; and physical condition: vanity, power and hope. Labor activity is perceived as a determinant of individuals' introduction in their environment and defines their role in the family and in the social field. Faced with disability, they feel deprived of their identity, vulnerable and without future prospects of social reintegration, an individual and familiar misfit process, but without social visibility and with negative consequences for global health is observed. Photovoice proved to be effective in apprehending perceptions and stimulating debate, providing essential inputs to promote equity in socially disadvantaged groups.

Assessment of the antibacterial, cytotoxic and mutagenic potential of the phenolic-rich hydroalcoholic extract from Copaifera trapezifolia Hayne leaves.

Copaifera trapezifolia Hayne occurs in the Atlantic Rainforest, which is considered one of the most important and endangered tropical forests on the planet. Although literature works have described many Copaifera spp., their biological activities remain little known. In the present study, we aimed to evaluate (1) the potential of the hydroalcoholic extract from C. trapezifolia leaves (CTE) to act against the causative agents of tooth decay and apical periodontitis and (2) the cytotoxicity and mutagenicity of CTE to ensure that it is safe for subsequent application. Concerning the tested bacteria, the MIC and the minimum bactericidal concentration of CTE varied between 100 and 400 µg ml-1. The time-kill assay conducted at a CTE concentration of 100 µg ml-1 evidenced bactericidal activity against Porphyromonas gingivalis (ATCC 33277) and Peptostreptococcus micros (clinical isolate) within 72 h. CTE at 200 µg ml-1 inhibited Porphyromonas gingivalis and Peptostreptococcus micros biofilm formation by at least 50 %. A combination of CTE with chlorhexidine dichlorohydrate did not prompt any synergistic effects. The colony-forming assay conducted on V79 cells showed that CTE was cytotoxic at concentrations above 156 µg ml-1. CTE exerted mutagenic effect on V79 cells, but the micronucleus test conducted on Swiss mice and the Ames test did not reveal any mutagenicity. Therefore, the use of standardized and safe extracts could be an important strategy to develop novel oral care products with antibacterial action. These extracts could also serve as a source of compounds for the discovery of new promising biomolecules.

In vitro Evaluation of Copaifera oblongifolia Oleoresin Against Bacteria Causing Oral Infections and Assessment of Its Cytotoxic Potential.

The oral cavity, which harbors more than 750 bacterial species, is one of the most diverse sites of the human body. Some of these bacteria have been associated with oral diseases, such as dental caries and endodontic infections. We report on the antimicrobial and cytotoxic activities of Copaifera oblongifolia oleoresin against bacteria that cause caries and endodontic infections. The aim of this study is to determine the minimum (MIC) and the bactericidal (MBC) inhibitory concentrations as well as the biofilm inhibition ability (through determination of MBIC50) of the C. oblongifolia oleoresin. This study also investigated the bactericidal kinetics (time-kill curves) and the synergistic effect of the C. oblongifolia oleoresin. Additionally, this study evaluated the cytotoxic activity of the oleoresin toward V79 cells by means of the colony-forming assay. The C. oblongifolia oleoresin gave promising MIC and MBC values, which ranged from 25 to 200 µg/mL. Analysis of the MBIC50values of the oleoresin revealed it displayed biofilm inhibitory activity against all the assayed bacteria. Analysis of the bactericidal kinetics showed different behaviors of the oleoresin against the tested bacteria at the different time intervals and concentrations assayed in this study. An additive effect of the oleoresin with chlorhexidine dihydrochloride occurred only for S. mitis and A. actinomycetemcomitans. The C. oblongifolia oleoresin showed cytotoxic activity at concentrations ≥ 625 µg/mL.

Portuguese Family Physicians' Awareness of Diagnostic and Laboratory Test Costs: A Cross-Sectional Study.

BACKGROUND: Physicians' ability to make cost-effective decisions has been shown to be affected by their knowledge of health care costs. This study assessed whether Portuguese family physicians are aware of the costs of the most frequently prescribed diagnostic and laboratory tests. METHODS: A cross-sectional study was conducted in a representative sample of Portuguese family physicians, using computer-assisted telephone interviews for data collection. A Likert scale was used to assess physician's level of agreement with four statements about health care costs. Family physicians were also asked to estimate the costs of diagnostic and laboratory tests. Each physician's cost estimate was compared with the true cost and the absolute error was calculated. RESULTS: One-quarter (24%; 95% confidence interval: 23%-25%) of all cost estimates were accurate to within 25% of the true cost, with 55% (95% IC: 53-56) overestimating and 21% (95% IC: 20-22) underestimating the true actual cost. The majority (76%) of family physicians thought they did not have or were uncertain as to whether they had adequate knowledge of diagnostic and laboratory test costs, and only 7% reported receiving adequate education. The majority of the family physicians (82%) said that they had adequate access to information about the diagnostic and laboratory test costs. Thirty-three percent thought that costs did not influence their decision to order tests, while 27% were uncertain. CONCLUSIONS: Portuguese family physicians have limited awareness of diagnostic and laboratory test costs, and our results demonstrate a need for improved education in this area. Further research should focus on identifying whether interventions in cost knowledge actually change ordering behavior, in identifying optimal methods to disseminate cost information, and on improving the cost-effectiveness of care.

[The Portuguese Guidelines and Patients Values]. / As Normas de Orientação Clínica em Portugal e os Valores dos Doentes.

INTRODUCTION: Clinical guidelines are support tools, aiming to improve quality of the clinical practice. Patient centered care allows best satisfaction rates, with greater health self-management, and potential gains in quality with fewer costs. OBJECTIVE: To evaluate the integration of patients' values in Portuguese guidelines. MATERIAL AND METHODS: We reviewed the 18 guidelines about cardiovascular diseases published in Portugal from 2011 to 2013, searching for the integration of patients' ideas, fears, expectations and preferences. RESULTS: Eight guidelines were related to diagnosis approach and 10 with treatment. We found references to patients' values in 5 (28%) guidelines, all about treatment aspects. The incorporation of patients' expectations was the most present feature. Reference to financial costs was present in 78% of the guidelines. DISCUSSION: Clinical guidelines are health technology instruments available to practitioners in order to improve the quality of care provided to patients, who are the real users of these tools. As in other countries, there is a tendency to disregard the users' value systems in the conception of the guidelines, giving the privilege to a population logic, not always applicable to the individual, and to financial arithmetic with low support in cost-effectiveness assessments. In the Portuguese case, the way guidelines were proposed conditioned also some suspicion both in the professionals and in the users. CONCLUSION: Portuguese guidelines have low incorporation of references to patients' values. This is more evident when questions about diagnosis are addressed, placing patients in a secondary role in the clinical decision-making process with potential losses in quality of care and eventual increase in costs.

Introdução: As normas de orientação clínica são instrumentos de apoio à decisão que visam a melhoria da qualidade, promovendo as boas práticas clínicas. Os cuidados orientados para o utente permitem uma melhor satisfação e autogestão da saúde, com ganhos de qualidade e potencialmente menores custos.Objetivo: Avaliar o grau de integração dos valores dos doentes nas normas de orientação clínica publicadas em Portugal. Material e Métodos: Reviram-se as 18 normas de orientação clínica da área cardiovascular publicadas em Portugal entre 2011 e 2013, procurando avaliar a introdução das ideias, medos, expectativas e preferências dos doentes. Resultados: Oito normas de orientação clínica estavam relacionadas com processos de diagnóstico e 10 com aspetos de terapêutica. Em cinco normas de orientação clínica (28%) foram encontradas referências a valores dos doentes, todas na área da terapêutica, não existindo nenhuma nas normas de orientação clínica relacionadas com o diagnóstico. A incorporação das expectativas dos doentes foi o aspeto mais presente. Em 78% existiam referências à valorização dos custos financeiros. Discussão: As normas de orientação clínica constituem-se como uma tecnologia de saúde ao dispor dos profissionais com o objetivo de melhorar a prestação dos cuidados assistenciais aos cidadãos, utilizadores últimos destes instrumentos. Como noutros países, há uma tendência a não considerar os utentes e os seus sistemas de valores na estrutura das orientações, privilegiando-se uma lógica populacional nem sempre aplicável ao caso concreto, e uma aritmética financeira pouco suportada em avaliações de custoefetividade. No caso português, a forma como foram propostas foi também condicionadora de desconfiança tanto nos profissionais como nos utentes.Conclusão: As normas de orientação clínica em Portugal apresentam uma baixa taxa de incorporação dos valores dos utentes, de uma forma mais visível na definição do diagnóstico, o que os coloca numa posição secundária no processo de decisão clínica com potenciais perdas na qualidade.

A population-based nationwide cross-sectional study on preventive health services utilization in Portugal--what services (and frequencies) are deemed necessary by patients?

BACKGROUND: Most of the strategies to induce a more rational use of preventive health services are oriented to the medical side of the doctor-patient relationship. However, the consultation model has changed, and patients now have a more important role in medical consultation. The aim of this study was to assess which healthcare services are deemed necessary, and with what frequency, by adults from the general Portuguese population. DESIGN: Population-based nationwide cross-sectional study Setting: Portuguese population Participants: One thousand Portuguese adults, surveyed by computer-assisted telephone interviewing and selected by a stratified cluster sampling design. MEASUREMENTS: Proportions and population prevalence estimates were determined for each healthcare service, taking into account whether respondents considered them necessary, and with what frequency. RESULTS: Respondent ages ranged between 18 and 97 years, and 520 of 1000 (52%) respondents were women. Among Portuguese adults, 99.2% (95% confidence interval (CI): 98.5 to 99.6) believe that they should undergo general routine blood and urine tests, to be repeated every 12.0 months on average (95% CI: 11.4 to 12.6); 87.4% (95% CI: 85.3 to 89.3) of the respondents reported having actually performed these tests. Of the 15 services surveyed, 14 were considered periodically necessary by more than 60% of respondents. Among the respondents, 37.7% (95% CI: 34.5 to 41.1) reported using healthcare services by their own initiative. CONCLUSIONS: The majority of Portuguese adults believe that they should utilize a great number of healthcare services, on a nearly annual basis; most actually follow this schedule. Our findings indicate a tendency towards the overuse of resources. Adequate patient-oriented strategies regarding the use of medical tests and preventive interventions--with appropriate information and discussion of risks and harms--are urgently needed, and crucial for achieving a more rational use of healthcare services and for preventing the consequences of over-testing.

Assessment of antimicrobial effect of Biosilicate® against anaerobic, microaerophilic and facultative anaerobic microorganisms.

This study assessed the antimicrobial activity of a new bioactive glass-ceramic (Biosilicate®) against anaerobic, microaerophilic, and facultative anaerobic microorganisms. Evaluation of the antimicrobial activity was carried out by three methods, namely agar diffusion, direct contact, and minimal inhibitory concentration (MIC). For the agar diffusion technique, bio glass-ceramic activity was observed against various microorganisms, with inhibition haloes ranging from 9.0 ± 1.0 to 22.3 ± 2.1 mm. For the direct contact technique, Biosilicate® displayed activity against all the microorganisms, except for S. aureus. In the first 10 min of contact between the microorganisms and Biosilicate®, there was a drastic reduction in the number of viable cells. Confirming the latter results, MIC showed that the Biosilicate® inhibited the growth of microorganisms, with variations between ≤ 2.5 and 20 mg/ml. The lowest MIC values (7.5 to ≤ 2.5 mg/ml) were obtained for oral microorganisms. In conclusion, Biosilicate® exhibits a wide spectrum of antimicrobial properties, including anaerobic bacteria.

Ambiente de informações para apoio à decisão dos gestores do controle do câncer de mama / Environmental information to support decision makers in control of breast cancer

O controle do Câncer em nosso país representa, atualmente, um dos grandesdesafios da Saúde Pública porque, além de ser a segunda causa de morte por doença, demanda a realização de ações de variados níveis de complexidade e, em contrapartida à dimensão de seus números, demonstra ter uma visibilidade inadequada pela sociedade brasileira e mesmo por parte dos profissionais de saúde. Com o objetivo de contribuir para o enfrentamento deste amplo desafio, a Gestão da Informação e a Gestão do Conhecimento apresentam um conjunto de processos, técnicas e ferramentas cuja aplicação pode representar um avanço na gestão das ações de Saúde Pública. Paradoxalmente em relação à profusão de dados, há uma dificuldade do gestor do SUS em obter informações relevantes para o processo de tomada de decisão, seja por sua falta, insuficiência, redundância, inconsistência e, principalmente, pela sua fragmentação. Esta foi à questão motivadora deste estudo e que conduziu à hipótese de sugerir a organização de um ambiente de informação, inovador, criado no ciberespaço, utilizando intensivamente tecnologias da informação, articulados com métodos demodelagem estatística, modelagem matemática e à inteligência computacional incorporando a perspectiva espacial e temporal e conceitos da Gestão da Informação eGestão do Conhecimento. O objetivo principal deste ambiente e, portanto, do presente trabalho é a construção do modelo de um ambiente informacional que sirva como uma ferramenta que auxilie o gestor do SUS na tomada de decisão para o controle do câncerde mama no Brasil.

Ambiente de Informações para Apoio à Decisão dos Gestores do Controle do Câncer de Mama

O controle do Câncer em nosso país representa, atualmente, um dos grandes desafios da Saúde Pública porque, além de ser a segunda causa de morte por doença, demanda a realização de ações de variados níveis de complexidade e, em contrapartida à dimensão de seus números, demonstra ter uma visibilidade inadequada pela sociedade brasileira e mesmo por parte dos profissionais de saúde. Com o objetivo de contribuir para o enfrentamento deste amplo desafio, a Gestão da Informação e a Gestão do Conhecimento apresentam um conjunto de processos, técnicas e ferramentas cuja aplicação pode representar um avanço na gestão das ações de Saúde Pública. Paradoxalmente em relação à profusão de dados, há uma dificuldade do gestor do SUS em obter informações relevantes para o processo de tomada de decisão, seja por sua falta, insuficiência, redundância, inconsistência e, principalmente, pela sua fragmentação. Esta foi à questão motivadora deste estudo e que conduziu à hipótese de sugerir a organização de um ambiente de informação, inovador, criado no ciberespaço, utilizando intensivamente tecnologias da informação, articulados com métodos de modelagem estatística, modelagem matemática e à inteligência computacional incorporando a perspectiva espacial e temporal e conceitos da Gestão da Informação e Gestão do Conhecimento. O objetivo principal deste ambiente e, portanto, do presente trabalho é a construção do modelo de um ambiente informacional que sirva como uma ferramenta que auxilie o gestor do SUS na tomada de decisão para o controle do câncer de mama no Brasil.

Cancer control in Brazil currently represents one of the greatest challenges of Public Health. Despite cancer’s current position as second cause of death by illness, the necessary effort to accomplish a variety of complex actions and, increase of cancer incidence increase, there is however an inadequate visibility by Brazilian society and health professionals. In order to contribute to this broad challenging debate, Information Management (IM) and Knowledge Management (KM) techniques and tools available could be applied to Public Health management and hence allow improvement. Contrastively to the profusion of Public Health data, it has been difficult for managers of the Brazilian Health System (Sistema Único de Saúde - SUS) to have access to decision making information, due to either unavailability, insufficiency, redundancy, inconsistency and, mainly, fragmentation of the available information. These were questions that motivated this study and lead to the hypothesis of organizing an information environment that would be innovational, created in virtual space (Internet), intensive use of information technologies, coupled by modeling statistics methods, mathematical modeling and incorporation of spatial and time based computational intelligence and, lastly, inclusion of IM and KM concepts. The main objective of this environment and, therefore, of the present work is the construction of a information environment model that assists the SUS manager to decision making for breast cancer control in Brazil.

Liberalismo: o direito e o avesso / Liberalism inside-outLibéralisme: l'endroit et l'envers

Liberalism, as manifested in self-defined liberal writings, has two sides: one, its true side, comprised of a whole body of systematically integrated proposals; the other, a patchwork quilt, an illusionist version, manipulated for political and ideological purposes. By means of a critique of eclecticism, the article aims to provide room for acknowledging non-autocratic concepts that are treated as if they were autocratic simply because they are non-liberal or anti-liberal.

Le libéralisme, tel qu'on le trouve dans les textes de ceux qui se déclarent libéraux, présente deux faces: l'une, la vraie, est formée d'un corps entier de propositions systématiquement intégrées; l'autre, un habit d'Arlequin, est sa version trompeuse, manipulée à des fins idéologiques. Au moyen d'une critique de l'éclectisme, on cherche dans cet article à reconnaître des conceptions non autocratiques qui sont traitées comme si elles étaient autocratiques du fait d'être non libérales ou antilibérales.

Profilaxia antimicrobiana em cirurgias oncologicas / Prophylatic antibiotics in surgical cancer

Antibióticos administrados profilaticamente durante o periodo perioperativo diminuem a morbidade relacionada a cirurgia, encurtando o tempo de hospitalizaçäo e reduzindo os custos hospitalares. Estes säo amplamente utilizados durante procedimentos cirurgicos, porem säo frequentemente administrados de modo incorreto. Neste estudo, os autores avaliaram a rotina de seleçäo e uso dos antibioticos profilaticos em pacientes cirurgicos com cancer no hospital do Cancer, Rio de Janeiro, Brasil. Durante 36 meses näo consecutivos, 1681 pacientes oncologicos submetidos a procedimentos cirurgicos foram seguidos prospectivamente por membros da Comissäo de Controle de Infeccao Hospitalar...