Distributive justice and equity in resource allocation: a temporal analysis of hospitalization costs in indigenous populations in Brazil.

INTRODUCTION: In Brazil, a country of continental dimensions, the health needs of each region have an impact. In this context and the name of the principle of equity, the SUS organizes actions especially aimed at social groups such as the elderly, children, pregnant women, and indigenous peoples. The concept of justice proposed by John Rawls is one of equity, which is essential to this country. METHODS: This is an ecological, descriptive study, which analyzed hospital spending on cardiovascular diseases in the Unified Health System (SUS) among the indigenous elderly population and other ethnicities/colors in Brazil, between 2010 and 2019. RESULTS: Hospitalization costs and fatality rates for indigenous populations and other colors/ethnicities, between 2010 and 2019, were evaluated. A reduction in hospitalization costs for the indigenous population and an increase in other populations was observed throughout the historical series, while there was an increase in fatality rates for both groups. A comparison was made between hospitalization costs and the fatality rates of indigenous populations and other colors/ethnicities according to sex, between 2010 and 2019. It was observed that regardless of sex, there are significant differences (p<0.05) between hospitalization costs and fatality rates, with higher costs for patients of other colors/ethnicities and higher fatality rates for the indigenous population. CONCLUSIONS: Hospitalization costs due to cardiovascular diseases in elderly people from indigenous populations were lower compared to other ethnicities in most federative units, which may suggest an unequal allocation of resources or access for this indigenous population to the SUS. Although there is no strong correlation between spending on hospital admissions and fatality rates, it was found that these rates increased between 2010 and 2019, while spending was reduced.

Percepção de equipes laboratoriais quanto a questões de bem-estar animal / Perception of laboratory staff regarding animal welfare issues

As equipes laboratoriais controlam diversas características do ambiente dos animais utilizados em pesquisas. Portanto, suas atitudes têm grande influência no bem-estar animal (BEA) e nos resultados obtidos. Buscou-se verificar o conhecimento e a percepção dessas equipes em relação a questões de BEA. Os dados foram coletados por meio de um questionário online composto por 22 questões abertas e 23 fechadas. As respostas são referentes a 62 participantes de diversas instituições de pesquisa brasileiras. Dezesseis (25,8%) não receberam treinamento para exercer suas funções, e 11 (18,0%) realizavam ou coordenavam procedimentos com potencial para causar dor ou morte. O principal fator limitante relatado para o uso de animais em pesquisas foi referente a questões éticas (38; 63,3%). Todos declararam conhecer o significado do termo BEA; porém, a maioria dos conceitos expressos foi de forma parcial (32; 64,0%). Tais resultados podem estar relacionados ao caráter optativo ou à indisponibilidade do ensino de BEA na maioria dos cursos de graduação no Brasil. Os animais vertebrados foram percebidos pelos respondentes como portadores de alto grau de senciência. Espécies em contato social e afetivo com os seres humanos foram vistas como mais sencientes que outros grupos. O número de respondentes interessados em um projeto de enriquecimento ambiental (34; 69,4%) sugere preocupação com o BEA. Os resultados apresentados podem subsidiar a localização de pontos críticos de BEA em laboratórios brasileiros e indicam possibilidades para melhoria no conhecimento científico de questões centrais relativas ao BEA.

Laboratory staff controls a series of environmental parameters affecting animals used in research. Therefore, staff attitudes influence both animal welfare (AW) and research results. This study aimed to verify the knowledge and perception of staff members on AW. Data were collected through a 22 open-question and 23 multiple-choice question online survey. 62 respondents from Brazilian institutions answered the survey. Sixteen (25.8%) participants did not receive training for their functions, from which 11 (18.0%) performed or coordinated procedures that may induce pain or death. The main limiting factor for the use of animals in research was ethical issues (38, 63.3%). All participants reported to know the meaning of AW, but most of the concepts given were partial (32, 64.0%). These results may be related to the unavailable or optional teaching of AW in most undergraduate courses in Brazil. Vertebrates were perceived by respondents as highly sentient. Species with a social and affective bond with human beings were seen as more sentient than other groups. There was interest in an environmental enrichment project (34, 69.4%) suggesting concern with AW. These results can collaborate in the identification of critical issues in AW in Brazilian laboratories and indicate opportunities to improve scientific knowledge of key issues related to AW.