“Many of us are rare”: the right to health and the moral economy of rare diseases activism in Brazil (1990-2020)

This article discusses the different meanings attributed to the right to health in the mobilizations to guarantee care for rare disease patients in Brazil. Since the early 1990s, rare disease patient family associations have been putting agendas to the public authorities, with demands ranging from the recognition of diseases to the development of research and diagnostic tests. The trajectory of the mobilizations to guarantee care for rare disease patients is part of a broader process of social articulation around the possibilities and limits of the Brazilian National Health System. The right to health is at the center of this process, being the Subject of varied debates and interpretations in the political, health, and legal arenas, involving arguments guided by scientific evidence, legal principles, and moral values. We argue that these variations in the directions of the right to health have involved concomitant processes of strengthening networks of rare disease actors and institutions, and of maturing the healthcare system, both converging towards the establishment of a “moral economy of rare disease patients”. This moral economy is centered on the idea that the public health relevance of these diseases cannot be identified by epidemiological evidence, but rather by individual and family experience. We used a wide scope of documentation: texts from newspapers and magazines widely circulated in the country, legislative material, publications in specialized journals, and website materials from rare disease patient organizations in Brazil

"Many of us are rare" : the right to health and the moral economy of rare diseases activism in Brazil (1990-2020)

This article discusses the different meanings attributed to the right to health in the mobilizations to guarantee care for rare disease patients in Brazil. Since the early 1990s, rare disease patient family associations have been putting agendas to the public authorities, with demands ranging from the recognition of diseases to the development of research and diagnostic tests. The trajectory of the mobilizations to guarantee care for rare disease patients is part of a broader process of social articulation around the possibilities and limits of the Brazilian National Health System. The right to health is at the center of this process, being the Subject of varied debates and interpretations in the political, health, and legal arenas, involving arguments guided by scientific evidence, legal principles, and moral values. We argue that these variations in the directions of the right to health have involved concomitant processes of strengthening networks of rare disease actors and institutions, and of maturing the health care system, both converging towards the establishment of a "moral economy of rare disease patients". This moral economy is centered on the idea that the public health relevance of these diseases cannot be identified by epidemiological evidence, but rather by individual and family experience. We used a wide scope of documentation: texts from newspapers and magazines widely circulated in the country, legislative material, publications in specialized journals, and website materials from rare disease patient organizations in Brazil.This article discusses the different meanings attributed to the right to health in the mobilizations to guarantee care for rare disease patients in Brazil. Since the early 1990s, rare disease patient family associations have been putting agendas to the public authorities, with demands ranging from the recognition of diseases to the development of research and diagnostic tests. The trajectory of the mobilizations to guarantee care for rare disease patients is part of a broader process of social articulation around the possibilities and limits of the Brazilian National Health System. The right to health is at the center of this process, being the Subject of varied debates and interpretations in the political, health, and legal arenas, involving arguments guided by scientific evidence, legal principles, and moral values. We argue that these variations in the directions of the right to health have involved concomitant processes of strengthening networks of rare disease actors and institutions, and of maturing the healthcare system, both converging towards the establishment of a "moral economy of rare disease patients". This moral economy is centered on the idea that the public health relevance of these diseases cannot be identified by epidemiological evidence, but rather by individual and family experience. We used a wide scope of documentation: texts from newspapers and magazines widely circulated in the country, legislative material, publications in specialized journals, and website materials from rare disease patient organizations in Brazil

Projeto detalhado de uma ponte rolante para uma empresa metal mecânica

It is known that crane is equipment used in transporting and lifting of loads, usually in industrial installations. It is a structure that is suspended, normally within a building, and shifting loads and materials in the vertical direction, transversal and longitudinal. In order to apply all the knowledge acquired during the course of mechanical engineering, more precisely in the disciplines of strength of materials, machine elements, solid mechanics, among others, this work has the purpose of develop a detailed design of an overhead crane to a metalworking company. Through the NBR 8400 was given the steel cable sizing, as well as selection of the same; was subsequently scaled the drum and finally, the main beam. By applying a methodology of product design, it was possible to develop the detailed design of the overhead crane.Sabe-se que ponte rolante é um equipamento usado no transporte e elevação de cargas, geralmente em instalações industriais. Trata-se de uma estrutura que fica suspensa, normalmente dentro de uma edificação, e que desloca cargas e materiais no sentido vertical, transversal e longitudinal. Com o intuito de aplicar todos os conhecimentos adquiridos durante o curso de Engenharia Mecânica, mais precisamente nas disciplinas de resistência dos materiais, elementos de máquina, mecânica dos sólidos, dentre outras, esse trabalho tem a finalidade de desenvolver um projeto detalhado de uma ponte rolante para uma empresa metal mecânica. Por meio da norma NBR 8400 foi determinado o dimensionamento do cabo de aço, bem como seleção do mesmo; posteriormente foi dimensionado o tambor e por fim, a viga principal. Através da aplicação de uma metodologia de projeto de produto, foi possível desenvolver o projeto detalhado da ponte rolante

Nuevos problemas de un nuevo sistema de salud: la creación de una política pública nacional de atención de enfermedades raras en Brasil (1990-2014)

This study discusses actors and institution movements leading to the disclosure in 2014 of Resolution 199 by the Brazilian Ministry of Health, which establishes the National Policy for the Comprehensive Care of Persons with Rare Diseases. Taking as sources the mainstream newspapers, drafts law, and secondary literature on the subject, we begin our analysis in the early 1990s when the first patient associations were created in Brazil – mainly for claiming more funds for research on genetic diseases – and arrive at the late 2010s when negotiations for a national policy are taking place in the National Congress. Resolution 199 is part of an ongoing process and the path towards its disclosure and the complications that followed have given us elements to discuss contemporary aspects of the Brazilian public health. Based on the references of the history of the present time and the social studies of science, we argue that two aspects have been fundamental to creating a national policy: framing different illnesses within the terminology “rare diseases” and the construction of a public perception about the right of health which is guaranteed by the 1988 Brazilian Constitution.En este trabajo se analizan los movimientos de actores e instituciones que llevaron a la promulgación, en 2014, de la Resolución 199 del Ministerio de Salud de Brasil, que establece la Política Nacional de Atención Integral a las Personas con Enfermedades Raras. Tomando como fuentes los principales periódicos, proyectos de ley y bibliografía secundaria sobre el tema, comenzamos nuestro análisis a principios de la década de 1990 con la creación de las primeras asociaciones de pacientes en Brasil, para reclamar fundamentalmente más fondos para la investigación de enfermedades genéticas, y llegamos a fines de la década de 2010 con las negociaciones para una política nacional. La Resolución 199 es parte de un proceso en curso, en el que el camino hacia la promulgación y las complicaciones posteriores nos dan elementos para discutir aspectos actuales de la salud pública brasileña. Sobre la base de la historia del tiempo presente y los estudios sociales de la ciencia, argumentamos que hay dos aspectos que han sido fundamentales para crear una política nacional: enmarcar diferentes enfermedades en la terminología “enfermedades raras” y la construcción de una percepción pública sobre el derecho a la salud, que se garantiza en la Constitución brasileña de 1988

Credit rating system: an application to public companies in Brazil

O artigo examina se eventos de default de companhias abertas no Brasil são previstos por um sistema de classificação de risco de crédito baseado em índices contábeis. O sistema de classificação proposto neste estudo utiliza a análise de conglomerados para classificar as empresas em oito classes de risco, das quais sete são destinadas a empresas solventes e uma para empresas insolventes (em default). A variável utilizada para atribuir as classificações de risco às empresas é a probabilidade de default estimada pelo modelo de risco de crédito desenvolvido por Brito e Assaf Neto (2008). O sistema de classificação de risco atribui ratings anuais para as companhias abertas não financeiras listadas na BM&FBOVESPA no período de 1994 a 2006. Com base nesses ratings, são geradas diversas matrizes de migração de risco para o período analisado. As matrizes de migração evidenciam a elevação do risco das empresas insolventes previamente ao ano de ocorrência do default. A maioria dessas empresas é classificada nas piores classes de risco ou apresenta migrações para ratings inferiores nos anos que precedem o default. Além disso, as taxas de mortalidade das empresas são crescentes nas classes de risco do sistema. Esses resultados evidenciam que insolvências empresariais podem ser previstas por sistemas de classificação de risco baseados, apenas, em índices contábeis.This paper examines whether default events of public companies in Brazil are predicted by a credit rating system based on accounting ratios. The credit rating system developed uses cluster analysis to classify companies in eight ratings, seven for solvent and one for default companies. The variable used to assign ratings to companies is the probability of default estimated by credit risk model developed by Brito and Assaf Neto (2008). The credit rating system assigns annual ratings to non-financial companies listed on Brazilian stock market from 1994 to 2006. Based on these ratings, several risk migration matrices are generated for the analysis period. The migration matrices show the risk increase of default companies prior to the year of occurrence of default event. Most of these companies are classified in the lowest rating or migrate to lower ratings in the years preceding the default. In addition, mortality rates of firms grow in the credit rating system. These results demonstrate that default events of companies can be predicted by a credit rating system based only on accounting ratios

Pareto optimality conditions and duality for vector quadratic fractional optimization problems

One of the most important optimality conditions to aid in solving a vector optimization problem is the first-order necessary optimality condition that generalizes the Karush-Kuhn-Tucker condition. However, to obtain the sufficient optimality conditions, it is necessary to impose additional assumptions on the objective functions and on the constraint set. The present work is concerned with the constrained vector quadratic fractional optimization problem. It shows that sufficient Pareto optimality conditions and the main duality theorems can be established without the assumption of generalized convexity in the objective functions, by considering some assumptions on a linear combination of Hessian matrices instead. The main aspect of this contribution is the development of Pareto optimality conditions based on a similar second-order sufficient condition for problems with convex constraints, without convexity assumptions on the objective functions. These conditions might be useful to determine termination criteria in the development of algorithms.Coordenação de aperfeiçoamento de pessoal de nivel superior (Brasil)Ministerio de Ciencia y TecnologíaConselho Nacional de Desenvolvimento Científico e Tecnológico (Brasil)Fundação de Amparo à Pesquisa do Estado de São Paul

Nonlinear cutting stock problem model to minimize the number of different patterns and objects

In this article we solve a nonlinear cutting stock problem which represents a cutting stock problem that considers the minimization of, both, the number of objects used and setup. We use a linearization of the nonlinear objective function to make possible the generation of good columns with the Gilmore and Gomory procedure. Each time a new column is added to the problem, we solve the original nonlinear problem by an Augmented Lagrangian method. This process is repeated until no more profitable columns is generated by Gilmore and Gomory technique. Finally, we apply a simple heuristic to obtain an integral solution for the original nonlinear integer problem.617