Cláusulas abusivas nos planos de saúde: análise da Súmula 302 do STJ

A presente monografia analisa a nova teoria contratual e sua aplicação nas relações de consumo que envolvem as atividades das operadoras de plano de saúde. Examina-se especificamente a validade de cláusula que limita no tempo a internação do consumidor. Destacam-se as dificuldades e problemas derivados do contrato de adesão de plano de saúde, o qual é elaborado unilateralmente pela empresa fornecedora. De outro lado, o consumidor, por precisar de serviço tão essencial, é obrigado a contratá-lo com as cláusulas que lhe são impostas, muitas vezes abusivas, as quais destoam dos princípios da teoria contratual contemporânea. A regulação do Estado não se dá apenas ao serviço público prestado diretamente por ele, como também, pela Lei n. 9.656/98, ao prestado pela iniciativa privada. Em que pese esta regulação, há abusos das empresas. A monografia aborda a legalidade e legitimidade de clausula-padrão bastante comum a qual, inclusive, foi objeto da Sumula 302 do Superior Tribunal de Justiça, a qual estabelece “É abusiva a cláusula contratual de plano de saúde que limita no tempo a internação hospitalar do segurado”. Examinam-se criticamente os argumentos contrários e favoráveis à clausula que limita no tempo a internação do consumidor

Urban bodies : Cena 11 Cia. de Dança [or] the connections between dance, body and city

Orientador: Haroldo GalloDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de ArtesResumo: Este trabalho teve por finalidade identificar possíveis relações entre corpo e cidade, e como tais relações podem revelar-se através da linguagem da dança. Interessou perceber de que maneira o espaço urbano torna-se um constituidor de referências do corpo contemporâneo, e como tais referências passam a dialogar com o resultado estético de criações coreográficas. Para tanto, foi proposta uma pesquisa centrada no repertório coreográfico do grupo Cena 11 Cia. de Dança (Florianópolis-SC) que, além de ter grande importância para a expansão da dança contemporânea brasileira mundo afora, possui uma série de características específicas em seu repertório coreográfico que remetem à cidade e ao corpo urbanizado. Entretanto, não se tratou de fazer uma análise crítica das obras do grupo, ou estudar especificamente a cidade de Florianópolis. Antes, objetivou-se fazer um estudo dos aspectos comuns às cidades contemporâneas e a partir daí, compreender de que maneira tais aspectos constituem a corporeidade do bailarino e consequentemente a estética de sua dança. Pretendeu-se, ainda, entender em que medida uma criação coreográfica pode também ser vista como um dos modos de a cidade escrever sua experiência contemporânea, como a dança torna-se uma forma de comunicação/linguagem da cidade e, assim, como ela pode tornar-se uma forma de conhecimento do cotidianoAbstract: This work sets out to identify possible relations between the body and the city, and how these relations are revealed through the language of dance. It's import is in recognizing the way urban space becomes an embodiment of references for the contemporary body, and how these references negotiate with the aesthetic result of choreographic creations. To do this I propose a study grounded on the repertory of the group, Cena 11 Cia. de Dança (Florianoplis -SC),which besides being important in spreading Brazilian contemporary dance throughout the world, possesses a series of specific characteristics within their choreographic repertoire which integrate the city and an urbanized body. Needless to say this work is not an critical analysis of the group's works, or even a specific study of the city of Florianopolis. Prior to this a study was made of common aspects of con temporary cities and from this, an endeavor was made to understand in what way these aspects constitute the corporeality of the dancer and consequently the aesthetic of his dance. I propose, furthermore, to understand in what measure a choreographic creation could also be seen as one of the ways a city writes it's contemporary experience, and how dance becomes a form of the city's communication/language as well as a form of quotidian knowledgeMestradoArtesMestre em Arte

TRATAMENTO FISIOTERAPÊUTICO NA VERTIGEM POSICIONAL PAROXÍSTICA BENIGNA: REVISÃO SISTEMÁTICA DA LITERATURA

A vertigem posicional paroxística benigna (VPPB) é a vestibulopatia mais comum entre as de origem periférica. A maioria dos pacientes que procura as clínicas médicas com vertigem e déficit de equilíbrio apresenta alterações na orelha interna. A VPPB atinge principalmente os idosos, mas também acomete crianças e adultos jovens. Ela pode tanto causar uma imperceptível alteração nas atividades de vida diária de seu portador, quanto pode ser muito incapacitante. Apesar de ser de difícil diagnóstico, manobras específicas podem ser utilizadas na avaliação de tal patologia. O presente estudo teve como objetivo agrupar os trabalhos científicos e fazer um levantamento sobre o que se tem pesquisado e utilizado na fisioterapia, especificamente para o tratamento da VPPB. Observou-se, através da pesquisa bibliográfica, que a reabilitação vestibular (RV), um método não invasivo e de simples aplicação, usado por diferentes profissionais ligados à área da saúde, apresenta bons resultados na VPPB. A RV utiliza diversos recursos e manobras que são escolhidas de forma individual, respeitando os sintomas e as limitações de cada paciente. A RV é um campo em desenvolvimento para a fisioterapia, e os estudos científicos nessa área ainda são poucos, principalmente em relação à eficácia dos protocolos de tratamento utilizados. Pode-se concluir que estudos científicos na fisioterapia aplicada à VPPB devem ser feitos, para que os protocolos conhecidos pelos demais profissionais da saúde envolvidos na RV sejam validados através da atuação do fisioterapeuta. Ao mesmo tempo, novos protocolos fisioterápicos também devem ser pesquisados

Reestruturação urbana e segregação sócio-espacial

A implantação de projetos urbanísticos relacionados aos Megaeventos Esportivos sediados no Brasil e dos interesses hegemônicos, superam os interesses populares relacionados ao direito à moradia. Seguindo a lógica de mercado, as necessidades de acumulação do capital superam a importância do pertencimento do indivíduo ou do grupo no seu contexto social ao lugar em questão, desalojando os indivíduos sem se preocupar com as consequências ao cotidiano dos mesmos. A reestruturação do espaço engloba os espaços de produção, os espaços de consumo e circulação, tanto quanto os espaços da reprodução. Existindo, assim, uma relação entre a reestruturação produtiva, iniciada a partir da crise do fordismo, e a reestruturação que se opera nos espaços intraurbanos e interurbanos. A partir das noções de segregação que a dinâmica capitalista de (des)apropriação do espaço urbano, e sua latente mercantilização, nota-se no presente cenário urbano brasileiro, sobretudo nas áreas de assentamentos precários, uma tendência à Reestruturação Urbana. Palavras-chave: reestruturação urbana, segregação socioespacial, espaço urbano.

The Characterization Of The Endoglucanase Cel12a From Gloeophyllum Trabeum Reveals An Enzyme Highly Active On β-glucan.

The basidiomycete fungus Gloeophyllum trabeum causes a typical brown rot and is known to use reactive oxygen species in the degradation of cellulose. The extracellular Cel12A is one of the few endo-1,4-β-glucanase produced by G. trabeum. Here we cloned cel12A and heterologously expressed it in Aspergillus niger. The identity of the resulting recombinant protein was confirmed by mass spectrometry. We used the purified GtCel12A to determine its substrate specificity and basic biochemical properties. The G. trabeum Cel12A showed highest activity on β-glucan, followed by lichenan, carboxymethylcellulose, phosphoric acid swollen cellulose, microcrystalline cellulose, and filter paper. The optimal pH and temperature for enzymatic activity were, respectively, 4.5 and 50 °C on β-glucan. Under these conditions specific activity was 239.2 ± 9.1 U mg(-1) and the half-life of the enzyme was 84.6 ± 3.5 hours. Thermofluor studies revealed that the enzyme was most thermal stable at pH 3. Using β-glucan as a substrate, the Km was 3.2 ± 0.5 mg mL(-1) and the Vmax was 0.41 ± 0.02 µmol min(-1). Analysis of the effects of GtCel12A on oat spelt and filter paper by scanning electron microscopy revealed the morphological changes taking place during the process.9e10839

Quantitative measurement of impairment in ADHD: perspectives for research and clinical practice

Background Functional impairment is needed to make an attention deficit hyperactivity disorder (ADHD) diagnosis, but there is a paucity of instruments addressing this issue. Objective Perform psychometric analysis of a functional impairment scale (FIE). Methods A sample of 320 individuals, including ADHD probands, their siblings and parents, filled the FIE. We analyzed psychometric properties for the entire sample and age groups. Factor structure was determined by a principal component factor analysis, using oblique rotation with Kaiser normalization and Eigenvalues higher than 1. Cronbach’s alpha and Spearman-Brown were calculated. Results Family analysis revealed four components: a) “family life”, b) “self-perception”, c) “performance” and d) “social life”. Adults’ analysis revealed two components: a) “family life, social life and self-perception” and b) “performance”. Children showed the domains: a) “performance and social life”, b) “self-perception” and c) “family life” components. Cronbach’s alpha were above 0.9 in all components. Discussion Results revealed up to four domains depending on the group considered. Different life demands might explain the variability of domains on the groups

PALEOPRECIPITATION CHANGES BASED ON PALEOSOLS PROFILES OF THE MARÍLIA FORMATION (UPPER CRETACEOUS) IN THE EASTERN PORTION OF THE BAURU BASIN IN SOUTHEASTERN BRAZIL

The Marília Formation is a Maastrichtian sequence of the Bauru Basin that crops out in the Southeastern Brazil. This formation consists of an illuvial deposits succession characterized by alternating sedimentary strata and paleosols. Pedogenic features related to climatic factors can be used as a tool for the interpretation of paleoenvironments. Through macro- and microscopic descriptions, mineralogical analysis and geochemical data, twenty paleosol sections were identified and characterized in the Marília Formation. The characterization of C, Ck, Bt, Btk and Gley horizons and the geochemical data allowed the identification of paleoclimatic factors influencing the formation of paleosols. Changes in the formation processes of these paleosols were mainly triggered by moisture variations. Paleoprecipitation estimates (MAP) obtained from CIA-K values in Bt and Btk horizons indicate that the precipitation rates varied from 20 to 1000 mm/year. These contrasting climatic conditions caused the overlap of distinct paleosol profiles, suggesting oscillation between arid to semi-arid conditions. The results from this work contribute to a better understanding of the Upper Cretaceous paleoclimatic in the Southeastern Brazil

Genes encoding Shiga toxin and the intimin receptor detected in faecal samples collected from wild canids

Background: Enteropathogenic Escherichia coli (EPEC) and Shiga toxin-producing E. coli (STEC) are diarrheagenic E. coli that can cause disease in humans. The pathotype EPEC leads to the attaching and effacing lesion, causing damage to the microvilli following to diarrhea. STEC pathotypes produces cytotoxins, which in humans are responsible for hemorrhagic colitis or hemolytic uremic syndrome. Animals are the reservoirs of these pathotypes, especially ruminants. However, other animal’s species can be associated as carriers of EPEC and STEC strains. The aim of this study was to analyze wild canid crab-eating fox (Cerdocyon thous) as potential natural carriers of STEC and EPEC E. coli. Materials, Methods & Results: Seven fecal samples were analyzed from the crab-eating fox of free-living, captured in a peri-urban area. Samples were collected from the rectal ampulla, and the animals were clinic evaluated, being considered healthy at the captured moment. The feces were inoculated on medium MacConkey agar, and then the plates were incubated at 37°C for 24 h. All colony forming units (CFU) were collected by plate washing with ultrapure water (2 mL) and posterior freezing at -20°C. The total bacterial DNA from the CFU collected was extracted, followed by PCR assay to search for three genes: stx1, stx2 (responsible for the synthesis of the Shiga toxin) and tir, which encodes the translocated intimin receptor, related to the A/E lesion formation. Three samples were detected as positive, being one animal detected as carrier of the stx2 gene (STEC strain), while two animals were identified as carrier of the tir gene (EPEC strains).The stx1 gene was not identified on the samples. Also, in the samples, only the presence of one gene studied at a time was observed. Therefore, we have found out that the crab-eating fox can act as reservoirs of STEC and EPEC strains. Discussion: The carrier’s animals of STEC and EPEC strains do not have receptors for the Shiga toxin, serving as asymptomatic vehicle. The wild canids collected and positives to STEC and EPEC E. coli strains analyzed here, did not shown any clinical signs, wherefore they have the potential of being a source of pathogens to other animals and even humans. The observation of this additional wild species, the crab-eating fox, as carriers of STEC and EPEC reinforces the importance of monitoring wild species and the need for caution because of the potential zoonosis. Nevertheless, there are other species of wild animals that were described as rarely-carriers of these pathogens, like deer, wild ruminants and birds. These E. coli pathotypes, potentially foodborne zoonotic pathogens, are acquired by humans from food and water contaminated, by oral-fecal route, or by direct contact with carries animals and their feces. The human contact with wild animals is getting ordinary; because of that, wild animals, like wild canids, may constitute a considerable risk to animal and humans health, mostly by the transmission of these bacteria strains to the environment. In conclusion, the identification of genes encoding Shiga toxin and the intimin receptor in wild canids feces highlight that STEC and EPEC pathogens could be spread by these wild animals. We reinforce that STEC and EPEC pathogens could be naturally carried by wild animals, such as the crab-eating fox, and therefore, is needed further research for better understanding their potential effect, and also the interaction between the pathogen and the host

European Working Group on Sarcopenia in Older People 2010 (EWGSOP1) and 2019 (EWGSOP2) criteria or slowness: which is the best predictor of mortality risk in older adults?

Objectives: to analyse the accuracy of grip strength and gait speed in identifying mortality; to compare the association between mortality and sarcopenia defined by the EWGSOP1 and EWGSOP2 using the best cut-off found in the present study and those recommended in the literature and to test whether slowness is better than these two definitions to identify the risk of death in older adults. / Methods: a longitudinal study was conducted involving 6,182 individuals aged 60 or older who participated in the English Longitudinal Study of Ageing. Sarcopenia was defined based on the EWGSOP1 and EWGSOP2 using different cut-off for low muscle strength (LMS). Mortality was analysed in a 14-year follow-up. / Results: compared with the LMS definitions in the literature (<32, <30, <27 and < 26 kg for men; <21, <20 and < 16 kg for women), the cut-off of <36 kg for men (sensitivity = 58.59%, specificity = 72.96%, area under the curve [AUC] = 0.66) and < 23 kg for women (sensitivity = 68.90%, specificity = 59.03%, AUC = 0.64) as well as a low gait speed (LGS) ≤0.8 m/s (sensitivity = 53.72%, specificity = 74.02%, AUC = 0.64) demonstrated the best accuracy for mortality. Using the cut-off found in the present study, probable sarcopenia [HR = 1.30 (95%CI: 1.16–1.46)], sarcopenia [HR = 1.48 (95%CI: 1.24–1.78)] and severe sarcopenia [HR = 1.78 (95%CI: 1.49–2.12)] according to EWGSOP2 were better predictors of mortality risk than EWGSOP1. LGS ≤0.8 m/s was a better mortality risk predictor only when LMS was defined by low cut-off. / Conclusions: using LMS <36 kg for men and < 23 kg for women and LGS ≤ 0.8 m/s, EWGSOP2 was the best predictor for mortality risk in older adults