Can litigation promote fairness in healthcare? The judicial review of rationing decisions in Brazil and England

This thesis analyses “health care litigation” in Brazil and England. By health care litigation I mean those lawsuits in which claimants demand from the State the provision of a certain health treatment based on their entitlement to receive health care from the public health system or funded by it. The question that guides this thesis is whether courts intervening in rationing decisions make the public health system more or less fair. The concept of fairness I use in this thesis draws on the idea of “accountability for reasonableness” developed by Norman Daniel and Charles Sabin. This research will analyse the case-law of courts in Brazil and England, and the impact of litigation on the public health system. Based on this research, I argue that health care litigation in Brazil, where courts interpret the right to health as an individual trump against rationing decisions, is making the public health system less fair. Conversely, in England, where courts mainly control the procedure rather than the substance of the rationing decisions, litigation contributed to make health authorities more accountable and rationing decisions more public and based on better reasons, robust evidence and fair principles. Interestingly, even though courts in both countries have judged their cases in different ways, in the long term, litigation was one of the reasons for the creation of health technology assessment systems that try to legitimate rationing decisions through more public and better reasoned decisions: CONITEC in Brazil and NICE in England. The analysis of healthcare litigation in Brazil and England also contributes to the broader debate about social rights adjudication. These cases provide empirical and nuanced evidence that can be compared with the experience of other jurisdictions to shed light on the potential, risks and limits of courts controlling the allocation of resources in social policies using the language of social rights

O Socialismo Reformista e a Participaçao do Movimento Socialista na Ordem Democrática Capitalista

O presente trabalho analisa dois grandes debates travados dentro do pensa- mento socialista nos séculos XIX e XX: entre organização partidária e espontanei- dade e entre revolução e participação na democracia parlamentar. A partir dos principais autores que participaram destes debates, juntamen- te com a experiência histórica, analiso como o socialismo reformista, que de- fendia a participação dos socialistas na democracia burguesa, foi fundamental nos países em que logrou sucesso para o desenvolvimento do Estado de Bem- Estar Social e, ao mesmo tempo, colaborou para enfraquecer os movimentos socialistas revolucionários. A escolha pela participação no jogo democrático trouxe também mudanças dentro do próprio movimento em relação aos rumos que pretendia seguir

Avaliação de tecnologias em saúde: evidência clínica, análise econômica e análise de decisão

Resenha Naciona

Reserva do possível, mínimo existencial e direito à saúde: algumas aproximações

Resenha Naciona

Size-Controlled Synthesis of Colloidal Gold Nanoparticles at Room Temperature Under the Influence of Glow Discharge

Highly dispersed colloidal gold (Au) nanoparticles were synthesized at room temperature using glow discharge plasma within only 5 min. The prepared Au colloids were characterized with UV–visible absorption spectra (UV–vis), X-ray photoelectron spectroscopy (XPS), and transmission electron microscopy (TEM) equipped with an energy dispersion X-ray spectrometer (EDX). UV–vis, XPS and EDX results confirmed that Au3+ ions in HAuCl4 solution could be effectively reduced into the metallic state at room temperature with the glow discharge plasma. TEM images showed that Au nanoparticles were highly dispersed. The size of colloidal Au nanoparticles could be easily tuned in the nanometer range by adjusting the initial concentration of HAuCl4 solution. Moreover, the as-synthesized Au colloids (dav = 3.64 nm) exhibited good catalytic activity for glucose oxidation. The nucleation and growth of colloidal Au particles under the influence of the plasma was closely related with the high-energy electrons generated by glow discharge plasma

Disentangling land model uncertainty via Matrix-based Ensemble Model Inter-comparison Platform (MEMIP)

Background Large uncertainty in modeling land carbon (C) uptake heavily impedes the accurate prediction of the global C budget. Identifying the uncertainty sources among models is crucial for model improvement yet has been difficult due to multiple feedbacks within Earth System Models (ESMs). Here we present a Matrix-based Ensemble Model Inter-comparison Platform (MEMIP) under a unified model traceability framework to evaluate multiple soil organic carbon (SOC) models. Using the MEMIP, we analyzed how the vertically resolved soil biogeochemistry structure influences SOC prediction in two soil organic matter (SOM) models. By comparing the model outputs from the C-only and CN modes, the SOC differences contributed by individual processes and N feedback between vegetation and soil were explicitly disentangled. Results Results showed that the multi-layer models with a vertically resolved structure predicted significantly higher SOC than the single layer models over the historical simulation (1900–2000). The SOC difference between the multi-layer models was remarkably higher than between the single-layer models. Traceability analysis indicated that over 80% of the SOC increase in the multi-layer models was contributed by the incorporation of depth-related processes, while SOC differences were similarly contributed by the processes and N feedback between models with the same soil depth representation. Conclusions The output suggested that feedback is a non-negligible contributor to the inter-model difference of SOC prediction, especially between models with similar process representation. Further analysis with TRENDY v7 and more extensive MEMIP outputs illustrated the potential important role of multi-layer structure to enlarge the current ensemble spread and the necessity of more detail model decomposition to fully disentangle inter-model differences. We stressed the importance of analyzing ensemble outputs from the fundamental model structures, and holding a holistic view in understanding the ensemble uncertainty

Anti-epileptic effect of Ganoderma lucidum polysaccharides by inhibition of intracellular calcium accumulation and stimulation of expression of CaMKII a in epileptic hippocampal neurons

Purpose: To investigate the mechanism of the anti-epileptic effect of Ganoderma lucidum polysaccharides (GLP), the changes of intracellular calcium and CaMK II a expression in a model of epileptic neurons were investigated. Method: Primary hippocampal neurons were divided into: 1) Control group, neurons were cultured with Neurobasal medium, for 3 hours; 2) Model group I: neurons were incubated with Mg2+ free medium for 3 hours; 3) Model group II: neurons were incubated with Mg2+ free medium for 3 hours then cultured with the normal medium for a further 3 hours; 4) GLP group I: neurons were incubated with Mg2+ free medium containing GLP (0.375 mg/ml) for 3 hours; 5) GLP group II: neurons were incubated with Mg2+ free medium for 3 hours then cultured with a normal culture medium containing GLP for a further 3 hours. The CaMK II a protein expression was assessed by Western-blot. Ca2+ turnover in neurons was assessed using Fluo-3/AM which was added into the replacement medium and Ca2+ turnover was observed under a laser scanning confocal microscope. Results: The CaMK II a expression in the model groups was less than in the control groups, however, in the GLP groups, it was higher than that observed in the model group. Ca2+ fluorescence intensity in GLP group I was significantly lower than that in model group I after 30 seconds, while in GLP group II, it was reduced significantly compared to model group II after 5 minutes. Conclusion: GLP may inhibit calcium overload and promote CaMK II a expression to protect epileptic neuron

Mapping the unconventional orbital texture in topological crystalline insulators

The newly discovered topological crystalline insulators (TCIs) harbor a complex band structure involving multiple Dirac cones. These materials are potentially highly tunable by external electric field, temperature or strain and could find future applications in field-effect transistors, photodetectors, and nano-mechanical systems. Theoretically, it has been predicted that different Dirac cones, offset in energy and momentum-space, might harbor vastly different orbital character, a unique property which if experimentally realized, would present an ideal platform for accomplishing new spintronic devices. However, the orbital texture of the Dirac cones, which is of immense importance in determining a variety of materials properties, still remains elusive in TCIs. Here, we unveil the orbital texture in a prototypical TCI Pb$_{1-x}$Sn$_x$Se. By using Fourier-transform (FT) scanning tunneling spectroscopy (STS) we measure the interference patterns produced by the scattering of surface state electrons. We discover that the intensity and energy dependences of FTs show distinct characteristics, which can directly be attributed to orbital effects. Our experiments reveal the complex band topology involving two Lifshitz transitions and establish the orbital nature of the Dirac bands in this new class of topological materials, which could provide a different pathway towards future quantum applications

O STF e as medidas para prevenção e tratamento da covid-19

Resumo O presente artigo analisa a jurisprudência do Supremo Tribunal Federal (STF) sobre políticas para prevenção e tratamento da covid-19. Com o auxílio da ciência de dados e da inteligência artificial, foi realizada a coleta sistemática e exaustiva da jurisprudência da Corte sobre esse assunto. As decisões coletadas foram organizadas e classificadas nos seguintes temas: distanciamento social; medidas diversas de combate à pandemia; uso de máscara; requisição administrativa; leitos de Unidade de Terapia Intensiva (UTI); vacinação; e acesso a dados. As decisões dentro de cada um desses temas foram analisadas para entender quais questões foram decididas pelo STF e como foram julgadas. A organização e a análise de 253 decisões nos permitem chegar, com nuances e detalhes, a algumas conclusões gerais sobre o papel da Corte em matéria de medidas para prevenção e tratamento da covid-19: parte significativa das decisões foi monocrática e em sede de liminar, o STF buscou proteger a capacidade de entes estaduais responderem à covid-19, foram manifestadas opiniões críticas à atuação do governo federal, em diversos casos houve explícita sobreposição entre questões formais de competência federativa e avaliações substantivas sobre a melhor política, e houve hesitação do STF em determinar a realização de medidas muito complexas para o combate à pandemia de covid-19